There are many steps to invitro fertilization (IVF). Your fertility specialist will work with you to establish the appropriate fertility care and will determine if IVF is part of the treatment. Once IVF has been established as part of the treatment, it will be customized to the individual or couple. Here is a general summary of the process and timeline:
Step 1: FIRST DAY OF MENSTRUATION
Day one of the menstrual cycle is the first day of the IVF cycle. Starting either on day 2 or 3 of the cycle oral medications and/or injections will be taken to stimulate follicle growth in the ovaries.
Step 2: OVARIAN FOLLICULAR GROWTH & MONITORING
Through medication, the ovaries will be stimulated to grow multiple follicles which contain eggs (instead of a single follicle/egg being grown during a typical natural menstrual cycle). You will have appointments at the fertility clinic to closely monitor and track the progression of follicular growth, which can include ultrasounds and blood tests.
Once there are sufficient eggs that are mature and ready for egg retrieval, one or two trigger shot(s) will be taken in preparation for egg retrieval and fertilization
Step 3: EGG RETRIEVAL & SPERM DONATION
During the egg retrieval process, the fertility physician will perform a follicular aspiration, which is a very thin needle used to harvest eggs. During this minor 15 – 20 minute procedure, the patient will be sedated. During the egg retrieval process, the male partner will be requested to provide a fresh sperm sample that will be washed and prepared for fertilization. If donor sperm is being used, it will be thawed and prepared.
Step 4: EGG FERTILIZATION
Once the eggs are retrieved, they will be fertilized with the male partner’s sperm or with donor sperm in cases that require donor sperm. During this step, intracytoplasmic sperm injection (ICSI) may be used to ensure a healthy sperm will fertilize each egg.
Step 5: EMBRYO GROWTH
The growing embryos will be monitored in the lab and during day 5 or 6, at the blastocyst stage of embryonic growth, either a fresh embryo transfer of an untested blastocyst , freeze-all (deferred embryo transfer) of untested blastocysts, or preimplantation genetic testing for aneuploidy (PGT-A) can be performed. For those electing to perform genetic testing of their embryos, after the test results are in, the selected frozen embryo will be thawed for transfer into the uterus with the upcoming cycle.
Step 6: EMBRYO TRANSFER & PREGNANCY TEST
During embryo transfer, a selected embryo will be placed in a woman’s uterus using a thin catheter in the hopes of establishing a successful pregnancy. Following the embryo transfer, the patient will wait for a period of about 9 days before taking a pregnancy blood test to measure the level of the pregnancy hormone, human chorionic gonadotropin (hCG). hCG levels can determine the presence or absence of pregnancy. If the hCG level is detectable (positive for pregnancy), then another level is checked two days later per routine. A transvaginal ultrasound at approximately 6 weeks of gestation two weeks later can evaluate for a gestation sac, yolk sac, fetal pole, and fetal cardiac motion.
