There are several steps involved in an in-vitro fertilization cycle (IVF). Before a cycle is initiated, the couple will have their treatment plan designed by their Dallas IVF Physician. Nurses do not make treatment plans at Dallas IVF.
Step One – Ovarian Stimulation
The female patient administers fertility medications to stimulate the production of multiple eggs. These medications, termed gonadotropins, are administered daily over a period of a few weeks. The medications are administered subcutaneously at home. While taking these medications, the patient’s progress is monitored at our offices through the aid of transvaginal ultrasounds and by testing blood estradiol levels every few days.
Step Two – Egg Retrieval
Once the eggs are of a mature size, as determined through office monitoring, the patient administers a “trigger” injection of either hCG (human chorionic gonadotropin) or lupron. The trigger injection helps mature the eggs and prepare them for the retrieval. Approximately 36 hours later, as an outpatient at our Fully Licensed and Accredited Ambulatory Surgery Center, the egg retrieval takes place. Egg retrievals are performed in an operating room with anesthesia administered by a board certified Anesthesiologist. A thin needle, which is attached to the side of an ultrasound probe, pierces the top of the vagina, and the eggs are retrieved. A typical egg retrieval last about 10 to 15 minutes. The patient recovers quickly following the procedure and is often discharged about an hour later from the facility. The patient is instructed to go home and rest, but can return to work the following day.
Step Three – Fertilization
A few hours after the eggs are retrieved, they are fertilized with the male partner’s sperm. This can be accomplished either through the ‘conventional’ method of placing the sperm in the Petri dish with the eggs, or through intracytoplasmic sperm injection (ICSI). In conventional IVF, the sperm naturally swim up to and then penetrate the egg. With ICSI, individual sperm are injected into the eggs to promote fertilization if the couple has a male factor.
Step Four – Cell division
Once an egg is fertilized with sperm, it is called an embryo. The embryo begins as a single cell and must then divide. Unhealthy embryos often stop dividing. The single cell splits into two cells. With time, the two cell embryo splits into 4, then into 8 cells. On the third day following an egg retrieval, most healthy embryos are at or about the 8-cell stage. On day-5, embryos should be at, or about, the blastocyst stage, which contains about a 100 cells.
The placement of the embryos back into the uterus in termed the uterine embryo transfer. This usually occurs on the 5th day following the egg retrieval when embryos are at the blastocyst stage. At times, when a woman only has a few embryos dividing, the transfer may occur on day 3.