In Vitro Fertilization (IVF)


Beginning an IVF cycle is an exciting and anxious time for a couple. Our Center provides couples with the maximum amount of clinical, emotional, and administrative support they will need to complete their “cycle” successfully – whether it results in a pregnancy or not.


Watch this video to learn how IVF works:


The following explanation is meant to simplify that occurs during various stages of IVF:

Definitions

  • Ovarian Follicle – a small, fluid-filled structure in which eggs develop
  • Oocyte – an egg
  • Embryo – a fertilized egg that has undergone division cleavage

Stage I : Ovarian Follicle Development through Controlled Ovarian Stimulation

Rotunda – The center for human reproduction uses fertility drugs that simulate the female partner, natural hormones to develop several normal follicles in the ovaries.

Any excess Oocytes that fertilize and develop into embryos at fertilization may later be stored through cryopreservation.

Follicular growth, development, and maturity are evaluated through frequent hormone monitoring and by ultrasounds. Typically, the hormones are measured through blood tests to evaluate ovarian response. Ultrasound is used several times during a cycle to measure accurately the follicular growth and size.

These steps allow the physician team to modify the treatment in some cases and to stop the cycle if the response to stimulation is not satisfactory. Once follicular maturation is achieved, the patient receives an intramuscular injection of a human which triggers oocyte maturation and ovulation. Oocyte retrieval is performed approximately 34 to 35 hours later.

Stage II.- Oocyte Retrieval through Puncture/Aspiration

If the last hormone blood test and ultrasound evaluation indicates healthy growth of follicles, then aspiration of mature follicles takes place. This entire procedure takes approximately 30 minutes performed under short general anesthesia at Rotunda – The Center for Human Reproduction. The physician locates each follicle through ultrasonic guidance and carefully aspirates them. The contents of the follicles are immediately taken to the IVF lab. Patients usually recover in one to two hours following Oocyte retrieval and are then discharged. Progesterone supplementation initiated from the day of the retrieval.

Stage III.- Oocyte Culture, Insemination, and Fertilization

In the IVF laboratory, follicular fluid is examined under a microscope to locate all eggs, which are then incubated in a special media. Generally, semen collection occurs at about the time of the egg retrieval but, in some cases, may be several hours later. The sperms are then added to the eggs in culture, where fertilization occurs. The resulting embryos are stored in the incubator and maintained in culture until the time of embryo transfer and/or cryopreservation.

Stage IV.- Embryo Transfer

Usually, transfer of the embryos takes place on day two to three post retrieval. The embryos are examined under the microscope and carefully aspirated into a thin transfer catheter. The loaded catheter is introduced into the uterus through the cervix where the embryos are placed. This procedure takes a few minutes and does not require anesthesia. The maximum number of embryos to be transferred at one time is 3-4.

After the transfer, the patient rests for two hours prior to discharge and complete bed rest for four days is required. Twelve days after the embryo transfer, a serum based pregnancy test is taken. During this period, patients are advised perform light activity and remain in contact with the Center. If pregnancy does not occur, our team reviews the IVF cycle and make specific recommendations for follow-up. The patient will speak with the clinical staff to review and if necessary, to discuss other options.

Cryopreservation

Vitrification, a cutting edge technology for cryopreservation (freezing) of embryos and eggs, is available at Rotunda – Center for Human Reproduction.

Patients who undergo IVF may have several eggs collected. The eggs are then fertilized with a sperm and checked for fertilization. Fertilized eggs are called embryos. A patient may have multiple high quality embryos eligible for embryo transfer back to the uterus. A certain number of embryos are chosen for embryo transfer, and the surplus of high quality embryos can be cryopreserved for future use.

Previously, embryos were cryopreserved using a slow freeze method. However, the survival rate of cryopreserved embryos with Slow Freeze method was only about 70%. Therefore, new methods were developed to improve cryopreservation techniques.

Vitrification is a new process for cryopreserving embryos. Many studies show survival rates of vitrified embryos to be far higher than survival rates of slow freeze embryos. We at Rotunda – CHR use the latest vitrification method, known as Cryotech Vitrification. The survival rate of embryos in our laboratory is about 98% with good quality embryos. The results of frozen embryo transfers after vitrification are extremely encouraging and we are excited to offer this cutting edge technology to all patients who chose to cryopreserve their embryos.