IVF or In Vitro Fertilization is the most effective treatment for infertility. This is a nerve-wracking treatment process but most people don’t know what steps are involved until they go through it. So, here is a guide for you.

IVF is a complex series of procedures that involves the fertilization of an egg in a specialized lab. After that, the fertilized eggs will be transferred to the uterus. Usually, one complete cycle of IVF takes almost two to three weeks. But for some women, more than one cycle is required to get pregnant. IVF is often performed when other fertility treatments to get pregnant have failed. Here are the steps of IVF that you should know before or after the appointment.

Preparation for An IN Vitro Fertilization Cycle –

1. Testing and Ovarian Stimulation

Before IVF, your fertility doctor will evaluate your uterus and fallopian tubes to ensure that there are no issues that require medical attention. Your doctor will also suggest you some tests including, hormonal assessment to check the thyroid levels and ovarian reserve by screening both husband and wife for STD (Sexually Transmitted Diseases) and a sperm analysis of the male partner.

The doctor will give you some fertility drugs for ovarian stimulation and depending on your treatment protocol, and you may have to take around one to four-shot every day for about a week to ten days. After few days, you will become an expert at self-injection because your doctor will teach you how to give yourself the injections before starting your treatment.

Ovarian stimulation is a process generally used to mature eggs for egg retrieval. Even if the ovulation is regular, your doctor will suggest fertility drugs to produce multiple eggs because the chance to get pregnant is higher with more eggs.

During the ovarian stimulation process, the doctor will monitor the growth and development of the follicle by using hormonal testing and vaginal ultrasound. Once the ultrasound verifies you have numerous mature follicles and your estrogen level is normal, your doctor will provide you a trigger shot of HCG.

2. Egg Retrieval

About 34 to 36 hours after receiving the HCG shot, before the eggs ovulate, the egg retrieval process will take place. At the beginning of the process, your doctor will give you a mild sedative so you will not feel any pain or discomfort. A transvaginal ultrasound will be used to insert a needle through the back wall of your vagina into the ovaries. The doctor will then use the needle to extract the follicle or gently suck the follicular fluid and oocyte from the follicle into the needle. The entire process takes less than 30 minutes. Every follicle contains one oocyte and these oocytes will be transferred to the embryology lab by the IVF physician for fertilization. After the procedure, you may experience mild abdominal cramping and feeling of pressure or fullness as well as light spotting, but you will feel better after few hours or the next day.

3. Sperm Retrieval

If you are using your partner’s semen, then he will provide the semen sample on the morning of egg retrieval. If required, your doctor may also use a needle to extract the sperm directly from the testicle. Donor sperm also can be used if your partner has poor sperm. Technicians separate the sperm from the semen fluid.

4. Egg Fertilization

Once the eggs reach the lab, embryologists will evaluate the maturity and quality. Mature eggs and sperms will be transferred into a culture medium, placed in an incubator and after 12 to 24 hours, they will be examined to check if there is any sign of fertilization.

There are two common methods of fertilization –

• Conventional Insemination: In this process, mature eggs and a single healthy sperm are combined and incubated all-night.
• Intra-cytoplasmic Sperm Injection: In this procedure, a single healthy sperm is directly injected into every mature egg. It is used if the semen quantity and quality are poor or the previous In Vitro Fertilization cycles failed.

Your physicians and embryologists will determine the process depending on multiple factors.

5. Embryo Transfer

Embryo transfer usually takes place two to five days after the egg retrieval. Generally, this process is done with a microscope, but genetic screening is performed in some specific cases. However, if doctors decide to perform genetic screening, a biopsy is taken from the embryo, usually on culture day 5 or 6. Your doctor will give you a mild sedative to make the process painless, but you might feel mild cramping after the transfer.

To begin the process, the doctor will insert a catheter (a long, thin and flexible tube) inside your vagina, through your cervix and into your uterus. By using a syringe, your doctor will place the embryo into your uterus.

If successful, the embryo will develop into the uterus and the embryo will hatch as well as an implant will take place in the uterine lining within one to two days after the embryo transfer.

Results:

About twelve to fourteen days after the egg retrieval, your doctor will test your blood sample to check whether you are pregnant or not. If the reports are positive, your doctor will refer you another an expert gynaecologist for prenatal care.

But if the reports are negative, doctor will suggest you stop your fertility drugs or if you are interested in attempting another IVF cycle, your doctor might suggest steps to improve the chances of pregnancy.

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