In Vitro Fertilization
In Vitro Fertilization (IVF) is a procedure first successfully utilized in 1978 in which a woman’s ovaries are stimulated with fertility drugs to produce multiple mature eggs, which are then removed from her body and are fertilized in the laboratory with her partner’s (or donor) sperm. The resulting embryos are cultured for three to five days, at which point the best 1 or 2 embryos are then transferred back into her uterus.
An IVF procedure at SIRM involves the following steps:
- Preparing for Controlled Ovarian Hyperstimulation (COH)
- Undergoing Controlled Ovarian Hyperstimulation
- Egg Retrieval
- Sperm Processing
- Fertilization of Eggs in the Laboratory
- Selecting the Best Embryos for Transfer
- Embryo Transfer
- Cryopreservation (Freezing) of Remaining Embryos (This is dependent on having additional viable embryos left after embryo transfer. Embryos can be frozen for use at a later time and at a much lower cost compared to a full IVF cycle.)
Natural Cycle IVF
Natural Cycle IVF is a no-stimulation approach used to eliminate the use of fertility drugs. In a natural cycle of IVF, the woman is monitored closely as she approaches ovulation. She may be given an hCG “trigger” shot to induce ovulation and “ripen” her egg(s). The egg is then retrieved and the cycle proceeds as a conventional IVF cycle, other than the fact that if the egg does not fertilize, or arrests in its development, the cycle will be cancelled at that point.
Aside from a woman’s age, the factor most heavily affecting egg/embryo quality in IVF is the method of ovarian stimulation used. There is no single stimulation protocol that is suitable for all IVF patients. Patients should not treated as if “one size fits all.” Each patient’s protocol for IVF stimulation must be individualized in order to have the best likelihood of success. Women with decreased ovarian reserve (DOR) can be especially difficult with respect to both quantity and quality of eggs.
Low-stim IVF , or minimal stimulation IVF, is a procedure that involves ovarian stimulation using low dosage medications (often oral drugs like clomiphene citrate, Clomid and Letrozole) under the premise that it is a safer than conventional gonadotropin stimulation regimens and has comparable success. Many centers tend to use this approach as each cycle is less expensive than conventional stimulation regimens. The Low-stim IVF regimen is indeed safer, but by doing a lower dose stimulation, a smaller number of eggs are recruited and retrieved, which can therefore decrease the overall likelihood of success. While there might be some benefit to using this approach in particular subsets of women, it should not be universally applied.
IVF Cycle Calendar
What are the steps and timing of an IVF cycle?
When you schedule your IVF procedure, you will be given a calendar by your clinical coordinator that will highlight all of the key components of your cycle, including medications, appointments, ultrasounds, tentative egg retrieval, embryo transfer and pregnancy test dates.
IVF Beta hCG Levels
Is my beta hCG strong? What do the numbers indicate?
The most important indicator in beta hCG tests is whether the number doubles every 48 hours. In some cases where a beta number doubles initially, then decreases its rate, it may indicate that a twin pregnancy has reduced to a singleton. When this is the case, it may slow initially, but should then begin to double again every 48 hours. Some betas may start off as low as 3 or 4, then progress to a healthy pregnancy, so there is really not a specific threshold number that indicates a viable pregnancy. Every case is different. Read more about interpreting beta hCG numbers HERE.
IVF and Acupuncture
There are varying opinions on the effectiveness of acupuncture at aiding successful IVF. Certain studies indicate that there are benefits, and many patients find that it gives them additional confidence and peace of mind. In the end, it is a personal decision.