In vitro fertilization (IVF) is a treatment where we recover eggs from a woman’s ovaries and place each egg into a Petri dish together with her partner’s sperm. The eggs and sperm join (fertilization) inside an incubator. We place the successfully fertilized eggs (embryos) back into the woman’s uterus several days later. The woman will need to take medications to stimulate extra egg development prior to the egg retrieval.
IVF is a treatment used to treat infertility from a variety of causes. A woman will undergo ovarian stimulation with medication in preparation for a surgical procedure to remove eggs for fertilization outside the body. The eggs and sperm will be mixed and allowed to rest in an incubator overnight. The next morning, the eggs that have fertilized will be counted and supplemented with additional fluids to supply nourishment. After 3 to 5 days of growing in an incubator, the resulting embryo(s) will be evaluated and the best one or two selected for transfer into the uterus. Pregnancy testing about 10 days later will determine the success of the treatment.
Jennifer Hamilton, RHS Laboratory Manager and Embryologist, wrote informative blogs about embryo development and grading. Link to A Guide to Embryo Development After Retrieval and Your Baby’s First Report Card – Embryo Grading.
We may also perform the following procedures in conjunction with an IVF cycle:
Intracytoplasmic Sperm Injection (ICSI)
Intracytoplasmic sperm injection (ICSI) is the injection of a single sperm into the middle of the egg in order to encourage fertilization. ICSI is usually reserved for cases where the sperm testing has revealed at least one abnormality and fertilization may be reduced or impossible.
Fertilized eggs, also called zygotes or embryos, will be nurtured in the incubators in our embryology laboratory. Embryos are nourished by a special media that has been developed to closely resemble the fluid inside the fallopian tube. Incubators are environmentally controlled to provide the proper growing conditions for the embryos. Unfortunately only the heartiest embryos will mature to blastocysts. Your IVF physician and embryologist will work closely together to recommend the day to perform an embryo transfer to increase your chances for a successful implantation.
Assisted hatching is a procedure performed on the embryo to attempt to soften or open the membrane around the embryo and aid in its attachment to the uterine wall after embryo transfer. Assisted hatching is used in IVF cycles where the female partner is age 38 or greater, if there has been a prior failed IVF cycle, or if the embryos were created from frozen eggs. Occasionally, hatching will be prescribed for frozen-thawed embryos prior to transfer. Studies have not revealed any problems related to assisted hatching, and have also shown a benefit to pregnancy success in the situations mentioned above.
We may suggest sperm cryopreservation, where we freeze and store healthy sperm cells for future use, if your partner has difficulty collecting a specimen or will be out of town during the IVF cycle. Prior to freezing any sperm specimens we will perform blood tests to check for any viral infections.
Preimplantation Genetic Diagnosis
Working with several world-renowned molecular genetics specialists, RHS offers Preimplantation Genetic Sampling (PGS), to identify genetic abnormalities in embryos that could lead to miscarriage or the birth of an unhealthy child. The results of the testing may be available in time for the embryos to be transferred on day 5 or 6, or all the embryos may be frozen until the genetic testing is completed. We may recommend PGS to you if your genetic screening or history suggests that you are at risk of producing children who would be affected by life threatening diseases, such as Cystic fibrosis or Huntington’s disease. Decision to use this technology can occur only after genetic counseling has occurred with the pre-implantation genetic experts.
Link to Dr. Albert’s blog: Pre-implantation Genetic Diagnosis and Screening: What Do You Need to Know?
Link to watch Dr. Kubik’s lecture about the history of IVF at Magee’s 2016 Alumni Day Program.