- In Vitro Fertilization (IVF) : The basics
- When to consider IVF
- IVF Treatment process
- Basics of eSET
- Is eSET for me?
For individuals and couples whose infertility persists despite conventional first-line treatments, in vitro fertilization (IVF) offers a logical next step.
In Vitro Fertilization, more commonly referred to as IVF, is a process by which a woman’s eggs are removed from her ovaries and fertilized in the laboratory with her partner’s sperm. The resulting embryos are incubated in the laboratory and transferred back into her uterus three to five days later.
Women undergoing IVF will receive subcutaneous injections for approximately ten to twelve days during which time she will have cycle monitoring to track her progress. The medications will stimulate the growth of a good number of eggs. Once her eggs are mature, she is given an injection called “Ovidrel” (or HCG) and 35 hours later, the eggs will be retrieved under intravenous sedation using a needle in our office. The eggs are immediately passed to the embryologist, the sperm is collected the same day and the eggs are fertilized.
Our IVF Success
At NewLife Fertility, we specialize in in-vitro fertilization and have built a reputation as a respected source for this advanced reproductive technology. We offer a variety of modifications to the standard IVF process to help patients with specific disorders.
With 50,000+ babies born since 2005, our fertility center and IVF experts offer the experience, technologies, guidance, and support to help you achieve an IVF pregnancy in the shortest time possible.
IVF: The Basics
- During IVF, eggs are collected from a woman’s ovaries in an outpatient surgical procedure and fertilized by sperm in our lab
- If the male partner has an abnormal semen analysis, then fertilization is achieved by injecting a single sperm into each egg in a process called Intra-Cytoplasmic Sperm Injection (ICSI)
- Individual treatments are called IVF cycles, and one cycle takes about 2-4 weeks, culminating in multiple eggs being retrieved from a woman’s ovaries and fertilized with sperm
- The fertilized eggs, now called embryos, are then implanted into the woman’s uterus three to five days after fertilization – or may be frozen for use in a subsequent cycle
- Prior to implantation, embryos can also be tested for their genetic competence through PGS (preimplantation genetic screening) and a single normal embryo can be implanted with a high probability of success (while minimizing the chance of multiples)
- Your fertility doctor at NewLife Fertility will work with you to determine an individualized and appropriate pathway to help you achieve your goals in creating or growing your family
Our experts often recommend PGS and PGD (preimplantation genetic diagnosis) testing during IVF to select the very the best embryos for transfer or to check for genetic conditions that you or your partner could pass to your children.
With the help of PGS, we can identify the cause of recurrent pregnancy losses or unsuccessful fertility cycles, select the very the best embryos prior to implantation, and increase your IVF success rate.
Minimal stimulation IVF (Mini IVF) offers a similar approach to standard in vitro fertilization, but with the goal of retrieving a smaller number of high-quality eggs, rather than a higher quantity of eggs. This offers women and couples the benefits of:
- Less time commitment
- Lower cost
- Fewer fertility medications
Unlike standard IVF, Mini IVF uses weaker medications or lower doses of fertility drugs to stimulate the ovaries. This translates to fewer eggs collected at egg retrieval time. Whereas traditional IVF often yields a chance to freeze embryos that are not transferred in a given cycle, it’s much less often that Mini IVF produces a surplus of embryos.
If you’re curious about whether Mini IVF is right for you, we invite you to discuss your options with your doctor or connect with us firstname.lastname@example.org or at 905-896-7100.
IVF provides many people with the opportunity to attempt pregnancy in the face of one or more factors that may otherwise decrease their chances.
Below you will find the most common reasons for individuals or couples to consider IVF treatment.
Reasons To Choose IVF
- Women or couples who have been unsuccessful with simpler treatments like IUI
- Women with age-related infertility
- Women with low ovarian reserve
- Women with recurrent miscarriage
- Women or men who carry or have a family history of genetic defects
- Women with blocked or damaged fallopian tubes
- Women who are unable to ovulate
- Women with polycystic ovary syndrome (PCOS)
- Women with endometriosis
- Men with poor sperm quality or quantity
- Couples with unexplained infertility
- LGBT individuals and couples
Have A Question?
Our goal is to provide information and advice that will help you to make informed and confident decisions. We are just a phone call or email away if you need answers!
At NewLife Fertility, the in vitro fertilization process is characterized by a variety of different stages.
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.
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 Boston 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 final maturation of the eggs and to spur ovulation.
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.
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).
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.
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 are able to 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.
To help thicken the uterine lining in order 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.
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.
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 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 which 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
- 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.
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