In Vitro Fertilization

In vitro fertilization and embryo transfer (IVF) is the fertilization of an egg outside the body with sperm and transfer of the resulting embryo into the uterus. Fertility medicines are used to stimulate many eggs to grow in the woman’s ovaries. Your progress is carefully monitored with blood work and transvaginal ultrasonography. When the eggs are ready for collection, a transvaginal oocyte retrieval is scheduled in our Edison facility under anesthesia. Eggs are then fertilized and allowed to grow in culture for 5 days. If the male partner has an abnormal semen analysis, we may need to assist fertilization in the IVF Lab in a process called Intra-Cytoplasmic Sperm Injection (ICSI). One or more embryos are then transferred into the woman’s uterus during the embryo transfer procedure. Embryos are transferred to the uterus either fresh or frozen.

IVF is our most successful procedure and will produce a pregnancy rate up to 4 times higher than intrauterine insemination (IUI). IVF is often the best approach for patients who have failed traditional infertility treatments. Patients who may benefit from IVF include those with:

• Severe sperm problems
• Endometriosis
• Damaged fallopian tubes
• Ovulation problems unresponsive to medications
• Unexplained infertility
• Poor egg quality or number

1. An individualized IVF plan is created by your ARM physician after your initial evaluation is completed. Your medical history, age, and test results are taken into consideration to design a plan that will maximize your chance for success. Your Fertility Coach is available to support you throughout this process.
2. Ovarian Stimulation: in order to produce multiple eggs during IVF, fertility medications are needed to stimulate the growth of many ovarian follicles. You will be carefully monitored during this time with hormone blood tests and ultrasound. Once the eggs are ready for collection, you will be given a special injection to mature them.
3. Egg Retrieval: The eggs are collected using vaginal ultrasound in a minor outpatient procedure in our Edison facility. Our anesthesia team will provide light anesthesia to make sure you are comfortable.
4. Embryo Culture: Soon after your eggs are collected, our embryology team will inseminate the eggs with sperm and begin embryo culture. If sperm quality is abnormal, sperm may need to be injected into the eggs to assist fertilization (ICSI). Fertilized eggs (now called embryos) form and will be transferred to a special incubator for 5 days of culture under careful observation.
5. Selecting Embryos for Transfer: By day 5 of culture we hope to see a normal-appearing embryo with many cells called a blastocyst. It is at this point that many patients consider testing their embryo(s) with genetic studies to see if the correct number of chromosomes are present. This is called CCS or Comprehensive Chromosomal Screening. Genetic studies are also done for couples with a risk of passing on a genetic disorder to their child. CCS helps us determine which embryos have the correct amount of genetic material and are likely to successfully implant in the uterus. These euploid embryos have a high potential to implant (60-70%) and produce a pregnancy that is less likely to miscarry. CCS also allows us to reduce the number of embryos transferred so that you are more likely to have a single-baby pregnancy. And that usually means a safer pregnancy.
6. Embryo Transfer: This is traditionally done on day 5 as a “fresh” embryo transfer. More recently, many of our patients choose to freeze all their embryos as this allows genetic embryo biopsy and may increase the success rate of IVF in the subsequent frozen embryo transfer cycle.
7. After Embryo Transfer: You will be on hormones to support the uterine lining and promote implantation. About 11-12 days after embryo transfer you will have a blood test to see if your IVF cycle was successful. If pregnancy is confirmed, you’ll continue hormone support and be given further instructions from the IVF team.