Can someone explain IVF?

I have a funny feeling this is our next step, and I was wondering if someone could explain (step by step) the protocol for this process? I'm wondering exactly what this involves and how long the process takes from start to finish (roughly).

I am a patient at LI IVF and am praying that I can get moving on this process ASAP. Does anyone know when the next series starts?

Any info would be greatly appreciated

Message edited 6/4/2008 5:02:17 PM.

Re: Can someone explain IVF?

hope this kinda helps........... i havent started my IVF cycle yet but this is from my RE's website.

IVF, in vitro fertilization, was first successfully performed in 1978 in England and since that time IVF has become a first line treatment for many infertility conditions. Success rates have improved dramatically since the conception of this first "IVF baby".

IVF differs from "natural fertilization" because the union of the egg and sperm (fertilization) occurs in a Petri dish rather than in the body, at the end of the fallopian tube. The term "in vitro" literally mean "outside of the body".

A successful IVF cycle requires that several steps be completed.

Follicular Stimulation and Monitoring
IVF requires numerous eggs compared to a natural cycle which only requires one. This is because some of the eggs used in an IVF cycle will be damaged during the ART procedures and others will not fertilize and develop.

To produce the number of eggs needed for IVF, and to appropriately time egg release, IVF patients are started on medications (Lupron, Antagon, Cetrotide) designed to suppress their own hormones (FSH and LH). FSH is administered by injection and directly stimulates the ovaries to recruit and develop numerous follicles, each of which contains an egg. Drugs like Lupron are critical to a successful cycle as they "block" natural ovulation. Otherwise, ovulation may occur prior to egg retrieval resulting in a "lost IVF cycle". While on these drugs, ovulation must be induced by the drugs hCG or LH.

The progress of the IVF cycle is monitored by ultrasound scans of the ovary. As the follicles develop, the number and size can be measured using transvaginal ultrasound. As healthy follicles develop in an IVF cycle they produce increasing levels of estrogen, which is monitored by blood tests. Estrogen levels are used to help determine the appropriate dosage of FSH and to avoid potential side effects, such as ovarian hyperstimulation syndrome.

Once the follicles, developed during the IVF cycle, are judged to be mature, an injection of hCG is given to initiate the final phase of egg development. Sufficient development and an adequate number of eggs must be present in order to proceed to retrieval.

Oocyte Retrieval
IVF oocyte retrieval is performed using intravenous sedation. A needle is inserted under ultrasound guidance through the vagina into the follicle on the ovary. The follicles, containing the eggs, are punctured and aspirated. If the procedure is successful, one or more of the eggs will be obtained.

Sperm are usually obtained by masturbation the same day. The eggs are inseminated with the processed sperm and fertilization is allowed to take place. Micromanipulation of the sperm and egg is sometimes required to achieve fertilization (ICSI – intracytoplasmic sperm injection). Allowing the embryos to grow in an environment established by culturing other cells from the woman sometimes improves the quality of the embryos (co-culture).

Sometimes the sperm count, or quality are poor (male infertility) and an adequate sample cannot be obtained by masturbation. In some of these cases, the sperm may be withdrawn directly from the testicles (TESA) or other parts of the male reproductive tract (MESA).

Intracytoplasmic sperm injection, ICSI, is often employed in case of male infertility. Using ICSI, a single sperm is injected into each egg. ICSI can be performed with extremely small quantities of ejaculate or sperm retrieved from the reproductive track.

Embryo Transfer
Once the embryos mature, a number (determined by the doctor, embryologist, and patient) of them are inserted through the cervix into the uterus by means of a small catheter.

In some IVF cycles, prior to transfer, some or all of the embryos may undergo assisted hatching to increase implantation rates. The embryo transfer is usually painless and no sedation is required. Most IVF patients will be given drugs, such as progesterone, after the embryo transfer to insure endometrial development.

Excess embryos may be frozen for possible transfer in a future cryopreserved IVF cycle. While cryopreserved IVF cycles produce lower success rates compared to fresh IVF cycles, their cost is much lower. This is because the embryos have already formed and their is no need for ovulation induction drugs or embryo culturing.

The Center For Human Reproduction's New York IVF Clinic success rates significantly exceed the national averages. Success rates for US clinics can be reviewed at the Centers for Disease Control Web site. However, be careful when comparing IVF programs as the treatment populations may be different. For example, an IVF center that employs IVF on a large number of women under the age of 30 will appear to have better success rates than a clinic that treats an excess of women 35 yrs. of age and older. There is a direct correlation between female age and IVF success rates.

Re: Can someone explain IVF?

Thanks, that was very informative

Re: Can someone explain IVF?

Posted by babyquestion

Thanks, that was very informative

Re: Can someone explain IVF?

there are also many many many posts on this board about IVF. If you use the search feature you will be able to read the experiences of many of us.

Re: Can someone explain IVF?

I am an LIIVF patient...here's the summary of my IVF cycle:

IVF interview/injection teaching first. DH had his SA done. 21 days of BCPs. During that time I had my water sono and endometrial biopsy done. We also had our meeting with the social worker. 3 days after stopping BCPs I had a blood test and sono then started stimming with Gonal-F and Repronex and taking Dexamethasone at night. 3 days later I started daily monitoring. Day 5 of stim cycle I added Ganerelix. My dosages on everything else stayed the same the whole time. I stimmed for a total of 7 days and then did the Novarel trigger. Daily monitoring stops after trigger. Egg retrieval and then 3 days later embryo transfer. Post retrieval I had to take Medrol, Doxycyclene and baby aspirin. Post transfer I had to do 3 days of PIO shots then switch to suppositories 4 times a day. I am still on baby aspirin and just added the estraderm patches today. I am 4dp3dt.

Please FM me if you have any questions. This was only my first IVF cycle, so I know plenty of people on here have way more experience than me, but if I can help, I'm happy to.

Re: Can someone explain IVF?

Posted by Lee

I am an LIIVF patient...here's the summary of my IVF cycle:

IVF interview/injection teaching first. DH had his SA done. 21 days of BCPs. During that time I had my water sono and endometrial biopsy done. We also had our meeting with the social worker. 3 days after stopping BCPs I had a blood test and sono then started stimming with Gonal-F and Repronex and taking Dexamethasone at night. 3 days later I started daily monitoring. Day 5 of stim cycle I added Ganerelix. My dosages on everything else stayed the same the whole time. I stimmed for a total of 7 days and then did the Novarel trigger. Daily monitoring stops after trigger. Egg retrieval and then 3 days later embryo transfer. Post retrieval I had to take Medrol, Doxycyclene and baby aspirin. Post transfer I had to do 3 days of PIO shots then switch to suppositories 4 times a day. I am still on baby aspirin and just added the estraderm patches today. I am 4dp3dt.

Please FM me if you have any questions. This was only my first IVF cycle, so I know plenty of people on here have way more experience than me, but if I can help, I'm happy to.

Re: Can someone explain IVF?

The social worker meeting is basically like "pre-cana" for IVFers. It was just a 50 minute meeting to discuss the emotional aspects of IVF as a couple as well as how we've been dealing with the infertility issues. Also to make sure we were both on the same page regarding some of the heavier issues such as what we would do with extra embryos when we are done, what would happen to our embryos if we divorced, etc. DH and I were both surprised by what a good experience it was. We had discussed all of this stuff previously, but LIIVF believes it is important to address some of the emotional support issues you go through during this process.

The endometrial biopsy is a really quick procedure. They basically snip a piece of your uterine lining so they can examine it to see if there are any issues they need to be aware of. I found it to be uncomfortable, but not unbearable - took Advil before and after. Personally, I found the water sono more uncomfortable than the biopsy, and I found both of these procedures more uncomfortable than the shots, the retrieval, or the transfer! Which I totally did not expect!

Re: Can someone explain IVF?

Posted by Lee

The social worker meeting is basically like "pre-cana" for IVFers. It was just a 50 minute meeting to discuss the emotional aspects of IVF as a couple as well as how we've been dealing with the infertility issues. Also to make sure we were both on the same page regarding some of the heavier issues such as what we would do with extra embryos when we are done, what would happen to our embryos if we divorced, etc. DH and I were both surprised by what a good experience it was. We had discussed all of this stuff previously, but LIIVF believes it is important to address some of the emotional support issues you go through during this process.

The endometrial biopsy is a really quick procedure. They basically snip a piece of your uterine lining so they can examine it to see if there are any issues they need to be aware of. I found it to be uncomfortable, but not unbearable - took Advil before and after. Personally, I found the water sono more uncomfortable than the biopsy, and I found both of these procedures more uncomfortable than the shots, the retrieval, or the transfer! Which I totally did not expect!

Re: Can someone explain IVF?

So for IVF... do you need to take 1 month off or something for the injections? Or does this all take place in 1 month... (meaning injections and retrival)

How many days do you need to take injections for?

I am wondering...

Re: Can someone explain IVF?

Re: Can someone explain IVF?

Re: Can someone explain IVF?

Wow this is great information - thanks for posting. I I even have an opportunity/chance to have it done!

The one thing DH and I don't understand is why do you have to take BCP? Apparently I have a lot to learn...