Thank you for your interest in the In Vitro Fertilization (IVF) procedure at Coastal Fertility Specialists. In Vitro Fertilization has helped many women with infertility get pregnant. Click on the quick links below for more details about each step in the IVF process.
The IVF procedure bypasses the fallopian tubes. As a result, patients with damaged or absent fallopian tubes can become pregnant. This technique has also been instrumental in helping patients with endometriosis, severe male factor infertility, and many other disorders become pregnant. In this section we review the IVF process step by step.
In-vitro fertilization (IVF) is a process that involves the administration of medications to stimulate the development, growth, and maturation of eggs on the ovaries. This process of egg recruitment typically starts with a medication called Lupron which helps us control the menstrual cycle by decreasing your body’s production of Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH). After the Lupron is administered for 12 to 14 days, we then start the administration of injectable medications to stimulate egg development.
The egg development will be followed closely with a combination of ultrasound monitoring and blood work. When the eggs have reached optimum maturation (typically after 10 days of medications) human chorionic gonadotropin (HCG) is administered to start the sequence of ovulation.
Approximately 35 hours after the HCG administration you are given anesthesia and your eggs are harvested from your ovaries with a needle guided by ultrasound. After the eggs are removed from the ovary they are placed in culture media designed to mimic the conditions of the fallopian tube (where fertilization typically takes place).
The eggs are then combined with the sperm and the resulting embryos are nourished in an incubator that is maintained at precise temperatures to mimic the conditions in the human body. Embryo development is then observed assessing embryo morphology, cell count and growth velocity.
At the appropriate stage of development the embryos are placed into the uterus through a very simple procedure similar to a pap smear. A pregnancy test is then performed approximately 10 days later.
Normally, fertilization of the egg occurs in the fallopian tube where the embryo spends three days developing to the 8-cell stage. This embryo then travels into the uterine cavity where it grows to a blastocyst (140 cells) by Day 5. At this point, on either Day 5 or 6, the embryo breaks through the outer membrane (hatching) and attaches to the wall of the uterus where it continues to grow into a baby.
Prior to 1998 most IVF programs transferred three to four embryos on day 3 at the 8-cell stage. The incidence of triplet pregnancies became unacceptably high, accounting for 10 to 15% of pregnancies. Fortunately, a technique which divided the culture process into two steps was developed by Dr. David Gardner, permitting IVF laboratories to grow embryos to Day 5 and thus transfer only two embryos while maintaining high pregnancy rates without the risk of triplet pregnancies or greater.
Blastocyst transfer is an important cornerstone of our IVF program as it allows us to evaluate the embryos over an extended period of time prior to embryo transfer. Not all patients are candidates for a blastocyst transfer, however, and we prefer to select the day of transfer based on the judgment of our embryologist regarding the best chance of a single or twin pregnancy.
Coastal Fertility Specialists also offers a variety of modifications to the standard IVF process to help patients with specific disorders. We offer intracytoplasmic sperm injection (ICSI) for couples with male factor infertility, preimplantation genetic diagnosis (PGD) for couples with genetic disorders and assisted hatching for patients with repeat IVF failure.