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If you’re considering IVF, you’re likely to have a myriad of questions. The road to fertility can be demanding, and many patients come to us with stories of frustration, confusion, heartache, and helplessness. Our role is to support you medically and emotionally from the beginning, and one of the best ways we can do that is through education. If we can give you a clear picture of all the treatment options available, it will be easier for you to feel confident and in control throughout the process.

It is likely that you already know at least one person who has become pregnant with IVF. While IVF is now a common fertility treatment, not everyone knows how it works or who it can help. While some questions can only be answered in a one-on-one consultation with your doctor, this guide should get you started. IVF is currently the most successful of all antiretroviral therapies (assisted reproductive technologies) and has helped millions of people achieve their dreams of developing families. This may be your answer as well.

Introduction: What is In Vitro Fertilization?

First of all, the basics. In vitro fertilization stands for in vitro fertilization. “In vitro” means “in glass” in Latin, which means that the fertilization of eggs and sperm takes place in a laboratory outside the body. In vitro fertilization allows us to create the ideal environment for successful fertilization and the growth of healthy embryos, “stacking the deck”.

IVF is not a single process: it is a complete journey with several different steps in a cycle. That’s where your strong relationship with the IVF team determines all the differences. Wanting a child is one of the most personal and emotional processes in the world, and asking for help from IVF doesn’t change that.

Here’s what your IVF journey looks like:

For Women:

A typical IVF cycle begins with a session of follicle-stimulating hormone (FSH) to encourage your ovaries to produce more eggs. It’s a series of injections that you do at home, but don’t worry, we’ll take you through the injection process at our office. Why do we need these drugs? We want to help you produce as many high-quality eggs as possible, which will increase your chances of fertilization.

Throughout the treatment, you will have an ultrasound and blood tests to check the development of your eggs. Once your eggs are mature enough, we will have you do the egg retrieval procedure. This is a small outpatient procedure that is performed under light sedation, and the actual procedure only takes 15 to 20 minutes, although you should plan to relax for the rest of the day.

Next, the eggs you collect will be combined with your partner’s or donor’s sperm. After 16 to 20 hours, the eggs are examined to determine if fertilization has occurred. In some cases, the egg can be injected with sperm alone, a process known as intracytoplasmic sperm injection or ICSI. Fertilized eggs are allowed to grow in the laboratory for 6 days before transfer. This gives them a great start and let’s keep an eye on their development.

In some cases, you may be given hormones to help prepare your uterus for implantation: these drugs stimulate the growth of the endometrium, essentially creating a good and comfortable environment for embryo transfer.

On the day of transfer, the highest quality embryos are selected and carefully placed into the uterus using a catheter. This is a very simple and quick procedure and usually does not require sedation. Once your doctor has placed the embryos, you are officially pregnant, but the actual implantation can take anywhere from 1 to 5 days. At this critical juncture, you may be given more medication to support the embryo and we will be closely monitoring your progress.

Two weeks after the transplant, we will take a pregnancy test to see if the implantation was successful. We will monitor you for the first 10 weeks of your pregnancy and then your care will be handed over to your obstetrician until delivery.

For Men:

You will be asked to provide a fresh sperm sample at the same time as the egg retrieval. The sperm undergo a special washing and spinning process to isolate the most active and healthy sperm for fertilization. Donor sperm is thawed and then processed with the same method before use.

Who can benefit from IVF?

The ideal IVF candidate is one who is in good overall health. In addition to this basic requirement, it’s really a question about your personal situation. The good news is that IVF is effective in treating many different causes of infertility. This is usually a good option:

Couples who have been trying to conceive for more than 6 months. Couples who are not yet able to conceive on their own after half a year usually have IVF very successfully. Women at all stages of the reproductive year are conceived through in vitro fertilization, using their own or donor eggs.

Women who have been unsuccessful with other fertility treatments, including fertility drugs and IUI (intrauterine insemination). Trying several different antiretroviral treatments without success can be very frustrating and painful, but in vitro fertilization often brings hope when other methods fail.

Most patients with infertility include:

• Tubal factor infertility. If you have scarring, blockage, damage, or absence of fallopian tubes, tubal fertilization is a great option because the IVF process bypasses the fallopian tubes entirely. It is often a more effective (and less invasive) alternative surgical solution.
• Endometriosis. In vitro fertilization can provide a way forward for patients affected by endometrial scarring.
• Polycystic ovary syndrome (PCOS). In vitro fertilization is considered to be a very effective treatment for infertility caused by PCOS.
• Male factor infertility. The problem of low sperm count or sperm quality can usually be solved with in vitro fertilization and ICSI (intracytoplasmic sperm injection).
• Unhealthy eggs/sperm or inability to get pregnant. With the help of a donor and/or surrogate, IVF can provide a pathway to your baby, even if the odds of illness are not in your favor.

Those who want to control the genes of their babies. Preimplantation genetic screening (PGS), which allows doctors to screen for chromosomal abnormalities in IVF embryos. If a patient is at risk for certain genetic diseases, preimplantation genetic diagnosis (PGD) can be used as a specific screening process to ensure that only healthy embryos are implanted.

Those couples who can conceive alone in 2 to 3 years or with a low-tech level of treatment, but do not want to risk waiting to find out that they are not pregnant. If you’re ready to start a family right now and decide you don’t want to take the risk, IVF can give you a way to control your fertility in a way you won’t get from a “wait-and-see” strategy.

Couples or women who want to get pregnant. LGBT couples and single women who want to have children may opt for IVF to have children, depending on their conditions and schedule.

Who might not benefit from IVF treatment?

Women who do not produce healthy eggs and do not want to use donors. Even in the laboratory, low ovarian reserve and egg quality problems can make fertilization difficult even under ideal conditions, but this does not mean that in vitro fertilization is not allowed at all. The more willing you are to use donor eggs, the higher your chances of success.

Women with certain conditions that may interfere with IVF success. If infertility is caused by fibroid tumors, uterine abnormalities, or ovarian dysfunction, in vitro fertilization may not be the right treatment option. These conditions don’t always rule it out, though, so you should consult your doctor. In some cases, other treatments or surgeries before you start IVF can help you overcome these obstacles.

Patients with severe obesity. Many treatments for infertility, including IVF, may be less effective in severely obese women. Very high BMI can affect egg quality, and fertility drugs may play different roles in obese patients. There are some studies that suggest that obese women may be more likely to have a successful IVF cycle of egg donation. As always, everyone is different, and obesity may not be an obstacle in every case. Your doctor will help you decide what’s right for you.

Whether or not you ultimately decide to try IVF, you should get the support and empowerment of your fertility specialist. As you explore your options, it is absolutely essential to build a close and trusting relationship with your doctor. Most importantly, don’t feel lonely.

Our clinical team is here to help. Feel free to ask as many questions as you want, as well as any questions or ideas you may have, even after a few hours.