In Vitro Fertilization

In Vitro Fertilization (IVF) is one of the most effective treatments available to help infertile patients achieve pregnancy. Most patients should expect a 25% to 50% probability of a successful pregnancy per cycle of In Vitro Fertilization at Bay IVF Center.

 

We use gentle, individualized ovarian stimulation protocols. We strive for the highest egg quality rather than quantity. This approach decreases the likelihood of ovarian hyperstimulation without reducing the probability of a successful outcome.

 

Since the physician care at Bay IVF Center is free and we only bill for the laboratory portion of In Vitro Fertilization, our patients' IVF cost is substantially reduced compared to typical IVF fees.

 

You should consider IVF treatment if any of the following applies to you:

 

• History of tubal blockage and pelvic adhesions
• Male Factor Infertility
• Infertility associated with endometriosis
• Infertility associated with Polycystic Ovary Syndrome (PCO)
• Unexplained infertility
• Long-standing infertility: no contraception for more than a year and a half
• Decreasing “ovarian reserve”: IVF may be the most appropriate treatment for women over the age of 39.
• You did not become pregnant with intrauterine insemination (IUI) cycles.
• You did not become pregnant with ovarian stimulation cycles with oral or injectable medications.

 

In Vitro Fertilization Procedure

 

Your ovaries are stimulated to produce multiple eggs, the eggs are retrieved, inseminated with sperm from your partner, incubated, and one or more of the resulting embryos are transferred into the uterus.

 

 

Medications are given as pills (oral contraceptives), vaginal capsules (progesterone), or very small injections just under the skin (Lupron, FSH, HCG).

 

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

 

 

 

In Vitro Fertilization treatment consists of the following five steps:

1. Ovarian Stimulation

    

   Lupron hormone injections are used to temporarily stop one’s own Follicle Stimulating Hormone (FSH) production to create a “clean slate” for ovarian stimulation. FSH injections are then added to stimulate production of high quality eggs (usually 6-14 eggs).

    

   During the 8 to 12 day ovarian stimulation, two to four ultrasound examinations and blood estrogen tests will be needed to follow the development of the eggs.

    

   When the eggs have become sufficiently mature, you will take an injection of Human Chorionic Gonadotropin (HCG) hormone. This medication completes the maturation process of the eggs.

    

   The ultrasound image below shows a stimulated ovary. Each of the grape-like follicles (dark circles) contains a microscopic egg.

    

   

    

    

2. Egg Retrieval

    

   Thirty-six hours after the HCG injection, the egg retrieval procedure is performed in our center. This is normally a 5 to 10 minute procedure. We use conscious sedation for analgesia, and your partner is invited to join you for the egg retrieval.

    

   Using ultrasound guidance, a thin aspirating needle is passed through the top of the vagina into the follicles. Only the tip of the aspirating needle enters the follicles and the follicular fluid is aspirated from them. The fluid is examined under a microscope to identify the eggs. Since the ovaries are located just above the vagina, the tip of the needle does not penetrate the uterus, cervix, or the Fallopian tubes.

    

3. Fertilization

    

   The male partner collects a semen sample by masturbation either at home or at our center and the highest quality sperm are added to the eggs six hours after the egg retrieval. During the subsequent overnight incubation, sperm penetrate the egg shell and fertilize the eggs.

    

   If your infertility history suggests the possibility of male infertility significant enough to keep the eggs from being fertilized using this method, you will be scheduled for Intracytoplasmic Sperm Injection (ICSI) procedure. In ICSI, a single sperm is inserted directly into an egg using micromanipulators.

    

   The next day, the eggs are examined for signs of fertilization. A normally fertilized egg (zygote) will show two pronuclei representing the genetic material from the egg and sperm (see images below).

    

   The following day, embryos reach 4 cells, the day after, 8 cells and by the fifth day after the egg retrieval, the embryos should reach the blastocyst stage.

     Fertilized Egg

  Four Cell Embryo

   Eight Cell Embryo

       Blastocyst

4. Embryo Transfer

    

   One to five days after the egg retrieval, the resulting embryo(s) is/are transferred into the uterus by passing a thin embryo transfer catheter through the cervix to the top of the uterus. This is a quick procedure that does not require any pain medications. You will be able to decide the number of embryos to transfer.

    

   Additional embryos that are not transferred at this time can be cryopreserved and stored in liquid nitrogen for potential future use.

    

5. Establishment of Pregnancy

    

   Progesterone is given for luteal phase support. A blood pregnancy test is scheduled two weeks after the egg retrieval. A fetal heartbeat ultrasound is performed two weeks and two days after a positive pregnancy test.

   

    

   The ultrasound picture on the left shows a six week pregnancy. The pregnancy sac is approximately 25 mm in diameter. The baby inside the sac is about 13 mm long, and yet it is possible to already distinguish the head and the "tail" portion of the baby's body as well as strong cardiac activity.

    

   At this point, your pregnancy becomes indistinguishable from a conception through intercourse.

For additional in-depth information, please see IVF Treatment Protocol, Pregnancy Probability, IVF Cost, and IVF Prerequisites.

 

If you have any questions regarding In Vitro Fertilization 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.