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Understanding IVF at TRIO 1/3

What Is IVF?

In Vitro Fertilization is the process of retrieving eggs from the ovaries and fertilizing these eggs with sperm. The fertilized eggs are then placed in an incubator for 5 days and then transferred to a uterus for pregnancy or cryopreserved for transfer at a later date. The goal of an IVF cycle is to produce one healthy baby.

What Should I Expect in an IVF Cycle?

Before your IVF cycle begins, blood tests have to be up to date. We rule out infectious diseases. You and your TRIO doctor will also discuss IVF or IVF with ICSI. And, you will discuss the medication protocol that you are going to be on. Your doctor will create a personalized treatment protocol.

At TRIO, we try to replicate the natural reproductive process as much as possible, so it’s important that you understand what happens in a normal menstrual cycle. Each month, the pituitary gland secretes FSH or Follicle Stimulating Hormone which stimulates the ovary to grow a follicle. That follicle contains one egg that is maturing. As the egg matures, the cells around it produce estrogen. As estrogen rises, the follicle continues to grow. Once the follicle reaches a certain size and the estrogen reaches its peak level, a signal back to the pituitary tells it to start secreting LH or luteinizing hormone rather than FSH. When the LH surge occurs, ovulation occurs.

When you are ready to start, you’ll call the clinic. Throughout the cycle, you’ll work closely with your TRIO team which includes your doctor, your nurse, and your patient liaison, a valuable resource who can answer any questions you might have. This team will explain in detail what to expect and show you how to administer fertility medication that has been prescribed for you. In addition, it is mandatory to see one of TRIO’s counsellors before you start an IVF cycle. Our counsellors specialize in fertility issues and are available to teach you coping strategies to get through the highs and lows of an IVF cycle. Studies prove patients who see a counsellor before IVF have a much better experience. We also offer a relatively new service, on-line patient support groups that are moderated by one of our counsellors. These have proven to be very popular and very helpful to many of our patients.

On your first treatment day, you’ll start your fertility medication. You’ll take these medications for approximately ten to twelve days. During that time, you’ll be asked to come to the clinic four to six times for blood tests and ultrasounds. We are monitoring the effects of the medication, so specifics such as the tests and the number of days for tests you’ll be required to come in will depend on your personal cycle. After each visit to the clinic, you’ll receive information about next steps on your iMineIVF app.

Every IVF cycle is unique, for example, if you come in for your blood and your ultrasound on day 11 of the cycle and we see that your follicles are the right size and your estrogen is at the right level, we may tell you to give yourself a late night injection of HCG which matures the eggs. We know that in approximately 38 hours all of those follicles will release the eggs, so in 35 to 36 hours we schedule your egg retrieval.

Egg Retrieval

On the same day, before retrieval begins, a sperm sample is required. The egg retrieval procedure itself takes about 20 minutes. You will be given medication for pain and sedation. We put a speculum inside the vagina and clean off the cervix. We use the same ultrasound technique we use during cycle monitoring to visualize the ovaries. We put a needle onto the end of the ultrasound to collect the eggs along with the follicular fluid which will end up in a test tube. This test tube will go immediately to the lab where the eggs will be counted. Before you leave that day, you will know exactly how many eggs you have. After the retrieval you’ll go back to the recovery room. You’ll stay there until you are ready to go home. We ask that you go home and go to bed because you are going to be tired and may experience after effects from the sedation. For the next 24 hours you should not drive, consume alcohol, or take other sedatives. Later that that day in the lab, your eggs will be fertilized. Over the next three days we will call and tell you how your embryos are doing, and when to come in for your embryo transfer.

Embryo Transfer

The transfer procedure takes about 10 to 15 minutes. The most uncomfortable part of the procedure is you have to have a full bladder because an ultrasound is performed. We will insert a speculum, cleanse your cervix and the embryos will be placed in the upper portion of the uterus using an embryo transfer catheter. You’ll be able to watch it happen on the ultrasound monitor. After the embryos are placed, we will slowly remove the catheter, and it will go back to the lab to ensure the embryos didn’t stick to the catheter. After the procedure you’ll go back to the recovery room where you’ll be able to empty your bladder and go home soon after. Following the embryo transfer, every woman patient will be on some form of progesterone continuing into the first trimester of pregnancy. You should consider yourself pregnant after your embryo transfer. You shouldn’t consume alcohol or drugs, and you should make sure that if you need medications your doctor knows that you could be pregnant.