IVF is a medical procedure where an egg and sperm are combined outside the body to create an embryo, which is then implanted into the uterus to help individuals or couples achieve pregnancy.
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In many situations where a couple is experiencing infertility, HRC fertility doctors can treat the problem with first-line fertility treatments, such as ovulation induction or intrauterine insemination (IUI).
In other cases, the condition causing infertility is treatable with surgery for the male or the female.
For women for whom first-line fertility treatments have been unsuccessful or who have other situations or conditions, the treatment of choice may be in vitro fertilization (IVF).
IVF was originally developed for women with tubal factor infertility (non-functioning fallopian tubes); however, thanks to major IVF advancements, it is not only used as a last-resort treatment.
In fact, it is often the first-line treatment. It can be used to treat various causes of infertility, such as blocked fallopian tubes, male infertility, ovulation disorders, endometriosis, and unexplained infertility. Advances in IVF technology have made it a first-line treatment for many couples, and it has helped millions of people around the world conceive.
IVF offers high success rates, especially when combined with additional techniques like genetic testing, embryo freezing, or egg/sperm donation. Each treatment plan is customized to address the unique needs of the couple, providing the best possible chance for a successful pregnancy.
For most patients, IVF offers the highest chance of pregnancy per cycle. It also provides patients with non-functional fallopian tubes and severe sperm abnormalities with an opportunity to conceive.
Some common female infertility indications that may lead women to choose IVF treatment include:
IVF is often the treatment of choice for couples who are experiencing male-factor infertility, particularly with intracytoplasmic sperm injection (ICSI), a procedure in which one sperm is injected directly into the egg. If you would like to learn whether IVF may be the best choice for you, contact us today.
In a typical ovulatory cycle, a single egg reaches maturity and is ovulated each month. During an IVF cycle, the goal is to encourage multiple eggs to grow simultaneously.
This goal is achieved using medications to stimulate the growth of multiple eggs. Typically, these medications are injectable forms of the same hormones the brain makes to stimulate egg growth (FSH and LH).
It’s important to note that IVF does not deplete the pool of eggs available for the future. The ovary “recruits” a group of eggs to grow every month; these eggs will either ovulate or be discarded by the body. Stimulating the ovaries for IVF “rescues” the eggs that would otherwise be discarded.
Ovarian stimulation for IVF is accomplished by administering an injectable form of follicle stimulating hormone (FSH: Gonal-F, Follistim, Bravelle, others) and luteinizing hormone (LH), which stimulate the development of the ovarian follicles. Most people will do 9-12 days of medications. Medications are administered through subcutaneous injections (injections into the abdominal fat). During the approximately 2 weeks of ovarian stimulation, patients will have several visits to one of our fertility centers for pelvic ultrasounds and blood tests to evaluate follicular growth and estrogen levels. The ultrasound and lab results are used to guide medication adjustments and retrieval timing. Once the follicles have reached an adequate size, a trigger injection (LH and/or hCG) is administered to stimulate the final maturation of the eggs in preparation for the retrieval. 35-36 hours after the trigger, the egg retrieval is performed.
Egg retrieval is typically conducted using transvaginal guided ultrasound while the patient is under anesthesia. A small needle is used to retrieve the eggs from the ovarian follicles, and they are transferred to the embryologist, who separates the eggs from the follicular fluid. The procedure takes approximately 15-20 minutes.
In some cases, a retrieval may be performed using an abdominal rather than a transvaginal approach, or may be done without anesthesia.
Eggs may be fertilized through conventional insemination (eggs and sperm are placed together and fertilization is allowed to occur spontaneously) or intracytoplasmic sperm injection (ICSI), where a single sperm is injected into each egg.
After fertilization occurs, embryos are allowed to grow in the lab to the blastocyst stage (day 5-7). Once the embryo reaches the blastocyst stage, it will receive a grade based on the number and organization of the cells. At the blastocyst stage, cells may be sampled from the embryo for preimplantation genetic testing (PGT). Although blastocysts have the highest implantation rates, in some cases, your doctor may recommend a transfer on day 3.
After fertilization, our embryology team may utilize the Geri time-lapse imaging system to monitor your embryos as they develop. This specialized incubator features individual cameras for each patient's embryos, capturing photos every few minutes to create a continuous video of their growth. By using this technology, we can evaluate the precise timing of cell divisions without ever removing the embryos from their optimal, controlled environment. This "closed culture" approach allows our experts to select the strongest embryos for transfer while maintaining the highest levels of safety and stability.
Embryo transfer is a 5-minute procedure in which an embryo is placed into the uterus. It does not require anesthesia or recovery time. A speculum is placed, and the embryo is introduced into the uterus using a soft catheter. Abdominal ultrasound is used to guide the transfer.
Embryo transfers may be performed fresh (3-5 days after egg retrieval) or frozen (the embryo is frozen at the time of retrieval and transferred in a subsequent menstrual cycle). Frozen embryo transfers are commonly performed because they allow for preimplantation genetic testing and reduce the risk of ovarian hyperstimulation syndrome (OHSS) associated with ovarian stimulation.
For a frozen embryo transfer, there are two general approaches to preparing the uterine lining. One is to use medication (estrogen and progesterone), and the other is to use a natural or modified natural approach in which a person’s ovulation is used to time the embryo transfer. Your doctor can help you decide which approach is best for you.
In most cases, your physician will recommend transfer of a single embryo, particularly if you are transferring a genetically tested embryo, using donor eggs, or are under the age of 37.
Researchers have found that transferring single embryos over several IVF cycles using both fresh and frozen embryos is less expensive and more effective than transferring two or more embryos at a time. And eSET is much less likely to result in multiple births and the ensuing risk of complications.
Infants born in multiple births are more often born early/preterm, are smaller (lower birth weight), and experience more adverse health outcomes than singleton infants. Complications linked with early delivery can include problems with the baby's lungs, brain, intestinal tract, or nervous system.
Women who carry multiples may be more likely to miscarry or need Caesarean sections, which may require a longer period of recovery and, at times, increase the risk of hemorrhage during and after delivery.
8-12 days after embryo transfer, you will have a pregnancy test in the office. Once pregnant, you will be carefully monitored with serial hCG levels and early ultrasounds. After a healthy pregnancy has been established, you will transition care to your OB at 8-10 weeks of pregnancy.
The IVF laboratory at HRC Fertility — where the eggs, sperm, and embryos are handled and IVF is performed — is an extremely important part of the IVF process.
HRC’s state-of-the-art embryology laboratory was built in 1988. Two embryologists we hired then are still part of the HRC team, plus several additional staff members. The HRC IVF lab is one of the top IVF labs in the world due to its advanced technology and staff, and is at the forefront of reproductive clinical research.
For more information on the HRC Fertility IVF Laboratory, please go here.
HRC Fertility is dedicated to educating people on everything related to fertility treatment options & IVF. For more information on IVF-related topics, jump to any section of interest below:
A procedure in which embryologists create a small hole in the outer lining using micromanipulation techniques under a microscope. To successfully implant into the uterine lining, the embryo must hatch out of the zona pellucida and attach to the walls of the uterus.
Cryopreservation is the freezing of embryos for use in future in vitro fertilization (IVF) cycles. During an IVF cycle, the fertilized eggs are transferred to the incubator, where they develop until ready for transfer to the uterus, usually in 3-5 days.
Embryologists have perfected techniques for transferring embryos to different solutions as they are frozen and thawed. Great care is taken not to rupture the membrane surrounding the embryo. The major advantages to using frozen embryos in future IVF cycles are that the female does not have to undergo ovulation induction, which also dramatically reduces medication costs. Success rates are variable depending on patient characteristics, embryo quality, and clinical history.
IVF has made it possible for a woman with ovarian failure to carry and deliver a child using an egg donor. The egg donor undergoes ovulation induction with FSH, and her eggs are retrieved when mature. At this point, the eggs may be frozen for a future donor egg IVF cycle, or used in the current cycle. If they are used in the current cycle, they are fertilized and allowed to develop.
IVF using an egg donor requires that the recipient's mother receive medications, such as progesterone, to prepare her endometrium to accept the developing embryos. Essentially, her cycle is synced with the egg donor’s. When the embryos mature and are ready for transfer, they will be placed into the recipient mother’s uterus. Egg donor success rates are equal to the age group of the donor and are typically high.
Elective single embryo transfer (eSET) with in vitro fertilization (IVF) performed in a high-quality laboratory has been found in several studies to be the best solution for patients with a good prognosis. eSET is particularly effective in patients who are under 35 or who conceived with their first IVF cycle, as well as those who are concerned about a multiple pregnancy or who are using donor eggs.
With eSET, one embryo is selected and placed in the fallopian tube or uterus. The embryo selected might be a fresh embryo or a frozen embryo from a prior IVF cycle. The embryo could also be from a donor.
Researchers have found that transferring single embryos over several IVF cycles using both fresh and frozen embryos is less expensive and more effective than transferring two or more embryos at a time. And eSET is much less likely to result in multiple births and the ensuing risk of complications.
Fertility drugs are available to treat many of the conditions that cause infertility, and many are known as “ovulation-inducing” drugs. Most patients should undergo a fertility workup prior to beginning any fertility drug treatment. There could be many causes of infertility in addition to ovulatory disorders, including endometriosis, tubal disease, cervical factor, and others. Also, fertility drug treatment should not be initiated until the male partner has undergone a semen analysis.
Success rates for IVF vary depending on factors such as age, the underlying cause of infertility, and egg quality. HRC Fertility’s IVF success rates exceed the national average, and our team provides personalized care to optimize your chances of success.
An IVF cycle typically lasts 4-6 weeks, including ovulation induction, egg retrieval, fertilization, and embryo transfer. The process may take longer depending on individual needs.
While IVF is generally safe, there are risks, including ovarian hyperstimulation syndrome (OHSS) and complications from the egg retrieval process. Your doctor will carefully monitor your treatment to minimize risks.
The number of embryos transferred depends on your age, embryo quality, and the IVF protocol used. Many women choose single embryo transfer (eSET) to reduce the risk of multiples while still maximizing the chance of pregnancy.
Yes, IVF can be combined with intracytoplasmic sperm injection (ICSI) to address male infertility, particularly in cases of low sperm count or motility. ICSI involves injecting a single sperm directly into an egg to achieve fertilization.
Excess embryos may be frozen for future use. These embryos can be stored indefinitely using cryopreservation and thawed for use in subsequent IVF cycles if needed.
