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IVF, or in vitro fertilization, is a reproductive procedure that involves fertilizing an egg outside of the human body. The resulting embryo is then carefully transferred into the female’s uterus using a specialized plastic catheter.
IVF treatment offers assistance to couples experiencing difficulties in conceiving. During the procedure, your sperm and eggs are combined in a controlled laboratory environment, allowing for fertilization to take place. Following a period of two to five days within an incubator, one to two of the resulting embryos are transferred to the woman’s uterus, with the hope that they will successfully implant and develop, similar to a natural pregnancy.
It’s important to consult with a fertility specialist who can provide personalized guidance and support throughout the IVF process, as each individual’s situation may vary.
In a natural menstrual cycle, typically only one egg is produced by the ovaries. However, in IVF, a process called ovulation induction is employed to stimulate the ovaries to produce a more favorable number of follicles, increasing the chances of successful pregnancy. The female partner begins receiving injections either on day 21 or day 2 of her menstrual cycle, depending on the specific protocol prescribed by the Physician. The growth of follicles is closely monitored through a series of transvaginal scans, allowing the Physician to adjust the dosage of the injections based on the progress of follicular development. Once the follicles reach maturity, egg retrieval is planned, typically after the administration of an HCG trigger that facilitates the final maturation of the eggs and subsequent ovulation. This carefully managed process maximizes the chances of retrieving viable eggs for fertilization during the IVF procedure.
Egg retrieval, a critical step in the IVF process, is performed under general anesthesia (GA) using a transvaginal ultrasound guided needle. It is essential to arrive for the procedure on an empty stomach after fasting for at least 6 hours to ensure the safety of the anesthesia. During the procedure, all the follicles are carefully aspirated using the transvaginal ultrasound guided needle. The aspirated follicular fluid is then examined under a microscope to identify and retrieve the eggs for further processing. This meticulous approach allows for the collection of viable eggs to proceed with the subsequent stages of the IVF treatment.
On the day of egg retrieval, a semen sample is required for the IVF procedure. It is recommended to abstain from sexual activity for a period of 2 to 6 days prior to producing the sample. Ideally, the sample should be produced at the center to ensure its quality and timely processing. However, if necessary, the sample can be brought from home, provided that it is delivered to the center within 45 minutes of production. This protocol ensures the availability of a fresh and viable semen sample for the fertilization process during IVF.
Within the incubator, the eggs are immersed in a nutrient-rich medium containing a high concentration of sperm, facilitating fertilization. The resulting embryos are carefully cultured for a period of two to five days, allowing them to develop and progress in a controlled laboratory environment. This controlled culture period plays a crucial role in the growth and maturation of the embryos before they are ready for transfer into the woman’s uterus during the IVF procedure.
During the IVF process, embryo transfer takes place on either day 3 or day 5 of embryo development. A specialized catheter is utilized for this procedure. The catheter is carefully loaded with the embryos, and under the guidance of a speculum inserted into the vagina, the cervix is exposed. Through the cervix, the catheter is gently inserted, delivering the embryos to the optimal location within the endometrial cavity. The embryo transfer procedure is typically painless and does not require sedation or additional medications. To facilitate the transfer, it is recommended to have a moderately full bladder. After the transfer, the catheter is slowly withdrawn and examined under a microscope to ensure no embryos are retained. In the rare event that an embryo is retained in the catheter, the transfer procedure is promptly repeated, and the catheter is rechecked to ensure successful embryo transfer.
It is recommended to undergo a pregnancy test two weeks after the embryo transfer procedure instead of relying on a urine pregnancy test (HPT) for accurate results. The reason behind this recommendation is that urine pregnancy tests can often provide false-negative results. We have witnessed numerous cases where couples received negative results from home urine pregnancy tests, only to later discover successful pregnancies resulting in the birth of beautiful babies. To ensure greater sensitivity and reliability, a blood test is necessary.
IVF success rate is around 35-40%.
After the embryo transfer at our IVF clinic, we advise the woman to rest on her back for a duration of 2 hours before leaving. Following that, we recommend limiting physical activity for the remainder of the day. It is important to clarify that “bed rest” does not necessarily mean being confined to the bed entirely, but rather engaging in relaxed activities such as sitting on the couch or in a comfortable recliner, enjoying leisure activities like watching videos or reading, or even playfully engaging with one’s partner. The following day, normal activities such as work and walking are permitted. However, activities that involve heavy bouncing of the uterus, such as water skiing, jogging, or engaging in high impact exercises or sexual activities, should be avoided until after the pregnancy test. Once a pregnancy is confirmed, it is generally safe to resume such activities.
For couples who travel from out of town or out of country for IVF and embryo transfer, we strongly advise against flying out on the same day as the transfer. It is recommended to wait until the following day before taking a flight. However, for patients who are driving back home, regardless of the distance, it is permissible to do so after a two-hour period of bedrest at our office following the transfer procedure.