IVF, In Vitro Fertilization
For those who have failed injectable medication with IUI, or for those individuals or couple whose needs warrant this level of care, IVF is extremely successful and represents the highest level of success, for all indications, in reproductive medicine. In IVF cycles, the woman receives injectable hormonal stimulation for usually 10-12 days, with ultrasound and blood monitoring to assess the safety and effectiveness of this regimen. Unlike IUI, however, in IVF cycles the main intervention after the HCG injection is an ultrasound-guide transvaginal collection (retrieval) of multiple oocytes (eggs) from the This procedure is done under conscious sedation anesthesia under the care of a Board- Certified anesthesiologist. The actual egg collection procedure is performed by the Reproductive Endocrinologist and takes 15-30 minutes on average.
Once the eggs are obtained, a lab specialist called an Embryologist will find and identify the microscopic eggs and fertilize the eggs in the lab using the husbands, partner or donor sperm. Advanced fertilization techniques, such as direct placement of individual sperm within the egg (Intracytoplasmic Sperm Injection – ICSI), is often used to enhance the success of the fertilization process.
Once fertilized, the fertilized eggs, now called embryos, will be grown in the laboratory for several days prior to replacement of a mutually agreed-upon number of embryos inside the uterus of the woman (embryo transfer) in order to facilitate success full pregnancy. The embryo is also often processed with gentle disruption of a portion of the human egg shell (Assisted Hatching- AH) prior to the Embryo Transfer, in order to achieve maximal chance of implantation success. Pregnancy rates with IVF can range from 40-60%, especially in women under the age of 40, though variability in individual response and success rates can occur.
Similar to IUI, a reduction in multiple birth rates and overstimulation can be facilitated by appropriate ultrasound and blood monitoring to maximize success and minimize complication. Additional embryos after the embryo transfer can also be frozen (cryopreserved) for another baby in the future or another attempt if the initial cycle is unsuccessful.