Pre-IVF: the infertility workup
During the initial consultation, the fertility specialist will take the patient’s medical history. After that, there will be three days of testing including ultrasound and bloodwork to determine the woman’s hormone levels and potential eggs. The clinician will perform a hysterosalpingogram to check the fallopian tubes and uterine cavity for abnormalities. Male partners will undergo a semen analysis.
After testing the clinician will talk to the patients about diagnosis. Many couples may have other fertility treatment options than just IVF. However, IVF is the first line treatment for tubal ligation or tubal disease, and severe male factor infertility.
The aim of the IVF cycle is to have as many mature eggs available as possible. In order to achieve this aim, the woman will be given injectable hormones to take for 8-14 days to stimulate egg production. During this period, the patient will visit the clinic several times for monitoring. The patient will also undergo ultrasound and bloodwork to assess the stimulation phase.
Egg retrieval and fertilization
Prior to the procedure, the patient will receive general anesthesia. The egg retrieval process takes between 20 -30 minutes. During the procedure, a physician will use a fine needle to remove the egg and fluid from each follicle. The recovery period is typically 30 minutes.
After retrieval, the eggs and sperm are sorted in a lab. The embryologist injects a healthy sperm into the egg. During this period, the physician may discuss preimplantation genetic screening (PGS). PGS determins whether the embryos are chromosomally normal. The fertilized egg is then placed in an incubator so that embryo development can begin. By day five the embryo is ready for transfer.
The embryologist will choose only the healthiest embryo to transfer. The embryo is transferred to the woman’s uterus on day 5 in the blastocyst stage. The transfer is a simple procedure that takes only 5 minutes. The doctor will implant the embryo into the woman’s uterus using a catheter; no anesthesia is needed.
The moment of truth
Two weeks after the embryo transfer, a pregnancy test will be given to determine if the IVF cycle was successful. Physicians recommend to avoid using at home pregnancy test as this tests often show a false positive secondary to the stimulating hormones remaining in the body. Many women experience success with IVF treatments and understanding the process will help with stress levels. Always discuss questions with a healthcare provider before making any medical decisions.
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