IVF Basics: How Does It Work?
You’ve been told your best chance at conceiving is with in-vitro fertilization (IVF). Many questions may come to mind: What is IVF? How does it work? How long does it take? How much does it cost?
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 success¹ (or a 6-month period if you are over 35 years of age) and your fertility specialist determines that your infertility is not due to a cause that is best treated by other methods.
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. The good news is IVF can either help to target some of these causes directly or overcome them by maximizing/optimizing the chances of having a sufficient number of eggs and sperm, and fertilized eggs.
What happens in IVF?
IVF is a type of assisted reproductive technology where the fertilization of the sperm and egg takes place outside of the body in a laboratory dish. 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 two) are placed directly into your uterus in a process called an embryo transfer. Since the first successful IVF in the UK in 1978, more than five million IVF babies have been born worldwide. During your initial consultation, your doctor will evaluate the reason for your infertility and determine your best course for treatment.
While every couple’s IVF journey is unique, the process typically consists of five main steps, which take place over a few weeks, the span of one menstrual cycle.
1. Ovarian Stimulation
The first step usually takes place between eight and 12 days of your cycle. 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 Follistim, Gonal F and Menopur. However, some treatment protocols call for “down-regulation,” or turning off your own hormonal system.
Then, you will 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 your safety. The reason for it is 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), called the “trigger”, to cause the eggs to mature and be ready for fertilization.
2. Egg Retrieval
About 36 hours after your hCG trigger, 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.
This is where the mature eggs are fertilized with your male partner’s sperm in the laboratory 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.
4. 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 uterus 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 uterus after your body gets back to its normal cycle (typically one to two months later).
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.
5. 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 pregnancy test to check if the embryo implanted into the lining of your uterus. If so, congratulations, you are pregnant!
How to prepare yourself for the possibility that the treatment does not work
Many patients can feel defeated and decide to quit trying after their first IVF cycle fails, even if they have good chances of conceiving with one or two more IVF cycles. You will maximize your chances of having a baby by focusing your efforts on affording a course of up to 3 IVF treatments if needed, instead of putting all your hopes and money on one.
With the median per-person cost of IVF² in the U.S. estimated at $24,000, not including 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.
The Univfy PreIVF® Report™ is the only personalized report that uses your IVF provider’s track record and your unique health data to give you an accurate and personalized prediction of success per IVF cycle as well as your financial options. The Univfy-Powered IVF Refund Program reduces the financial risk in the case that you need multiple IVF cycles to conceive a baby. Find an IVF provider who has partnered with Univfy to expand affordability and access to IVF treatment by visiting our map.
1: Eunice Kennedy Shriver National Institute of Child Health and Human Development. Fertility and infertility. www.nichd.nih.gov/health/topics/infertility
2: Patricia Katz, PhD, Jonathan Showstack, PhD, James F. Smith, MD, MS, Robert D. Nachtigall, MD, Susan G. Millstein, PhD, Holly Wing, MA, Michael L Eisenberg, MD, Lauri A. Pasch, PhD, Mary S. Crougham, PhD, Nancy Adler, PhD. (2011). Costs of infertility treatment: Results fom an 18-month prospective cohort study. Fertility and Sterility. www.ncbi.nlm.nih.gov/pmc/articles/PMC3043157/
The contents of this blog are for informational purposes only. Content in this post is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Reliance on any information provided by Univfy, Univfy employees, or others appearing in this blog or on the Univfy website is solely at your own risk.