In Vitro Fertilization (IVF)
Boston IVF has performed thousands of successful IVF cycles nationally and achieved high pregnancy rates. Our medical team includes fertility specialists, IVF nurse coordinators, embryologists and lab techs – who all work in unison to maximize your chance of a successful pregnancy.
IVF is one of the most widely used treatments for infertility, and is a popular option for many couples who cannot conceive through conventional therapies.
Normally, a woman will produce a mature egg each month. The egg is released from the ovary at the time of ovulation and transported to the fallopian tube. Usually, in the fallopian tube, it will encounter sperm and be fertilized. The fertilized egg develops into an embryo and travels to the womb, where it attaches and grows.
In IVF, the egg is collected directly from the ovary before ovulation and is fertilized with sperm in the laboratory. The fertilized egg will be incubated for a period of 3 to 5 days. The resulting embryo is then transferred into the uterus (womb) passing through a small canal, called the cervix, which can be accessed through the vagina.
Reasons for IVF include poor sperm quality and/or quantity, obstructions between the egg and sperm, ovulation problems, and sperm-egg interaction problems and unexplained infertility. These problems can prevent couples having a baby naturally, and IVF helps to solve this.
IVF treatment can be broken down into three separate phases:
• The stimulation of the development of several eggs
• The collection of the eggs and their fertilization in the laboratory by your partner’s sperm
• The transfer of the resulting embryos into your uterus
The IVF Process
1. The most common IVF treatment begins with ovulation induction – which is the stimulation of the ovaries to prepare and release a number of mature oocytes, or eggs. To assist in follicle growth, you will be started on medications that may include Gonal-F, Follistim, Bravelle, Menopur, and/or Reprove. This process starts about one week before menstruation with the administration of medications to prevent early ovulation. Once menstruation begins, fertility medications are given daily to stimulate the maturation of oocytes. When the eggs are fully mature, usually about eight to ten days later, an additional medication is given and the patient is prepared for egg retrieval.
2. The next steps occurs when mature eggs are collected by ultrasound guided needle aspiration. This technique, called an egg retrieval, is performed at our center with IV sedation, takes between 10 and 15 minutes – and recovery is brief. Here, follicles are located by ultrasound and then a needle is guided through the vaginal wall into the ovary to aspirate the eggs from the follicles. Semen is collected on the same day as the egg retrieval procedure.
3. Once the eggs are retrieved, our embryologist will use a microscope to isolate the eggs, place them in a special culture medium (fluid) and allow them to remain there for approximately 2-3 hours. A semen specimen provided on the day of the egg retrieval will be used in the fertilization process. The eggs will be examined for the first time approximately 18 hours after the time of potential fertilization to determine if they have fertilized. The eggs are then monitored at intervals while, hopefully, fertilization and embryo development take place.
4. The embryo transfer procedure is very simple and requires no anesthesia. The transfer is performed 3-5 days after the egg retrieval. The embryo(s) are picked up into a very fine catheter, which is inserted through the cervix, into the uterus, and the embryo(s) are placed within the uterine cavity. This procedure is very simple and does not require an anesthetic. The embryos will then continue to grow in the uterus until they implant. The exact number of embryos transferred depends on your age and the quality of your embryos. We choose the healthiest embryos that are the most likely to result in pregnancy. If you have any extra healthy embryos, you may choose to have them frozen for a future embryo transfer. The transfer process lasts only a few minutes and you can return home soon afterwards.
5. Seventeen days after retrieval you will have a blood test to find out if you are pregnant. If your test is positive we will schedule an ultrasound for you. Once the ultrasound confirms that you have a healthy pregnancy, your doctor will discuss plans for pregnancy care with you.