IVF is a procedure in which Dr Berios will remove one or more eggs from the ovaries that are then fertilized by sperm. This is done by placing both the egg and the sperm in a dish which allows the sperm to fertilize the egg. If they are successfully fertilized in the laboratory, they will be transferred into the women’s uterus. Then hopefully one of the eggs will implant and develop.
IVF IS A FIVE-STAGE PROCESS
Stage 1: Ovarian Stimulation, monitoring and ovulation triggering
Having more mature eggs available for fertilization will increase the chances of pregnancy. Most women will only release one mature egg every month. Some medications are used to prevent an early release of eggs while other medications are used to stimulate the ovaries to develop more ovarian follicles – sometimes between five and ten.
Stage 2: Egg Retrieval
Once ovarian stimulation is complete and follicles have matured, Dr Berios will try to retrieve as many eggs as possible. Egg retrieval is done under mild sedation, local anaesthesia or in some cases general anaesthesia. The mature follicles are identified using an ultrasound and then a needle is passed through the vagina to withdraw the fluid from the mature follicle with gentle suction. The fluid is then examined under a microscope to see if an egg has been retrieved. The process is repeated for each mature follicle in both ovaries. All retrieved eggs are removed from the follicular fluid and placed in an incubator.
Stage 3: Fertilisation
Approximately two hours before the eggs are retrieved; a semen sample is collected from the male partner and processed to select the strongest, most active sperm. The sperm are then placed with the eggs in an incubator set to the same temperature as a woman’s body. The following day, the eggs are examined under a microscope to determine whether fertilization has occurred. If it has, the resulting embryos will be ready to transfer to the uterus.
Stage 4: Embryo Development and Transfer
The transfer will be done between day two (2 – 4 cell stage) and day five (blastocyst stage – around 100 cells) of development. This allows for assessment of embryo cleavage (the way an embryo divides) and ensures the embryo is still developing so that only embryos capable of resulting in a pregnancy are transferred.
The transfer of the embryo can be performed without anaesthesia. It is not a complicated procedure – more like a Pap Smear. The embryos are placed in a tube and transferred to the uterus. The number of embryos transferred depends on a woman’s age, cause of infertility, pregnancy history and other factors.
Stage 5: Luteal Phase Support
The luteal phase is the two week period between the embryo transfer and the pregnancy test. It is usually recommended that you take it easy for a couple of days after the transfer. After 48 hours, you can resume your normal activities – these will not affect implantation.
The corpus luteum (the follicle after the egg is released) does not produce the hormones oestradiol and progesterone to prepare the uterus for embryo implantation as it would in a natural cycle. This is due to the treatment prior to egg collection and the collection process itself. In order to ensure there is adequate progesterone present, you will be prescribed progesterone.
After approximately 16 days, you will return to Dr Berios for a blood test to determine whether a pregnancy has occurred.
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