Have you been told you may need in-vitro fertilization (IVF) to conceive? Typically, you and your partner are considered a candidate for IVF treatment if you have been trying to conceive naturally over a 12-month period without success (or a 6-month period if you are over 35 years of age), you have already tried other fertility treatments, or your doctor has not identified a clinical diagnosis that can be treated. Perhaps you have uterine fibroids, endometriosis, polycystic ovarian syndrome (PCOS), or diminished ovarian reserve. Maybe your male partner has low sperm count or motility. You may even have a case of unexplained infertility. In any case, the good news is IVF can help treat some of these causes.
Many questions probably come to mind when you are considering IVF: What is IVF? How does it work? How long does it take? How much does it cost? To try and help you sort out your decision, here is a brief guide on what to expect during your IVF journey.
IVF is a type of assisted reproductive technology. The fertilization of the sperm and egg takes place outside of the body in a laboratory dish, where once fertilized, the embryos are grown in a very nutritious broth, called culture media, in an incubator for a few days. Then, a selected embryo (or embryos) are placed directly into your uterus (embryo transfer). Since the first successful IVF in Great Britain in 1978, five million IVF babies have been born worldwide.
When considering IVF, you and your partner will most likely want to know what to expect during each step of the treatment process. During your initial consultation, your doctor will evaluate the reason for your infertility and determine your best course for treatment. Click here to read Univfy’s Expert Blog by Dr. Jamie Grifo of New York University on what types of questions and tests to expect during this consultation.
While every couple’s IVF journey is unique, the IVF process typically consists of five main steps, which take place over a few weeks, the span of one menstrual cycle.
Ovarian Stimulation: In the first step, which typically takes place between eight and 12 days, your doctor will prescribe certain fertility medications to stimulate your ovaries to develop multiple eggs. The most common medications used are injectable hormones called gonadotropins such as Repronex, Follistim, Gonal F, and Menopurr. However, some treatment protocols call for “down-regulation,” or turning off your own hormonal system. You will then get ultrasounds and blood tests to monitor the growth of the ovarian follicles. Each ovarian follicle houses one egg that will also get primed for egg maturation. The monitoring of ovarian stimulation is critical for safety in order to minimize or prevent a complication called ovarian hyperstimulation syndrome, where the ovaries are overstimulated and can cause problems with other organ systems. Once the ovarian follicles develop to a certain size, your doctor will order an injection of human chorionic gonadotropin (hCG) to cause the eggs to mature and be ready for fertilization.
Egg Retrieval: About 36 hours after your hCG injection, your doctor will retrieve your eggs and take sperm from your partner’s semen sample. You will take a light anesthetic and pain medication to make you comfortable. An ultrasound probe is then inserted into your vagina to locate ovarian follicles, and a thin needle is used to retrieve those eggs from your ovaries while your doctor watches on the ultrasound in real-time. Multiple eggs can be removed within 30 minutes or less. Your male partner’s sperm is then collected and washed to fertilize your eggs.
IVF: This is where the mature eggs are fertilized with your male partner’s sperm in the laboratory and when the actual fertilization occurs in-vitro, or out of the body. It takes approximately 18 hours for the embryologists to determine if fertilization has occurred, and another 24 to 72 hours to establish if the embryos are developing well. Typically, the embryos will stay in the laboratory between two to five days.
Embryo Transfer: Depending on your IVF center’s program and your individual situation, one or more embryos may be placed (e.g. transferred) to your womb on Day 3 or Day 5 of embryo culture. This is called fresh embryo transfer. Alternatively, your embryos may be frozen (e.g. cryopreserved) first and transferred to your womb after your body gets back to its normal cycle (typically one to two months later). Then, you and your partner will discuss with your doctor the number of embryos to be transferred and which embryos to transfer, depending on their quality. The embryologist will load your embryo(s) into a thin catheter, which your doctor will use to transfer them into your uterus. This procedure is relatively painless and short, though it is understandably a stressful experience for patients.
Embryo Implantation: In the following six to 10 days after embryo transfer, you should limit certain activities and continue with required medications. Your doctor will then order a blood test to check if the embryo implanted into the lining of your uterus. If so, congratulations, you are pregnant!
What to do if the treatment does not work: If the treatment is unsuccessful, it can be disappointing. One way to prepare yourself for this possibility, and still be able to think positively, is to know that your response to IVF treatment can be entered into Univfy’s PredictIVF Test to help you determine your chances for success in your next IVF cycle. This is a way to turn a failed treatment into accurate, personalized information to help make a future decision that is right for you and your family. Be sure to consult with your fertility specialist to discuss next steps.
With the average cost of IVF cycles running between $12,000 and $15,000 in the US, excluding the cost for some medications and special procedures, it is helpful to know your personalized chances of IVF success ahead of time to plan better for both your finances and your treatment. Univfy IVF Prediction Tests can give you a highly accurate personalized probability of IVF success. Most fertility clinics offer multi-cycle packages at a discount rate per cycle. The Univfy IVF Cost Calculator can help you decide whether you want to buy IVF as a single cycle, or in a multi-cycle bundle, depending on your personalized success rate. To learn more on how to make a smarter IVF decision based on your chance of IVF success, please click here.
Remember, we are here for you during your IVF journey. Please email firstname.lastname@example.org if you have any questions or wish to share with us your IVF story, and be sure to join us on Facebook and follow us on Twitter @Univfy.
Visit Considering IVF for more fertility health information and interactive tools to personalize your fertility path.