IVF
Overview from Huntington Reproductive Center, Southern
California
IVF is now considered a “first line” treatment for many conditions that cause infertility. IVF is especially valuable in treating patients with fallopian tube disease since IVF does not require the eggs to be transported through the tubes. Eggs are retrieved directly from the ovarian follicles.
IVF consists of a series of steps beginning with ovulation induction. The female is given a drug to control her ovulatory cycle, usually Lupron or Ganirelix. Ovulation cannot occur while on these drugs until an injection of hCG or LH is given allowing the physician to “control” the IVF stimulation.
IVF ovarian stimulation is accomplished by administering Follicle stimulating hormone (Gonal-F, Follistim, Bravelle, others) which directly stimulates the development of the ovarian follicles. These drugs are administered subcutaneously and Gonal-F and Follistim are supplied in a convenient pen mechanism.
IVF has literally made possible thousands of healthy births from couples previously considered infertile. IVF has had a dramatic impact on the treatment of male infertility. In the past, using a sperm donor was often the only hope in cases of male infertility. Intracytoplasmic sperm injection (ICSI) was introduced in the 1990's and opened the door for successful conception in couples with moderate to severe male factor infertility.
IVF with ICSI is now the mainstay treatment for moderate to severe male infertility. IVF / ICSI involves inserting a single sperm directly into the egg. The sperm is usually obtained from the ejaculate; however, it can also be obtained directly from the male reproductive tract including the testicles. IVF makes it possible for men with no sperm in their ejaculate to father healthy genetically related children. IVF with ICSI also enables men with severe spinal cord disorders to father children.
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 in the IVF cycle, the eggs may be frozen for a future cycle, or used in the current cycle. If they are used in the current cycle, they are fertilized and allowed to mature.
IVF using an egg donor requires that the recipient mother receive medications, such as progesterone, to prepare her endometrium to accept the developing embryos. Essentially, her cycle is synched with the egg donors. When the embryos mature and are ready for transfer, they will be placed into the recipient mother's uterus. Donor Success rates are equal to the  age group of the donor and are typically high.
IVF patients must come to our office for ultrasound evaluations and estradiol hormone measurements. Ultrasound is used to view follicular development, measure the endometrial lining, and examine the uterus. Estradiol hormone measurements are an indication that healthy follicles are developing and help avoid potentially serious side effects.
IVF egg retrieval is conducted using transvaginal guided ultrasound while the patient is under general anesthesia. An injection of hCG is given prior to the retrieval to finally prepare the eggs. 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.
If IVF with ICSI is scheduled, a sperm will be inserted directly into each egg. Otherwise the eggs are exposed to the sperm and fertilization is allowed to occur.
Once the eggs are fertilized, now embryos, they are transferred to the incubator. In most IVF cycles, the eggs will be incubated for 3-5 days. Oftentimes, embryos have differentiated into the blastocyst stage by day 5 and blastocysts are heartier and more likely to implant and develop. For these reasons, fewer blastocysts can usually be transferred lowering the rate of multiple births.
IVF embryo transfer to the uterus occurs once the embryos mature a painless procedure conducted at our office. The patient is given progesterone to insure proper endometrial (lining of the uterus) development. It must thicken and become more vascular to support the developing fetus.
IVF has been conducted thousands of times and is responsible for innumerable births. Long range studies indicate there is no increased risk for birth defects or other abnormalities in children born from the procedure.
Our IVF success rates exceed the national averages. Please see our “Success Rates” page which is filed with the Society of Assisted Reproductive Technologies and the Centers for Disease Control.
Be Sure and Visit Our IVF Web Site which Contains More Extensive Information About ART Procedures Including IVF, Donor Egg, ICSI, Egg Freezing, PGD, and More.
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