Soft-IVF™ Protocol

In Vitro Fertilization is one of the most effective treatments available to help infertile patients achieve pregnancy.

 

Compared with conventional IVF, Soft-IVF™ uses much milder stimulation of the ovaries which, for some patients, can result in the development of higher quality eggs.

 

There is a significant reduction in the treatment cost and the number of office visits (typically three to five). Soft-IVF eliminates much of the dangers of ovarian hyperstimulation and minimizes the risk of a high multiple pregnancy (triplets and more). It can be a very effective treatment for male factor infertility.

 

Most patients should expect a 25% to 33% probability of a successful pregnancy per Soft-IVF procedure.

 

Soft-IVF treatment consists of:

1. Ovarian stimulation to induce growth of multiple eggs within the ovaries
2. Ultrasound guided egg retrieval
3. Fertilization of the egg(s)
4. Transfer of the fertilized egg(s) into the uterus
5. Establishment of pregnancy

This is an example of a Soft-IVF treatment sequence. Actual treatment is individualized:

 

 

1. Ovarian Stimulation

    

   Soft-IVF treatment begins with the onset of a menstrual period. Oral contraceptives are used initially to prime the ovaries for optimal response. An ultrasound is done the day after your last oral contraceptive pill to rule out any ovarian cysts (very unlikely). Your menstrual period will start approximately three days after your last oral contraceptive pill. The start of this period is day one of your new menstrual cycle.

    

   In the morning of cycle day three, you will have a Lupron injection. The volume of the Lupron injection is very small and it is given subcutaneously (just under the skin). Lupron starts the ovarian stimulation. It has minimal, if any, side effects, most commonly transient headaches. Localized skin reaction at the injection site may also occur.

    

   In the evening of cycle day three, you will start taking Clomid tablets daily for a total of eight days (cycle day three to ten). Ovarian stimulation typically results in the development of two to five eggs within the ovaries. Most women should not expect side-effects with Clomid. The most common Clomid side-effects (10% probability) are hot flashes and mood swings (feeling more emotionally sensitive, tearful, or even depressed or anxious).

    

   The male partner starts taking oral antibiotics (Doxycycline) on cycle day six to reduce the possibility of bacterial contamination of the sperm. He takes the antibiotic through the day before the egg retrieval procedure. The female partner starts Doxycycline on cycle day ten to reduce the possibility of bacterial contamination during the egg retrieval and embryo transfer procedures. She takes the antibiotic through the day after the egg retrieval procedure. Common side effects are transient nausea and the possibility of vomiting, especially if the medication is taken on an empty stomach.

    

   An ultrasound is performed on cycle day eleven to assess the number and size of the developing ovarian follicles (grape-like “blisters” containing eggs). You may need one or more additional days of Clomid and ultrasounds. Once the size of the follicles indicates that the eggs are ready, you will have a subcutaneous injection of Human Chorionic Gonadotropin hormone (HCG). This medication triggers the final stage of egg maturation. Thirty-five hours after the HCG injection, the eggs are aspirated from the ovaries. HCG typically does not have any side-effects.

    

2. Ultrasound Guided Transvaginal Egg Retrieval

    

   Using ultrasound guidance, the tip of a thin aspirating needle is passed through the top of the vagina into the cul-de-sac (a space behind the uterus). The ovaries are located near the bottom of the cul-de-sac allowing the tip of the aspirating needle to enter the ovarian follicles and aspirate the follicular fluid from them. The fluid is examined under a microscope to identify the eggs.

    

   The egg retrieval takes approximately five minutes. Medications are used for pain relief. It is possible to have a short lasting menstrual-like cramp sensation when the tip of the needle passes through the top of the vagina (once for each ovary). The actual follicle aspiration is typically not felt by the patient. Egg retrieval is a very safe procedure.

    

3. IVF Laboratory

    

   On average, two to four eggs are aspirated during the egg retrieval procedure. Eggs are identified under a microscope and placed in culture medium filled petri dishes. The composition of the medium resembles the fluid secreted by the Fallopian tubes.

    

   The male partner collects a semen specimen by masturbation the morning of the egg retrieval. Following the egg retrieval, the highest quality sperm are extracted from the semen sample and Intracytoplasmic Sperm Injection (ICSI) is performed to maximize the probability of normal fertilization. If there are enough eggs available, a combination of ICSI and in vitro type of fertilization is performed. With in vitro fertilization, each egg has 50,000 of the highest quality sperm added to it, and overnight, one of the sperm should penetrate the egg shell and fertilize the egg.

    

   ICSI is a very precise micromanipulation procedure in which a single live sperm is inserted directly into the center of an egg. ICSI has been used extensively in Advanced Reproductive Treatments (ART) since 1993. Studies show that the incidence of congenital abnormalities (birth defects) following ICSI appears to be no higher than that of the general ART population. This observation is based on the experience of tens of thousands of babies born worldwide using ICSI.

    

   Evidence of fertilization can be seen the next day, 14 to 16 hours after insemination. The fertilized eggs are transferred into growth medium and continue to be cultured in the IVF laboratory.

    

4. Embryo Transfer

    

   The embryo transfer is performed one to five days after the egg retrieval. The Gamete Embryologists assess the embryos prior to the embryo transfer to determine their likelihood of implantation. The embryo(s) is/are "loaded" into the tip of a very thin embryo transfer catheter with a very small volume of transfer medium. The catheter is then passed through the cervical canal to within 5 mm of the top of the uterus and the embryo(s) are gently released. The transfer usually takes only a few seconds to complete. The front and back walls of the uterus will gently hold the embryos in place. No resting is required afterwards and you can immediately resume your normal lifestyle. There is no restriction on your sexual or physical activity.

    

   Most partners usually select one to three embryos for the transfer. Approximately 20% of Soft-IVF pregnancies are twins and there are very few triplet or higher order pregnancies.

    

   If there are more embryos available on the day of the embryo transfer than the number of embryos you wish to have transferred, these extra embryos can be further cultured to a blastocyst (day 5 embryo), cryopreserved, and stored in liquid nitrogen for potential future use.

    

5. Establishment of Pregnancy

    

   The lining of the uterus is made receptive for the embryos through the action of the hormones estrogen and progesterone produced by the ovaries. Ovarian progesterone production is supplemented with three Lupron injections identical to the Lupron injection you took at the beginning of your ovarian stimulation.

    

   A blood pregnancy test is done approximately fourteen days after the egg retrieval. If the pregnancy test is positive, an ultrasound examination is scheduled two weeks later to visualize the implantation site and to look for a heartbeat. Once a heartbeat is seen, there is a 90% to 95% probability that the pregnancy will continue successfully. From this point on, the pregnancy becomes indistinguishable from a pregnancy conceived through intercourse.

If you have any questions regarding Soft-IVF or to request an appointment, please contact us by phone at 650-322-0500, via email at care@BayIVF.com, or use the Contact Bay IVF Center form on this page.

 

Please visit softivf.com for additional information related to the Soft-IVF treatment.