Is Your First IVF Cycle Creating Anxiety?
In vitro fertilization (IVF) has been coming to the rescue of hundreds of thousands of couples struggling with fertility problems or those with unique family planning challenges. IVF is an innovative medical process that falls under the assisted reproductive technology (ART) umbrella. With IVF, embryos are created outside the body using sperm and eggs. One or more viable embryos are then medically implanted into the potential parent’s uterus. Despite the many benefits, IVF can be a long and challenging process. Many become confused, overwhelmed, or unaware of the many stages of IVF. Learning the step-by-step process can help potential patients navigate with confidence.
Start with IVF consultation
Before any medical procedures, IVF patients will have consultations with doctors and other specialists with several goals. These initial tests can help doctors determine the possible reasons for infertility. Physical tests, blood tests, and other scans provide the complete fertility picture. From there, the fertility team can advise the patient of the best course of action. The patient will learn the procedures, tests, and hormone medicines needed for a potentially successful IVF cycle. Factors like the timeline, cost, and preparation required will be covered in additional meetings.
Getting started with ovarian stimulation
After initial fertility testing and evaluations, the IVF process can begin. The first step consists of stimulation of the ovaries to produce multiple eggs needed for IVF. The patient will require injectable and possibly oral hormone medication. A fertility pharmacist dispenses the recommended hormone medication at the best possible doses. The drugs are injected by the patient for 8-14 days to stimulate the ovaries. During this time, the fertility team monitors the effectiveness of the medication with blood tests and ultrasound scans. The maturation of ovarian follicles, which contain the eggs, is essential for IVF success.
A trigger for egg retrieval
Doctors will monitor the hormone medication for several days, which is essential to prevent early ovulation. In the coming days, the patient may need gonadotropin-releasing hormone (GnRH) agonists. This hormone drug can suppress the natural hormone release until the ideal time. When the follicle reaches the ideal size, another trigger shot is needed. This is an injection of human chorionic gonadotropin (hCG) or GnRH agonist to mature the eggs for retrieval. The patient is required to adhere to the medication to increase the chances of success.
Retrieval, fertilization, and embryo development
The next step involves removing the eggs before a natural release. This retrieval happens about 36 hours after the trigger shot. The patient will come into the fertility center at the appropriate time. During this process, the patient will be prepared for this minimally invasive procedure. The doctor will place the patient under sedation for a smoother process. An ultrasound device guides the doctor to the ovaries while using a needle. The needle is guided through the vaginal wall, and the eggs are aspirated from the ovaries. The retrieved eggs are transferred to the embryologist, who helps with embryo development. Sperm from a donor or collected from the patient is then used with the eggs to create multiple embryos.
Are you ready for your transfer?
Fertilization of the eggs with sperm is a delicate process. The fertility team will need several days to mature the embryos after using sperm and eggs in a petri dish. The embryologist can use intracytoplasmic sperm injection (ICSI), where a single sperm is used at a time to fertilize each egg. The team carefully monitors the eggs for successful fertilization. Further monitoring and tests are necessary to determine the healthiest embryos. At the required time, the fertility team will prepare to transfer the best available embryo to the woman’s uterus. Before then, patients use progesterone to prepare the uterine lining. On the day of transfer, single or multiple embryos are gently guided into the uterine cavity.
Is the IVF cycle a success?
The patient is expected to continue progesterone medication to support the uterine lining. After the transfer, there will be a waiting period before checking for pregnancy. This is a 2-week period as the uterine lining develops and the embryo implants into the uterus. At the 2-week stage, a blood test can confirm pregnancy. If hormone levels indicate pregnancy, an ultrasound can confirm the pregnancy and embryo development. If the test is negative, the team will review the cycle to look for errors and determine next steps. This period can be overwhelming for patients. Doctors recommend enlisting family support and stress reduction techniques.
A bright future with a budding family
IVF can be a lengthy process with many steps. Both doctor and patient are heavily involved and must work hard to ensure success. Each step is critical and influences success rates. The fertility team can add other steps, such as genetic testing, for better results. IVF also comes with emotional challenges and side effects when using hormone medication. Despite the challenges, IVF has increasing success rates, but may need multiple cycles. Work with the fertility team for a deeper understanding of each step, and look forward to a successful pregnancy.
