Under the care and direction of an experienced reproductive endocrinologist, a woman begins taking fertility medications to encourage the development of eggs within the ovaries. These medications increase the number of embryos ultimately available to be replaced by stimulating several follicles to produce more than one egg. Once multiple eggs have developed, an additional medication (a one time injection of hCG) is taken to help the eggs to mature. Once this process is complete the woman is ready to undergo what is commonly referred to as “egg retrieval” (typically performed 36 hours after hCG administration).
Egg retrieval is a minor surgical procedure that can be performed on an outpatient basis at Boston IVF's surgery center. It typically takes about an hour and requires general anesthesia. After the vaginal ultrasound is placed in the vagina and the ovarian follicles are located, a needle is directed through the back wall of the vagina and into the ovarian follicles. From here, the eggs are easily retrieved.
|Fertilization and Embryo Development
Once the eggs have been retrieved, they are carefully identified, labeled and taken to the lab. To begin the fertilization process, they are placed in a petri dish with a special solution for 2 to 3 hours. During this time, a semen sample is collected from the male partner and delivered to the lab where it undergoes a clarifying process referred to as “washing”, which isolates the healthiest sperm. Once the sperm are washed, they are incubated and placed in the petri dish with the eggs. Alternately, patients dealing with problems such as male factor may elect to use intracytoplasmic sperm injection (ICSI) to assist in the fertilization process. After 18 hours, the eggs are examined. If normal fertilization occurs, then two to four of the resulting embryos will be selected and returned to the woman's uterus in one to three days.
Embryo transfer is a simple procedure that does not require anesthesia, although we do perform them at our outpatient surgery center. Rest and recovery are recommended for 24 to 48 hours thereafter. The selected embryos are inserted into a thin tube and guided toward the woman's uterus, where it is hoped they will continue their natural fetal development. Any additional embryos not transferred can be frozen at this point and used in a later IVF cycle if pregnancy does not occur or a subsequent pregnancy is pursued.