- Ovarian Suppression and Stimulation
Key elements of the IVF procedure are techniques designed to suppress and stimulate the ovaries so eggs (oocytes) can be retrieved before they are spontaneously released during natural ovulation. Daily medications that are administered by the patient at home stimulate the production of multiple eggs and increase the potential availability of embryos (fertilized eggs) for transfer and possible cryopreservation
- Oocyte (egg) Retrieval
When monitoring by the physician determines that the eggs are ready for retrieval, a procedure is performed under sedation administered by an anesthesiologist. Using an ultrasound probe, a needle is guided through the vaginal wall and fluid is aspirated from each follicle and immediately taken to the laboratory where eggs are identified and moved to an individual dish of nutrient medial stored in an incubator. Egg retrieval is usually not painful and recovery should be brief.
- Intracytoplasmic Sperm Injection (ICSI)
If not enough active normal sperm are available, a process called ICSI is used. An embryologist will inject a single sperm into the egg for fertilization. This process is performed under a special microscope using a micro-suction instrument to hold the egg while one sperm in a fine glass needle is injected into it. ICSI requires great skill and expertise, but allows couples to overcome the barriers of low sperm count, motility and sperm maturity.
Cryopreservation is the process of freezing and storing sperm, eggs or embryos for later use.
Vitrification is an ultra-rapid cooling technique that allows the water inside and surrounding the egg/embryo to instantaneously super cool into a state with no ice crystal formation at all.
- Blastocyst embryo
A blastocyst is formed when an embryo reaches the five to seven day development stage. At this point in development, the embryo has between 60 and 100 cells distributed in two areas: an outer embryo lining (which will later form the placenta), and an inner mass (which will later become the fetus). During a natural cycle, the embryo needs to have entered the blastocyst stage once it arrives in the uterus to ensure proper implantation.
- Insemination and Fertilization
During the egg retrieval, a specimen of semen will be used for fertilization. This semen is processed and placed in the dishes for insemination. At least fifty thousand sperm are placed in each dish with the eggs and left to incubate together in a carefully controlled laboratory environment. Fertilization will be frequently monitored over the next few days.
- Embryo Transfer and Implantation
Three to five days after the egg retrieval (based on cell growth), the embryos will be transferred into the uterus in a nonsurgical procedure in our special procedure room. Usually taking only 10-5 minutes, patients can resume light activity the following day. The number of embryos transferred will depend on the patient’s age, quality of the embryos and the patient’s medical history. Implantation will occur over the next two to five days. Cryopreservation can be performed on remaining embryos that are not transferred if quality shows they can have a good chance of sustaining the freeze and thaw procedures.
Successful implantation is verified by a series of quantitative blood pregnancy tests two weeks after the egg retrieval. If implantation has not occurred, the patient will have a menstrual period soon after stopping the pregnancy support medications.
- Donor Egg Cycle
If eggs are not available from the patient, an egg donor can be used. Eggs from another woman (either anonymous or known) are fertilized with the sperm from the intended parent or sperm donor. The resulting embryo(s) are transferred either back into the female patient or a gestational surrogate.
- Gestational Carrier
A Gestational carrier is when a woman carries and delivers a baby for someone else. The gestational carrier is not biologically or genetically related to the child she is carrying.