Q&A: What is the background on the IVF process?
I know the the IVF process is relatively common these days, but I'm not sure about all that is involved. Would you please give me some background information?
Here’s part of an article I wrote on this subject that I hope will address your question:
In vitro fertilization, often referred to as IVF, is a highly successful assisted reproductive technology. The term in vitro literally means “in glass.” It refers to the process by which a woman’s eggs are fertilized outside her in the laboratory. Fertilization, however, is only one of the four basic steps in an IVF treatment cycle:
- Development and maturation of the eggs—ovulation induction
- Retrieval of the eggs
- Fertilization of the eggs and the development of embryos
- Transfer of embryos back into the uterus
- Ovulation Induction
Under the care and direction of an experienced reproductive endocrinologist, a woman begins taking fertility medications to encourage the development of eggs within the ovaries. These medications increase the number of embryos ultimately available to be replaced by stimulating several follicles to produce more than one egg. Once multiple eggs have developed, an additional medication (a one time injection of hCG) is taken to help the eggs to mature. Once this process is complete the woman is ready to undergo what is commonly referred to as “egg retrieval” (typically performed 36 hours after hCG administration).
- Egg Retrieval
Egg retrieval is a minor surgical procedure that can be performed on an outpatient basis. It typically takes about an hour and requires general anesthesia. Similar to a diagnostic laparoscopy, a small incision is made in the woman’s abdomen. Carbon dioxide gas is then introduced into the abdominal cavity through the incision to lift the abdominal wall and expose the inner organs and follicles. After the vaginal ultrasound is placed in the vagina and the ovarian follicles are located, a needle is directed through the back wall of the vagina and into the ovarian follicles. From here, the eggs are easily retrieved.
- Fertilization and Embryo Development
Once the eggs have been retrieved, they are carefully identified, labeled and taken to the lab. To begin the fertilization process, they are placed in a petri dish with a special solution for 2 to 3 hours. During this time, a semen sample is collected from the male partner and delivered to the lab where it undergoes a clarifying process referred to as “washing”, which isolates the healthiest sperm. Once the sperm are washed, they are incubated and placed in the petri dish with the eggs. Alternately, patients dealing with problems such as male factor may elect to use intracytoplasmic sperm injection (ICSI) to assist in the fertilization process. After 18 hours, the eggs are examined. If normal fertilization occurs, then two to four of the resulting embryos will be selected and returned to the woman’s uterus in one to three days.
- Embryo Transfer
Embryo transfer is a simple procedure that does not require anesthesia, although we do perform them at our outpatient surgery center. Rest and recovery are recommended for 24 to 48 hours thereafter. The selected embryos are inserted into a thin tube and guided toward the woman’s uterus, where it is hoped they will continue their natural fetal development. Any additional embryos not transferred can be frozen at this point and used in a later IVF cycle if pregnancy does not occur, or if a subsequent pregnancy is pursued.
Dr. Michael M. Alper