Dealing with infertility makes you feel out of control. You have no say over your ability to reproduce, you feel lost regarding your plans for the future, as though you’ve been thrust, unwillingly, into your “new normal”. It’s easy to succumb to the sense that you are no longer in charge.
Obviously, you do have the absolute say-so in your ability to move forward, even with infertility. That’s why we encourage you to actively be a part of your IVF process. From day one, your participation is the key to your success. We are a team including everyone at LA IVF, focused on the same goal, and you’re the one in charge.
Many patients know a good bit about the IVF process, even before they choose to pursue it. You’ve no doubt googled various sites, and researched your options. There’s a good deal of information out there, and most of it is sound. It’s important for you to remain informed and aware throughout your treatment.
The ideal way to stay involved is by partnering with the fertility support staff, especially your IVF nurse and treating doctor. You’ll have questions and concerns each step of the way and your nurse is here to support you in all aspects of your treatment. Knowing what to expect, and why, helps you understand, eliminating the fear and stress that comes with the unknown.
Steps in the IVF Process
The IVF process can be fairly overwhelming at first. So much of the success of IVF depends on the timing of your reproductive functions. With that in mind, this highly choreographed process involves many steps. Here’s what you might expect.
- Oral Contraceptives: When you begin your IVF treatment you will likely need to take birth control pills. The birth control pills are necessary to ensure a better response of your ovaries to the stimulation injections which will follow. Oral contraceptives also allow for more control over your cycle. IVF is a big commitment and you don’t want to have any interruptions, such as a scheduled work trip, or the like. The pill helps you coordinate your schedule, synchronize your ovaries and eggs for the best possible outcome.
- Blood Tests and Ultrasound: You’ll begin injections to stimulate the ovaries the day after stopping oral contraceptives. Concurrent with the stimulation injections, you’ll need to have regular ultrasounds and blood tests. As we watch for signs that ovulation is imminent we will begin to introduce drugs that prevent premature ovulation. When the maturity of the eggs is verified, retrieval will be scheduled. Prior to retrieval you’ll be injected with an ovulation trigger. You may also be administered an antibiotic to prevent infection.
- Egg Retrieval: Under IV sedation (you will be asleep) your eggs are retrieved using an ultrasound guided needle. The probe and needle are inserted vaginally, and the eggs are collected in a tube, passed along to the embryologist, and later fertilized.
- Sperm Processing: The sperm, either donor sperm, or that of your partner, is collected, and must undergo necessary biochemical changes before fertilization can occur.
- Fertilization:Fertilization in the laboratory can take place in one of 2 ways, depending on the reason for your infertility. In the first method, sperm and egg are placed together to allow fertilization to occur called the “insemination for IVF” method and they are then checked within 24 hours to make sure fertilization has occurred. The second method is used in a various instances and almost routinely done today, called ICSI. Using a microscope, the egg is injected directly with a single sperm that is picked by the embryologist. This sperm may be the best sperm to inject in cases of male factor infertility.
- Culturing of Embryos: After fertilization occurs, eggs are cultured for 3-6 days and observed for development. Although most embryos that are chromosomal abnormal will stop developing, that isn’t always the case. Many patients with concerns will opt for preimplantation genetic testing (PGT). This testing ensures the embryos are sound and ready for transfer to the mother’s uterus, or freezing.
- Transfer of Embryo: Using a thin catheter, guided by ultrasound, the embryo is transferred directly into your uterus through the vaginal approach, almost like a Pap smear test is done. In order to have the most successful outcome, and depending upon the method used to transfer the embryo, you will need to have a full or semi-full bladder. You will also be administered the medication called diazepam (Valium – pill to make sure relaxed) so you remain calm and experience minimal anxiety.
- Post-Transfer Management: Following your embryo transfer, you’ll be given specific instructions, along with hormone supplements, either in injection form, or as a vaginal suppository. These hormones will help your body support the pregnancy in the first trimester. 8-10 days after the implantation of the embryo, you will be given a blood test to check for pregnancy. If all is well, you will continue the hormone supplements until around the 12th week. You will undergo an ultrasound of the fetus about 2 weeks after pregnancy is confirmed. At this appointment you’ll be able to see your developing baby, and witness the heartbeat. You will continue to be followed closely, and the health of your unborn baby confirmed, for about 10 weeks, at which time you will be referred to your general obstetrician for prenatal care, and delivery.
Each IVF Treatment is Unique
Just as there are many different reasons natural conception isn’t taking place, there are different concerns in IVF treatment. Each patient is unique and what one patient experiences may not be the same as what you experience. If you are concerned about anything involved in your own IVF journey, please ask.
The best way to allay your fears, and feel in control of your circumstances, is by educating yourself. Ask questions, no matter how silly they may sound to you. Our experienced, and professional support team at LA IVF will do all we can to keep you stress-free, and in control, during this exciting chapter of your life.