In Vitro Fertilization (IVF)

In Vitro Fertilization (IVF) is a highly successful form of Assistive Reproductive Technology (ART) many people use today to achieve a pregnancy. In 2009, more than 60,000 infants were born with the use of ART. Throughout his many years of dedicating his practice to expanding the families of his patients, Dr. Russell has not only helped thousand of couples conceive IVF babies over the past 25 years, but has also been an innovator in the development of the methods we use today for our IVF procedures. There are five basic phases to the IVF cycle, which are overviewed below.

Stimulation of the Ovary

In a normal menstrual cycle, just one egg (oocyte) develops and matures within the ovary. The egg is housed in a fluid filled structure in the ovary, called a follicle, which can be seen on ultrasound. In an IVF cycle, self-administered fertility medications are used to stimulate the ovaries to produce multiple follicles containing eggs.

The IVF team will educate you on when you will start your stimulation medications, and how to use them. You will use the self-administered fertility medications for approximately 9-11 days, depending on how your ovaries respond. You will visit the office frequently during your stimulation to monitor your blood hormone levels and follicular development with ultrasound.

Once the majority of the follicles have reached a mature size, another medication, human chorionic gonadotropin (hCG) will be given by injection. You will be given explicit instructions on when and how to take the hCG. The hCG must be given at the appropriate time of follicle development to prepare the egg for removal from the body, also called the egg retrieval.

Retrieval of the Egg

Once the eggs are mature and ready for insemination, a procedure called egg retrieval will be performed. This procedure is done in the office with the use of ultrasound guidance and in most cases under a light sedation. The procedure itself takes roughly 10-15 minutes. However, you can expect to remain in the office for at least 1 hour following the retrieval for monitoring. You will be informed of the number of eggs retrieved prior to leaving the office.

Fertilization of the Egg

IntraCytoplasmic Sperm Injection (ICSI) is a procedure that manually causes fertilization to occur by injecting a single selected sperm into the egg. This is typically used for all IVF inseminations, and done the day of retrieval. If using your partner, or known donor, the sperm will be collected on the day of retrieval.

Embryo Transfer

During the cycle, the IVF team will determine whether the transfer will be on day 3 or day 5 after the egg retrieval. This is based on set criteria for embryo quality and quantity. The embryo transfer process is similar to the IUI or a routine pelvic exam and pap test. A speculum is placed in the vagina, the cervix is cleaned with sterile culture media and the embryo is inserted through the cervix with the assistance of ultrasound guidance to place the embryo at the top of the uterine cavity. The number of embryos to transfer will depend on embryo quality. Due to the high success rate in donor recipient cycles, we strongly encourage consideration of a single embryo transfer.

Post Embryo Transfer

After completion of your stimulated cycle, you will require additional hormone replacement to ensure the environment in the uterus is appropriate for implantation. Therefore, roughly 7 and 9 days after your retrieval, you will return to the office for hormone testing. If any changes need to be made to your medication regimen, they can be done so at this time. Your pregnancy test is performed roughly 10-12 days following your embryo transfer.

Once we have confirmed your pregnancy with a blood test, we will have you follow up with a repeat pregnancy test and ultrasound to continue to monitor the development of the pregnancy. In most cases, DIRM will work with your OB/GYN to provide your initial obstetrical care for the first 12 weeks of your pregnancy. After your first trimester, you will continue your obstetrical care with your OB/GYN, or, if you do not have one, we can provide the names of excellent obstetrician/gynecologists in your area.

Unfortunately, not all IVF cycles result in pregnancy. You are encouraged to schedule a follow-up consultation with Dr Russell should your cycle not result in a pregnancy. The purpose of this visit would be to summarize your cycle, answer questions, and discuss future plans, such as future IVF cycles, other infertility options or non-medical family building options.