In the United States alone, close to 1 percent of all babies are born through IVF each year. In fact, over three million babies in the world have been born in this manner. Chances are that if you’re successful with IVF, your child will most likely have schoolmates who were conceived the same way. If you’re like most people though, you may be wondering, what is IVF?
IVF basically means the fertilization of the egg and sperm outside the body. Your infertility doctor can accomplish this by first having you take daily injections that will help produce hopefully around ten to fifteen eggs, depending on your profile. Although the thought of injecting yourself may scare you, most everyone learns how to self-inject after some instruction.
Your infertility doctor will then monitor the rate of growth of the follicles (the sac that contains the egg) via ultrasounds. Once the follicles are noted to be anywhere between 18-22mm, the eggs are then matured via a separate injection given called hCG. The time of hCG administration is critical since ovulation will occur anywhere between thirty-six to forty-two hours after the hCG was given. Your clinical coordinator will tell you specifically at what time to take the medication.
Right before you are expected to ovulate, your infertility doctor will then extract the eggs from the ovaries usually with a needle placed through vagina while you are anesthetized. The eggs are placed in a Petri dish and fertilized with sperm. The embryos are grown and cultivated in an incubator usually for either three days or five days. A few of the embryos are then transferred back into the uterine cavity by placing a speculum like a regular pap smear and passing a catheter through the cervical canal and into the uterus.
If there are any embryos that were not transferred back, then most laboratories will attempt to freeze and store them for later use. Most of the time, if you do not deliver a baby after the first attempt, then the second time you can simply thaw a few of the frozen embryos and have these transferred back without having to undergo the whole IVF process. But say you do get pregnant and deliver a child after the first attempt and you have frozen embryos, these embryos can be thawed at a later date and transferred back into your uterine cavity to provide a sibling for your child.
If this process sounds complicated, you will be guided every step of the way and a detailed daily calendar will be provided to you by your fertility center to help make the process a lot easier.
How do you determine how many embryos to transfer and if they should be transferred at three or five days?
This is the million dollar question, and in an ideal world, only one embryo would be transferred which would yield one baby. Unfortunately, not all embryos are created equal. Different embryos can be of different quality. Now, please this is only an analogy and in by no means am I trying to make less of an embryo, but to help you understand, looking at embryos is like going to the fruit stand. You can tell if a fruit (whether avocado, peach, etc.) is overly ripe, a little damaged, or is simply perfect looking. Some people will have perfect embryos, and in this case and while considering other factors, only one embryo can be chosen to be transferred. If the embryos are not looking so hot, then maybe more embryos can be considered for transferred. The American Society for Reproductive Medicine (ASRM) has generic guidelines in which they recommend that women under thirty-five years of age should have one transferred, thirty-five to thirty-seven up to three embryos or two blastocysts, thirty-seven to forty-three embryos or two blastocysts, older than forty no more than five embryos or three blastocysts.