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In Vitro Fertilization
In Vitro Fertilization (IVF)
In Vitro Fertilization (IVF) treats infertility from various causes like tubal problems, male factors, endometriosis, and unknown ones. California Fertility Partners offers IVF at its LA center. It involves ovarian stimulation, egg retrieval by ultrasound - guided needle, in - lab insemination, culturing embryos for 3 - 5 days, and ultrasound - guided transfer to the uterus.
IVF is a popular, effective treatment. Eggs and sperm are combined in a lab, and the fertilized embryos are transferred to the uterus for a possible pregnancy.
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A Woman’s Natural Cycle
A woman’s natural cycle is self-regulated to produce one egg per month. The eggs develop within fluid-filled sacs inside the ovaries called follicles. The hormones that are released by the pituitary to stimulate the follicles to grow each month is called follicle stimulating hormone, or FSH. By giving daily injections of medications containing FSH we can increase the blood level of these hormones, causing multiple eggs to develop to maturity.
Medication used to Prepare for IVF
There are several different types of medication used to prepare the ovaries for an IVF aspiration. Lupron and Ganirelix are used to prevent the surge of LH in mid-cycle and thereby prevent ovulation. Preparations containing FSH and LH include: Gonal F, Follistim, and Menopur. These medications are used to stimulate multiple follicle growth.
Harvesting your eggs
Careful monitoring of the ovaries during treatment is essential for the development of high quality eggs as well as patient safety. Serial ultrasounds and blood tests are used to evaluate the response and timing of egg recovery. The sizes of the follicles correlate with maturity of the eggs inside. When the eggs reach predicted maturity, an ultrasound guided aspiration procedure is scheduled to harvest the eggs.
Egg Retrieval
The egg retrieval is a simple outpatient surgical procedure that is performed under intravenous anesthesia. A vaginal ultrasound probe is used to guide a needle through the vaginal wall and into the ovary. Once the needle is inside the follicle, suction is used to aspirate the fluid and egg into a test tube. The embryologist then examines the fluid for the presence of an egg. The entire procedure takes approximately twenty minutes to perform.
Sperm Injection
Our embryologist then mixes the eggs with sperm or assists fertilization by sperm injection (ICSI). The embryos are then cultured in a tightly controlled laboratory environment for 3-5 days. Extra embryos may be frozen and stored until a later time. The number of embryos transferred into the uterus is determined based on the woman’s age. This is because embryo transfers are done primarily at the day 5 blastocyst stage today. One or two blastocysts will be the number transferred.
Embryo Freezing
Some women are fortunate enough to have sufficient eggs and embryos from one egg retrieval procedure to allow the extra embryos to be frozen and stored for future use. Any remaining good quality embryos that are not transferred in the fresh cycle may be frozen. The frozen embryos may be stored for an indefinite time period. When needed, the embryos are thawed and transferred into a hormonally prepared uterus. Today based on improved pregnancy outcome most embryos are frozen during the IVF cycle of stimulation and then transferred in a subsequent cycle so that ovarian stimulation for multiple egg production does not interfere with embryo implementation.
If you have been trying to conceive for six months or longer without success, we invite you to reserve a consultation at our fertility clinic. During your visit, an expert fertility doctor will meet with you to discuss your future family-building goals, and we will perform diagnostic testing (including bloodwork, ultrasound, and semen analysis, if appropriate) to evaluate your reproductive health.
During the course of a natural menstrual cycle, your brain produces hormones that stimulate one of your ovaries to release a single mature egg. During an ovulation induction cycle, you are prescribed those same hormones, known as fertility medications. These medications stimulate the ovaries to mature several eggs at once. When these eggs are matured and successfully retrieved, these eggs can be combined with sperm to create embryos.
Immediately after eggs have been retrieved, our embryology team assesses the maturity of each egg, then transfers the mature eggs to an incubator. Typically, sperm are then combined with the eggs and fertilization occurs naturally. If low sperm count or low sperm motility are a factor, our embryologists can employ intracytoplasmic sperm injection ("ICSI") to inject a single sperm directly into each egg. If a sperm sample is considered 'borderline,' some eggs may be injected while others are given the chance to fertilize naturally in the petri dish.
Approximately 18 hours after the egg and sperm were combined in the incubator, the embryology team evaluates the successful fertilization of each mature egg. The embryology team then monitors embryo development for an additional 2-4 days to assess embryo morphology (the shape and appearance of cells within the embryo). Embryos typically remain in observation in the laboratory for a total of 5 days.
After an egg retrieval and embryo creation cycle, you will discuss the quantity and quality of your embryos with your physician. There are two types of embryo transfer: fresh or frozen. In a fresh embryo transfer cycle, an embryo is transferred to the uterus after 3-5 days of observation in the embryology laboratory, and any additional embryos are frozen for future use. In a frozen embryo transfer (FET) cycle, all embryos are frozen after 3-5 days of development in the laboratory. If you wish to perform preimplantation genetic testing (PGT), embryos will be biopsied, then frozen while a culture of cells is sent to the genetic testing lab for analysis. Whether you proceed with a fresh embryo transfer or an FET, the embryo transfer process itself is very simple, and rarely requires sedation or anesthesia.
How It Works: IVF
Embark on the IVF journey. Discover the steps that could bring you the joy of parenthood.
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