In Vitro Fertilization (IVF)

An Overview of IVF

In natural conception, the woman’s egg is fertilized by sperm in her fallopian tube. In vitro fertilization (IVF) replicates this process in our advanced embryology lab. We combine the egg and sperm to create embryos, which are carefully monitored until they reach an optimal stage of development. We utilize Preimplantation Genetic Testing for Aneuploidy (PGT-A) to screen embryos for chromosomal abnormalities, ensuring we select the most viable embryo for implantation. Our lab is specifically designed to provide the ideal conditions for embryo growth, maximizing the potential for a successful pregnancy. The selected embryo is then transferred to the woman’s uterus, where it can grow into a healthy baby.

When Should You Consider IVF?

IVF is often the most effective treatment when other fertility treatments, like intrauterine insemination (IUI), have not been successful. It is commonly recommended for the following conditions:

• Age-Related Infertility: Poor egg quality or low ovarian reserve.
• Recurrent Miscarriage: Multiple pregnancy losses can indicate underlying fertility issues.
• Unsuccessful IUI Cycles: When IUI doesn’t result in pregnancy.
• Blocked or Damaged Fallopian Tubes: This can prevent eggs from meeting sperm naturally.
• Women who are unable to ovulate
• Sperm Issues: Low sperm count, poor motility, or other sperm abnormalities.
• Endometriosis or Uterine Scarring: Conditions that interfere with implantation or embryo growth.
• Women with Polycystic ovary syndrome (PCOS)
• Unexplained Infertility: No clear cause for fertility struggles.
• Genetic Diseases: IVF can help avoid passing on genetic conditions, especially with the use of PGT-A.
• Donor Eggs/Sperm or Gestational Carrier: IVF enables the use of donor eggs or sperm, or a gestational carrier if necessary.
• 2SLGBTQIA+ Families: IVF can support diverse family-building paths.
• Fertility Preservation: IVF is also used for egg or embryo freezing for future use.

What Is Preimplantation Genetic Testing (PGT-A)?

PGT-A is a crucial step in IVF that involves testing embryos for chromosomal abnormalities before they are implanted. This helps identify the embryos with the highest chance of a healthy pregnancy, improving the overall success rate of IVF. By selecting embryos that are genetically healthy, PGT-A can help reduce the risk of miscarriage and increase the chances of a successful live birth.

How IVF Works: Step-by-Step

1. Initial Consultation

Your initial consultation, the very first step in the IVF process, is an opportunity for your NewLife clinical team to learn more about your medical history and begin to design a customized IVF treatment plan that addresses your goals and maximizes your success. Once a comprehensive workup of your Day 3 hormone levels and other preliminary tests have been completed, your care team will prepare you to begin your IVF cycle.

2. Ovarian Stimulation

Normally, a woman produces one egg per month in her menstruation cycle. Fertility medications signal the ovaries to boost egg production and produce several eggs. This process of stimulation may continue for seven to ten days, during which time your care team at NewLife Fertility

IVF will monitor your fertility treatment progress with ultrasounds to examine the ovaries and with blood work to monitor hormone levels.

Once the egg-containing follicles have reached a healthy size, an injection of hCG (human chorionic gonadotropin) is used to allow the final maturation of the eggs and to spur ovulation.

3. Egg Retrieval

Thirty-six hours after the hCG injection, the eggs are ready to be removed from the woman’s ovaries. To collect mature eggs from the woman’s body, a physician performs a minor outpatient surgery called a vaginal ultrasound egg retrieval. The surgery is a short thirty-minute procedure performed in-clinic. Light anesthesia is administered to ensure comfort. Most women are able to return home an hour or so after the procedure.

On the same day, your partner will provide a fresh semen sample to our lab. If you have obtained frozen donor sperm, we will ensure this sample has been tested prior to your retrieval. Following egg retrieval, you will begin progesterone to prepare the uterus for implantation of the embryo. Implantation will occur five to six days later.

4. Embryo Development

Our embryologists combine the eggs with sperm for fertilization. Fertilized eggs, now called embryos, are transferred to our incubators to develop further. The sperm fertilizes an egg a few hours after insemination. If your embryologist thinks the chance of fertilization is low, the sperm may be directly injected into the egg. This process is called Intracytoplasmic Sperm Injection (ICSI).

5. Embryo Selection

Our team of embryologists will regularly monitor your embryos to make sure they’re growing properly. Within about five days, a normal embryo develops into many cells that are actively dividing. At this point, individuals or couples with a risk of passing on a genetic disorder to their child or women with a history of failed IVF or miscarriage may consider and participate in genetic testing (PGS or PDG).

Our embryologists then assess embryo quality and decide which embryos are healthiest. Genetic testing of embryos (PGS – Preimplantation Genetic Screening) affords embryologists another layer of information about the embryos for the selection process. To ensure your best chance at a successful, healthy pregnancy, the highest quality embryo is selected.

6. Embryo Transfer

To those who fit the criteria for treatment, we recommend elective single embryo transfer (eSET), which is the process of transferring one single healthy embryo, rather than a few. This is our first choice in selected couples because we know that transferring multiple embryos is associated with multiple pregnancies, and the greatest chance for a healthy pregnancy comes from a single-child pregnancy.

Three to five days after egg retrieval and fertilization, embryos are transferred into the woman’s uterus. This procedure occurs in-clinic using a catheter inserted through the cervix. Most women can resume regular activities the next day. If an embryo sticks to the uterine lining and grows, pregnancy results. Any unused embryos may be frozen to allow the option of future implantation.

7. Post-Transfer

To help thicken the uterine lining to make it easier for the embryo to implant, you will continue progesterone therapy for two weeks after embryo transfer. A blood test for pregnancy is performed several days after the embryo transfer. If pregnancy is confirmed, you will continue progesterone for another three to four weeks, until your placenta begins to produce enough progesterone to support the pregnancy on its own. If pregnancy cannot be confirmed, you may decide with your doctor to begin another cycle of IVF.

8. Pregnancy Test and Beyond

About 10-12 days after the embryo transfer, you’ll return for a blood test (beta hCG) to confirm pregnancy. If successful, you will continue progesterone support until your pregnancy is confirmed via ultrasound. Your care will continue until a fetal heartbeat is detected, after which you will be referred back to your family physician or ob/gyn.

IVF success rates are intimately tied with embryo selection; that is, choosing to implant the embryo with the highest probability of leading to a successful, healthy pregnancy and birth.

Elective Single Embryo Transfer (eSET) is an option to implant one single embryo into a woman’s uterus, rather than a few. For those patients with a good prognosis for success who also meet the recommended guidelines for treatment, eSET provides the same success rate as IVF.

How It Helps

The biggest advantage of eSET is a greatly reduced risk of multiple births (twins, triplets, etc.). Our goal is always to achieve one singleton pregnancy per cycle to ensure a healthy baby and happy parents. One key component of working to achieve this goal is by using embryos conservatively.

At NewLife Fertility, we educate our prospective parents to help them make the best, most informed decisions in regard to their treatment. If IVF is a part of your fertility plan, your doctor will be ready to discuss whether eSET is the right option for you on your path toward growing your family.

eSET Background

Traditionally, IVF has involved the transfer of multiple embryos in an attempt to improve success rates. The theory was that the more embryos transferred, the more likely an embryo would implant and result in pregnancy. Recent research, however, plus improvements in the fertility treatments, have shown this is not the case.

Today, with better techniques available to grow and select the best quality embryos, the decision to decrease the number of embryos transferred results in greatly decreasing the risk of multiple births, therefore increasing the chance of a successful pregnancy.

What is eSET?

A single-embryo transfer (eSET) is an IVF technique that allows our team to identify and implant one high-quality embryo into a woman’s uterus.

Risks Of Twins And Triplets

While some patients may perceive ‘multiples’ as a time-saving and safe outcome in an IVF cycle, there are a number of complications to be mindful of, for both the baby and mother. Transferring multiple embryos often leads to multiple pregnancies, which can result in:

• Higher risks of miscarriage
• Higher chances of premature birth
• Preeclampsia
• Gestational diabetes
• Higher rates of C-section delivery
• Postpartum depression

“One size does not fit all” when it comes to the number of embryos we transfer.

Our team utilizes a customized approach to patient care that is designed to optimize outcomes for each patient. eSET is an option for all patients that have at least one chromosomally normal embryo, as identified through PGS.

eSET is recommended for women:

• Younger than 35 years of age
• Beginning their first IVF cycle
• With prior IVF success
• With a large number of high-quality embryos
• Who have embryos available for freezing
• Who are recipients of donor eggs

The first step in deciding if eSET is right for you is to discuss the option with your fertility doctor at NewLife Fertility Centre.

Selecting An Embryo

High-quality eggs produce high-quality embryos, which, therefore, helps the embryo to continue to grow and ‘stick’ once inside the uterus. Embryos must be strong enough to survive the early stages of development. As a woman ages, her ability to produce high-quality eggs begins to diminish, which, in turn, affects the quality of her embryos and, ultimately, the success of her pregnancy.

To choose the highest-quality embryo for transfer, the laboratory grades each one based on its appearance. This assessment includes a number of factors, including the number and size of the cells and the rate of development. Improved laboratory conditions now allow us to grow embryos to day 5 of development, the blastocyst stage.

These embryos, left to develop for five days, contain hundreds of cells. If an embryo reaches the blastocyst stage, we know it is a superior, healthy embryo and has a better chance of implanting successfully. While no method can reliably predict which embryo will produce live offspring (because so many other components factor into birth rate), eSET does offer an opportunity to select the embryo most likely to grow inside the uterus.

Financial Considerations and Support

Understanding the cost of IVF is important in planning your fertility journey. Depending on your circumstances, you may qualify for funding through OHIP (for Ontario residents under age 43), or private insurance coverage. If not, financing options are available through our partners Beautifi, and Medicard, allowing easy monthly payments for up to $50,000. Speak to our care team for detailed information about financial options.

Additional Fertility Services

• ICSI-IVF (Intracytoplasmic Sperm Injection): If sperm quality is an issue, ICSI can improve fertilization rates by injecting a single sperm directly into the egg. This is recommended for conditions like low sperm count or motility.
• Donor Egg/Sperm: IVF with donor eggs or sperm is an option for those unable to use their own genetic material.
• Embryo Testing: PGT-A can be performed to ensure the embryos are genetically healthy, improving the likelihood of a successful pregnancy.

Why Choose NewLife IVF?

At NewLife, we are leaders in IVF treatment, offering one of the largest in-house teams of fertility specialists in Canada. We pride ourselves on providing exceptional care, with a personalized approach and the latest technology in fertility treatments. Whether you are facing specific fertility challenges or exploring family-building options, we are committed to guiding you through every step of your journey with compassion and expertise