In Vitro Fertilization (IVF)
In vitro fertilization (IVF) is a procedure in which a reproductive endocrinologist fertilizes one or more eggs with sperm inside the embryology laboratory. The most viable embryos are then transferred into the uterus. IVF is the most successful treatment you can do using your own eggs and sperm (or those of a donor). Fertility Centers of Illinois uses the most innovative and advanced technologies which are the key to our high success rates.
When to Seek IVF Treatment
Once diagnostic testing is complete, your physician will review your treatment options. Many patients start with basic, ‘low-tech’ treatments like hormone therapies or IUI and then transition to IVF if needed. While IVF is not always the first step in treatment, it is a highly effective approach that fertility specialists use when less aggressive options are not successful.
There are instances when IVF would be the first line of treatment. IVF is recommended for patients with the following conditions:
Advanced maternal age: Age is the single biggest factor affecting the chances of conceiving and having a healthy baby because egg quantity and quality decline with age. By age 40, the chance of getting pregnant on your own each month is approximately 1%.
Tubal disease or tubal ligation: If a patient has a tubal ligation, IVF treatment would be the best treatment option since it bypasses the Fallopian tubes to achieve pregnancy.
Severe male factor infertility: If the semen analysis shows there are not enough healthy sperm to be successful with more basic treatment, such as intrauterine insemination (IUI), then IVF treatment can help patients overcome male factor infertility. With IVF treatment, an advanced method of fertilization known as intracytoplasmic sperm injection (ICSI) (pronounced “ick-see”) can be performed in the lab. With ICSI, only one healthy sperm is needed for each egg.
Severe Endometriosis: For women who have this condition, their endometrial tissue (the tissue lining the inside of the uterus) grows outside of the uterus. The endometrial tissue can attach to other organs in the abdominal cavity, such as the ovaries and the Fallopian tubes. The uterus will respond to this tissue the same way it responds to menstrual cycle hormones – it will swell and thicken and ultimately, shed.
Recurrent miscarriage: Recurrent miscarriage, also called recurrent pregnancy loss, is defined as two or more consecutive clinical pregnancy losses before 20 weeks gestation. It is important to consider clinical pregnancies rather than biochemical pregnancies, as biochemical pregnancies are usually not included in a diagnosis of recurrent pregnancy loss.
Poor ovarian reserve: Diminished ovarian reserve, also referred to as low ovarian reserve or low egg count, is when there are fewer eggs in the ovaries compared to people of the same age. If there is a low ovarian reserve, the chance of getting pregnant decreases while the chance of miscarriage increases.
The Process
Ovarian stimulation medication: The goal of this step is to help the ovaries produce eggs for the retrieval. For 8-12 days, the patient takes injectable medications that boost egg production and maturation.
Ultrasound & Blood Monitoring: Every 1-3, the patient comes in for pelvic ultrasounds and bloodwork to track the cycle’s progress and adjust medication as needed. Once a “ripe” egg is present, a patient receives a “trigger shot” that causes ovulation within about 36 hours.
Egg Retrieval: On the day of the egg retrieval, the patient will meet with the operating physician and anesthetist before the procedure begins. Anesthesia will be administered so the patient can sleep comfortably throughout the procedure. Using an ultrasound as a guide, the physician will remove ovarian follicles containing eggs which are then transferred to an embryologist. The egg retrieval takes approximately 15 minutes followed by a period of recovery. Patients can expect to take the day off work and often feel bloated or experience minor cramping and spotting afterward.
Sperm Collection: A sperm sample from the partner or donor is thawed and processed by the laboratory. During preparation, the sperm sample is “washed” to remove debris, immobile sperm and the seminal fluid, then the sperm cells are highly concentrated into a small volume. This ensures that the healthiest sperm and combined with the eggs following the retrieval.
Fertilization: Eggs and sperm are placed in a petri dish to fertilize on their own.
ICSI: Intracytoplasmic sperm injection (ICSI) is recommended in some cases such as male factor infertility or preimplantation genetic testing. During ICSI, embryologists draw one sperm into a thin pipette, then inject the sperm into an egg with the assistance of a special microscope.
Embryo Development: In the days following fertilization, embryologists regularly monitor embryos to ensure the best quality are selected for transfer for the greatest chance of success. Embryos are evaluated on a grading scale that includes the number of cells, their uniformity, and how developed the embryo looks. Rapid cell division occurs until the embryo enters the blastocyst stage around days 5 or 6.
Embryo Transfer Procedure: The embryo transfer is a simple and fast procedure that doesn’t require any anesthesia or recovery time. On the day of your transfer, a healthy embryo is selected and the remaining embryos can be cryopreserved (frozen) for future use. During the procedure, a woman lies on an exam table just like a routine pelvic exam. An embryo is transferred to the uterus through a thin, long, flexible catheter under ultrasound guidance.
Follow-Up: Now the wait begins. About two weeks after embryo transfer, follow up blood testing determines if pregnancy has resulted.
Intracytoplasmic sperm injection (ICSI)
ICSI is recommended in some cases such as male factor infertility or preimplantation genetic testing. During ICSI, embryologists draw one sperm into a thin pipette, then inject the sperm into an egg with the assistance of a special microscope.
