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How Does IVF Work?

Click Here! IVF Step by Step in Photos

Anyone working with a Gestational Carrier or going through the IVF process on their own should know that the procedure used is called In vitro fertilization, in which the egg is fertilized outside of the body. The following steps also encompass what the Intended Mother or Egg Donor (in part for an egg retrival) or Gestational Carrier would need to go through for an IVF procedure. Most clinics use the familiar steps listed below but some may have their own procedures. This is just an overview. **Please click the link above to see the IVF process in photo form!

Step One: Development of the ovarian follicle

Although most women usually develop a single egg per month, most Reproductive Endocrinologists (RE) want to maximize the number of eggs retrieved in an IVF cycle. To do this the Intended Mother or Egg Donor will take medication to produce several follicles at one time.

 The clinic will monitor egg development by using ultrasound and checking hormone blood levels. When the follicles reach maturity the patient will receive an injection of HCG (human chronic gonadotrophin) usually late at night or early morning. This will be the start of the final phase of the egg development. The patient may be asked to limit activity during this part of cycle.

Step Two: Harvesting the eggs

Most egg retrievals from the ovaries are completed between 34 and 36 hours after the HCG injection. The timing is extremely important here to allow the RE the best chance of a successful fertilization.

Aspiration of the eggs is guided by ultrasound and is typically done in the clinic with IV sedation to minimize nausea and discomfort. The Intended Mother or Egg Donor usually spends an hour in the recovery room and then is released to return home.

After the retrieval some women may experience a small amount post retrieval discomfort or bleeding. Those experiences are completely normal, however, if  fever, extreme abdominal discomfort, or excessive bleeding are experienced the woman should call the clinic immediately.

Step Three: Semen Collection

The IVF clinic will recommended that the Intended Father or Sperm Donor not ejaculate for at least two days prior the egg retrieval. To maintain potency, the semen specimen needs to be delivered immediately prior to the egg retrieval. Some clinics may provide a private area for masturbation and collection. Alternately the semen can be collected at home and brought to the clinic within a certain specified time frame. The clinic will give the patient the proper guidelines for semen collection.

Step Four:  What happens in the IVF Lab

Directly after the egg retrieval, they are taken into the lab.  The eggs are put into a petri dish with a culture medium. The dish is placed then placed in an incubator which mimics the conditions of the human body (temperature etc.) The sperm is then placed into the medium with the eggs for fertilization.

The embryos are monitored daily. If the fertilization and growth are normal, the embryo transfer can be completed within three to five days.

Step Five: The embryo transfer

Embryo transfers simply deliver the embryos into the uterus. There is no need for sedation or anesthesia. It may not feel any different from an annual Pap smear.

A speculum is placed into the vagina. The embryos (usually no more then 3) are placed in a catheter along with a small amount of fluid, and then the tiny plastic tube is introduced into the uterus through the cervix and the embryo(s) are transferred into the endometrial cavity.

After the procedure, the patient will need to rest in bed for one hour, with her head down slightly and feet up. After going home, she will need to rest in bed for the rest of the day. On the next day she can resume non-strenuous activity. Please note that each clinic has their own protocol and will advise the patient to follow their specified directions.

Step Six: After transfer care

Generally, on the day of the egg retrieval, the patient will be told to start progesterone. This medication can come in many forms including injections and vaginal suppositories. This medication will be taken each day (please follow the steps the clinic has outlined for your case). On or about fourteen days after the embryo transfer a blood pregnancy test (HCG) is ordered to see if indeed the transfer has worked and there is a pregnancy. If the test is positive, an ultrasound will be performed two weeks later to confirm the pregnancy. If everything goes as planned then at about 10 weeks the patient will be released to her obstetrician.

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