IVF Procedure Cambridge MA
Embryo transfer is the final "stage" of the IVF procedure. Once embryos have been transferred to the patient's uterus, all she can do is wait and hope that at least one of them will implant in her uterine lining and grow into a baby. Transfer takes place after the eggs have been retrieved from her ovaries and fertilized using sperm from her partner or from a donor in the laboratory.
Preparing The Uterus
To increase the chances of successful embryo implantation, a woman may need some help in the form of drugs to encourage her uterine lining, or endometrium, to thicken and get ready to receive an embryo. Normally, this thickening of the uterus occurs during the ovulation-inducing process . The fertility doctors at the woman's clinic will monitor the progress of her uterine lining using ultrasound scans. If it seems to be too thin, they'll prescribe her some estrogen and progesterone - these are hormones that encourage growth of the endometrium.
After fertilization takes place, the embryos are usually left for 2 to 3 days to develop before transfer. Embryos have usually divided to form between 2 to 8 cells before they are transferred to the uterus. Sometimes they can be left for a few more days to develop more and grow stronger - this is called a blastocyst transfer.
Embryo transfer is usually painless although some women do report some mild cramping. If you're someone who usually feels discomfort during a Pap smear test, you may want to request a mild sedative before the procedure, because just like a Pap smear test, embryo transfer requires the opening up of the cervix using a speculum.
Transfer is carried out in conjunction with an abdominal ultrasound exam. The doctor performing the procedure takes a transfer catheter loaded with the embryos and inserts it through the vagina and cervix until it reaches the top or "fundus" of the uterus. He simultaneously watches what he's doing on the ultrasound screen. He then expels the embryos from the catheter and withdraws it. The hope is that one of the embryos will implant and the patient will become pregnant.
Number Of Embryos
It is only ethical that fertility doctors limit the number of embryos transferred to the uterus, because if more than one implants and a multiple pregnancy is conceived, both mother and babies will be at risk. Most doctors will therefore transfer no more than 3 embryos at one time. The older the patient, the more embryos are usuall...
IVF procedure may differ from case to case, because each couple suffering from reduced fertility has their own individual set of circumstances. The fertility specialist overseeing the progress of an IVF treatment cycle will make decisions about procedure based on the female partner's overall health, the reasons for the couple's infertility, and the number of eggs produced during the treatment process, as well as a number of other factors.
Basic IVF procedure consists of several treatment stages, all of which usually take place.
IVF procedure generally begins with a regime of hormone treatment for the female partner lasting several days. The aim is to suppress her natural menstrual cycle and induce ovulation at a time determined by her fertility specialist. Different drugs will be prescribed for different women.
Also referred to as egg harvesting, egg retrieval involves removing mature eggs from the female partner's ovaries just before ovulation takes place.
At the fertilization stage, sperm cells from the male partner's semen sample are put into a Petri dish, in a laboratory, along with the female partner's eggs. The aim is to give the sperm cells a better chance of fertilizing the eggs.
At this stage in the procedure, fertilized eggs (which are now embryos) are transferred back to the female partner's uterus. The aim is to have at least one of the embryos implant in her uterine lining and grow into a healthy baby.
Variations In Procedure
There are many reasons why a fertility specialist may decide to introduce an additional element to IVF procedure in order to boost a couple's chances of success. For example:
Assisted hatching - this may be required to better prepare the eggs for fertilization.
Progesterone supplements - when introduced at the right time, these can help thicken the uterine lining in preparation for embryo transfer.
Blastocyst transfer - in this procedure, the fertilized embryos are given more time to mature and strengthen before they are transferred to the uterus.
Egg freezing and storage - this may be recommended to women whose ovaries produce only a few eggs during the IVF procedure.
Embryo freezing and storage - embryos can be preserved and used in future IVF procedures.
ICSI and IMSI - these methods of fertilization are recommended to couples who are affected by male factor infertility.
IVF Procedure Risks...
The first day your menstrual flow kicks into full force, you'll pick up the phone and call the doctor. On the second or third day of your cycle, you'll be given a baseline blood test and an ultrasound. Assuming all looks good, you'll be told to stop taking your fertility medications.
You'll be placed on gonadotropin medications that contain FSH for a period of 4-5 nights. On the fifth or sixth day of this stimulation medication, you'll come in for another ultrasound and blood test. The doctor will now be on the lookout for signs that the eggs have matured and that you are ready for egg retrieval.
After the fifth or sixth day of stimulation, GnRH antagonists such as Cetrotide or Antagon will be added to the regimen to block premature ovulation. By day seven or eight, the dose of FSH is lowered and replaced instead with a low dose of hCG.
In most cases, a woman will be ready to receive the injection that will trigger ovulation on the ninth or tenth day of her cycle. Egg retrieval is performed two days later. Antibiotic pills will be administered to cut down your risk of infection and after retrieval you'll be given one more dose of antibiotics.
Progesterone is then administered. Some physicians prefer to give the medication both by intramuscular injection and by vaginal ointment or suppository, as well.
Embryo transfer is done on the fifth day after the eggs have been retrieved. The progesterone is continued and you'll be given a pregnancy test one week after the transfer .
That's the gist of the basics and the scheduling of IVF . However, the procedure can seem baffling to a person who hasn't the benefit of a medical degree. The ultrasound is a good example of a puzzling aspect of IVF. Can it be that the doctor counted 20 eggs during the ultrasound?
Women are often surprised to hear the count during an ultrasound test. But this count doesn't represent the number of eggs that are found. The black circles that are seen on the ultrasound are follicles. These follicles should not be confused with eggs. Follicles are ovarian cysts that contain fluid and the developing eggs.
As the eggs grow to maturity, the follicles begin to produce more and more fluid so that they become much larger. The eggs themselves cannot be seen on an ultrasound, only these swollen follicles. In the course of an egg retrieval procedure, the doctor aspirates the fluid from the follicles with a needl...