Our Services & Treatments
In Vitro Fertilization – Embryo Transfer (IVF / ICSI -ET)
In Vitro Fertilization is commonly referred to as IVF. IVF is the process of fertilization by manually combining an egg and sperm in a laboratory dish. When the IVF procedure is successful, the process is combined with a procedure known as embryo transfer , which involves physically placing the embryo in the uterus.
What is involved with in vitro fertilization?
There are five basic steps in the IVF and embryo transfer process which include the following:
Monitor and stimulate the development of healthy egg(s) in the ovaries.
Collect the eggs.
Secure the sperm.
Combine the eggs and sperm together in the laboratory and provide the appropriate environment for fertilization and early embryo growth.
Transfer embryos into the uterus.
Frequently Asked Questions
Below is a Graphical Illustration of In Vitro Fertilization – Embryo Transfer (IVF / ICSI -ET)
> Representation of an Oocyte Retrieval (Merck-Serono)
> Representation of an Embryo Transfer (Merck-Serono)
STEP 1: Fertility medications are prescribed to control the timing of the egg ripening and to increase the chance of collecting multiple eggs during one of the woman's cycles. This is often referred to as controlled ovarian hyperstimulation and involves using a number of protocols which would have been chosen for the patient. At BART the majority of our patients use the Short Protocol. The stimulating injections are usual given for a period of of 8 to 10days. Multiple eggs are desired because some eggs will not develop or fertilize after retrieval. Egg development is monitored using ultrasound to examine the ovaries, and blood test are done to check hormone levels. When 3 or more eggs are larger then 18mm, a tigger is given to induce ovulation (Medication: Ovidrel).
STEP 2: Eggs are retrieved through a minor surgical procedure that uses ultrasound imaging to guide a hollow needle through the pelvic cavity. Sedation and local anaesthesia are provided to reduce and remove potential discomfort. The eggs are removed from the ovaries in a procedure called follicular aspiration or oocyte pickup. Some women may experience cramping on the day of retrieval, which usually subsides the following day; however, a feeling of fullness or pressure may continue for several days following the procedure.
STEP 3: Sperm, usually obtained by ejaculation is prepared for combining with the eggs.
STEP 4: In a process called insemination, the sperm and eggs are placed next to each other in an incubator located in the laboratory. The incubators enable fertilization to occur.
In some cases where there is a lower probability of fertilization, Intracytoplasmic Sperm Injection (ICSI) may be used. Through this procedure, a single sperm is injected directly into the egg in an attempt to achieve fertilization. At BART we prefer to do ICSI on most of our cases. The eggs are monitored to confirm that fertilization and cell division are taking place. Once this occurs, the fertilized eggs are considered to be embryos. The woman has to start using her drugs for luteal phase support from the day of the retrieval
STEP 5: The embryos are usually transferred into the woman's uterus from three to five days later, but in most cases the transfer occurs between three to five days following egg retrieval. At this stage, the fertilized egg has developed into a six-to-eight cell embryo (for a Day 3 transfer) or a blastocyst (for a Day 5 transfer). The transfer process involves a speculum which is inserted into the vagina to expose the cervix. A predetermined number of embryos (generally between 2 - 3 embryos) are loaded into a catheter. This catheter is then inserted into the womb and the embryos are released. This process is often guided by ultrasound. The procedure is usually painless, but some women experience mild cramping. These steps are followed by rest and specific post embryo transfer medications for 12 days. That is Gestone, Cyclogest, Meticortin, Proganova, Ecotrin and Folic acid. 12 days after the embryo transfer, a pregnancy test is performed via a blood test.