Understanding the steps for performing IVF (In Vitro Fertilization)
IVF is not a complex process to understand. Broken down into its most basic parts, IVF has five main steps.
Each of these five steps can be performed in a slightly different manner based on the preferences of the physician. At IVF1, we use an evidence based approach to determine the protocols for IVF.
IVF from start to finish – A really brief summary of IVF and some common misconceptions
Step 1 – Stimulate the growth and development of multiple eggs within the ovaries
Drugs to stimulate the ovaries to produce multiple eggs
- Fertility Drugs for Stimulation of Egg Development Fertility drugs are used to stimulate the development of multiple eggs during in vitro fertilization (IVF).
- Low dose hCG The addition of very low doses of hCG to the medication protocol reduces costs and improves the stimulation of the ovaries.
- Dual Trigger with hCG and Lupron – The final injections of hCG and Lupron prepares for retrieval.
Drugs to prevent Premature ovulation
- Cetrotide and Ganirelix in IVF Cetrotide and Ganirelix are the primary medications that help prevent premature ovulation.
- Lupron treatment in IVF An older method for preventing ovulation
Drugs to assist development of the uterine lining
- Progesterone supplementation Progesterone is administered to help sustain the uterine lining (endometrium) if an immediate “fresh” transfer of an embryos is planned.
Step 2 Egg retrieval (removal of the eggs)
Step 3 Fertilization of the eggs
Step 4 Embryo culture (Growing Embryos in the laboratory)
Step 5 Embryo transfer
What issues are important if I get pregnant from an IVF cycle?
IVF birth defects – Is IVF associated with a greater incidence of birth defects or not?
Screening for abnormalities in an IVF Pregnancy Screening – Many women who have IVF are older and therefore at greater risk for babies with chromosome abnormalities. These women may have screening tests for abnormalities performed. The results should be interpreted with caution, however. Read why here.
Frequently Asked Questions About IVF
I’ve heard IVF is painful. Is that true?
There are four parts of IVF that have the potential to cause discomfort.
Injections of fertility medications – It is never fun to receive injections but luckily most of the injections used during IVF use very small needles which just have to go under the skin. These are called subcutaneous injections.
Monitoring – While you are taking fertility medications, you will need to come to the office periodically to have blood tests (more needles!) and transvaginal ultrasounds – which have about the same level of discomfort as a PAP smear.
Ovaries getting larger – The purpose of the fertility medication is to mature many eggs in your ovaries at the same time. Normally, only one egg at a time matures in your ovary. More eggs means that your ovaries will be larger than you are used to. Women describe bloating, cramping or abdominal fullness as the sensation they feel while taking fertility medication.
Egg Retrieval – In order to remove the eggs from the ovaries, it is necessary to pass a needle through the vagina. For most women, egg retrieval is an uncomfortable procedure. Luckily, this part is performed under anesthesia so you won’t feel a thing.
Isn’t IVF Very expensive?
You would be very surprised. While it is certainly more expensive than other types of infertility treatments, the chance for pregnancy is usually much higher. Therefore, you don’t need to do as many treatments to be successful.
In Illinois, state law requires most employers to provide insurance that covers IVF. If your employer is exempt from the law, you can still purchase insurance that covers IVF through the Illinois Healthcare Marketplace. IVF1 also provides treatment financing through our affiliation with Insperity.
Is bed rest important after an IVF embryo transfer?
No. A number of studies have looked at IVF pregnancy rates in women who were instructed to rest after an embryo transfer and compared them to pregnancy rates in women who were not instructed to rest. The conclusion of every study that has looked at this was that bed rest after embryo transfer does not improve the chances for an IVF pregnancy.
Doesn’t IVF have a high risk for multiple pregnancy?
Actually, IVF is the only fertility treatment that allows you to control the risk for multiple pregnancy. In IVF, the chance for pregnancy and the risk for multiple pregnancy is determined, in part, by the number of embryos you decide to place into the uterus. Generally, a higher number of embryos results in a higher chance for pregnancy and a higher risk for multiples.
In order to reduce the chance for twins, a couple can choose to transfer a single embryo. The chance for having a twin pregnancy would be 3%.