IVF Cycle
Following is a summary of the IVF Cycle:
Step 1 - Evaluation
A full evaluation confirms the need for IVF and prepares for the cycle, which includes extensive patient education and a few diagnostic tests. This preparation may take 1-2 months.
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Step 2 - Ovulation stimulation
Beginning with the onset of a woman’s menstrual cycle two hormonal medications are given, one to control when a woman will ovulate and the other to stimulate production eggs. These daily hormonal injections occur over 10 to 12 days. Two or three transvaginal ultrasounds are performed to assess the growth and maturity of the follicles containing the eggs. Once mature (ready to ovulate), a third hormone is given to trigger the eggs release (ovulation). This is usually cycle day 12.
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Step 3 - Oocyte retrieval
One hour prior to the eggs releasing from the ovary, they are aspirated through a needle into a test tube. Anesthesia provides no pain while the transvaginal ultrasound guides the needle into the separate follicles to aspirate the eggs. An average egg yield is about 15, but varies widely from 1 to 92. Once the patient awakes from her sleep, she often only fells the sensation of ovulation.
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Step 4 - Laboratory
The eggs are mixed or injected (ICSI) with the husband’s sperm. The lab is equipped with state-of-the-art instruments, microscopes, incubators, airflow hoods, and room filters to ensure the highest quality outcomes. Typically 60% of eggs retrieved will become fertilized (the same as in nature). These fertilized eggs are incubated over 3 to 5 days until ready to enter the uterus.
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Step 5 - Embryo transfer
Following evaluation of the quality of the developing embryos, a decision is made by the patients how many to transfer to the uterus. Usually, patients decide to transfer 2 to 4 embryos. In an atraumatic catheter, they are transferred through the cervix into the uterus under ultrasound guidance. The procedure is pain-free. It is often a very reverent experience to see the embryos placed into the womb. Spare embryos can be cryopreserved on this day and stored for future attempts.
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Step 6 - Luteal phase monitoring
The patient takes progesterone daily while waiting for the pregnancy test. We wait 10 days after the embryo transfer to determine whether an embryo implanted. Once it takes hold, the hormone it produces is detected in the mother’s blood stream. This confirms an early pregnancy.
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Step 7 - Implantation
Successful implantation marks the beginning of a 9-month gestation. The mother-to-be will return to her personal physician for prenatal care. If an embryo did not implant, the patient can use the frozen embryos or begin a new treatment cycle.
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