In vitro fertilization is one of the most effective treatments available to achieve a pregnancy. Most couples will have a 25 to 50% probability of a live birth per IVF procedure at Nova. For some couples, this probability will exceed 50%.
- Traditionally IVF has been used to treat patients with a history of tubal blockage
and pelvic adhesions (scarring).
- Male factor infertility is another common indication.
- Infertility associated with endometriosis and idiopathic (unexplained) infertility
has been successfully overcome with IVF.
- Longstanding infertility (2 years or longer) is another common reason for couples to choose IVF.
- Decreasing egg quality due to advanced female age may leave a couple with IVF
as the only meaningful treatment option. We strongly recommend considering in vitro fertilization
if the female partner is over age 39.
- IVF is also an excellent test of egg and sperm quality.
- Family gender balancing/pre-implantation genetic diagnosis (PGD) can be added to in vitro fertilization.
- If sperm cannot be obtained by masturbation, it can be aspirated from the testes or epididymis.
Below is an example of an IVF treatment sequence. Actual treatment is individualized.
All medications are given as pills, vaginal capsules or tiny, shallow injections just under the skin. All stages of this treatment take place in our clinic.
IVF consists of the following steps:
- Ovarian Stimulation
To maximize the probability of a live birth, we use FSH (follicle stimulating hormone) and LH (luteinizing hormone) to stimulate production of as many high quality eggs as possible (usually 6-14 eggs). These hormones are administered as shallow, subcutaneous injections.
During the 7 to 12 day ovarian stimulation, two to four ultrasound examinations and blood estrogen determinations are used to follow the development of the eggs. When the eggs are ready for retrieval, you will take another subcutaneous injection of hCG (human chorionic gonadotropin) hormone. This hormone completes the maturation process of the eggs.
The ultrasound image below shows fully stimulated ovaries. Each of the grape-like follicles (0.5 to 1 inch in diameter) contains a microscopic egg.
- Egg Retrieval
Thirty-six hours after the hCG injection, a non-surgical oocyte retrieval is done in our center. This is typically a 5 to 10 minute procedure.
Using ultrasound guidance, a thin aspirating needle is passed through the top of the vagina into the follicles. Only the tip of the aspirating needle enters the pelvic area. Since the ovaries are located just above the top of the vagina, the tip of the needle is passed into the follicles without penetrating the uterus, cervix or the Fallopian tubes.
- Fertilization
The male partner collects a semen sample by masturbation either at home or at our office and
the highest quality sperm are added to the eggs 6 hours after the egg retrieval.
If your infertility history suggests the possibility of a male factor significant enough to keep the eggs from being fertilized using regular laboratory methods, you will be scheduled for the ICSI procedure. ICSI or Intracytoplasmic Sperm Injection, is a micromanipulation technique in which a single sperm is inserted directly into an egg.
The next day, Nova embryologists will examine the eggs for signs of fertilization. A normally fertilized egg (zygote) will show two pronuclei representing the genetic material from the egg and sperm (image at left).
The following day, embryos reach 4 cells, the day after, 8 cells and by day 5 after egg retrieval, they should reach the blastocyst stage.
- Embryo Transfer
One to five days after the egg retrieval, the resulting embryo(s) are transferred into the uterus by passing a thin embryo transfer catheter through the cervix to the top of the uterus.
Extra embryos that are not transferred at this time can be cryopreserved and stored in liquid nitrogen.
- Establishment of Pregnancy
Progesterone vaginal capsules are given for luteal phase support. A blood pregnancy test is scheduled approximately two weeks after the embryo transfer. A fetal heartbeat ultrasound is done two weeks after a positive pregnancy test.
This ultrasound picture shows a six week pregnancy. The pregnancy sac is approximately an inch in diameter.
The baby inside the sac is about 0.5 inch long, yet it is possible to already distinguish the head and the "tail"
portion of the baby's body.
For additional in-depth information, please see Nova Treatments and Fees page.
If you wish to schedule an appointment for in vitro fertilization, please go to In Vitro Fertilization New Patient Appointment.
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