IVF is one of the most commonly known, and commonly used treatment methods to achieve pregnancy for those individuals suffering from infertility.
During conception, the egg, which is released from the ovary, is fertilized by a sperm in a female's fallopian tube. Through IVF, the fertilization process occurs in a laboratory, where embryologists:
First steps fertility is pleased to be part of the Ontario Ministry of Health funding program. This will pay the cost of the IVF cycle, including embryo transfers. It does not cover the cost of medication. Speak to Dr. Weisberg about putting your name on the list.
Unlike a natural cycle where one egg is produced each month, with IVF we teach patients to administer hormones that will produce multiple eggs.
The patient's response to the drugs are monitored over the next 10 to 12 days, via vaginal ultrasound and blood work. The first session is three or four days after the patient has started injections, and continues at least every other day until she is ready for egg retrieval.
Though the IVF process has proven successful in most cases, it's important to note that up to 10% of patients do not respond to the medications as planned. In this instance, Dr. Weisberg will let you know whether the treatment should be canceled or converted to an Inter-Uterine Insemination cycle.
Once your test results show a number of follicles inside your ovaries have reached a diameter of about 2 cm, the egg retrieval procedure is scheduled. 34 to 36 hours prior to the time for the egg retrieval, the patient is informed to take an injection of a medication that will induce the final maturation of her eggs.
Once retrieval is complete, the test tubes will be sent to an embryology lab where technicians will examine the fluid in the test tubes to identify and remove all eggs.
Some discomfort after the egg retrieval process is normal, and can be relieved with rest, a heating pad or hot water bottle, or pain relievers. Patients who experience pain for more than two days after the procedure are encouraged to contact Dr. Weisberg.
Fertilization of the retrieved eggs occurs a few hours after egg retrieval and may utilize either a fresh sperm sample, which will be produced on the day of the retrieval, or frozen sperm.
The lab assesses the eggs prior to fertilization and only the eggs that are mature, will be injected with sperm.
In general, a normal sperm sample can result in approximately 70 to 80% of the eggs being fertilized. However, it is important to note that not all eggs collected will be fertilized, or result in a high quality embryos.
Once embryos have grown to day 5 or 6, the embryos will be frozen and used during a transfer cycle. First Steps Fertility does not do fresh embryo transfers. The woman’s body needs to have a chance to recover from the hormone injections and high estrogen levels. It also needs the time to prepare a perfect lining of the uterus.
During the cycle for the embryo transfer, estrogen is used to thicken the lining of the uterus. Once the lining reaches a certain thickness, progesterone is added to prepare the lining for implantation.
After embryo transfer, you are advised to take it easy for the next 24 hours. This does not mean bed rest, which has been shown to decrease pregnancy rates. It is recommended that you return to your usual level of activity, but without exercise.
Two weeks after the transfer, you will return to the clinic for a pregnancy test. Once a healthy pregnancy has been confirmed via ultrasound, Dr. Weisberg will discuss prenatal care options with you.
Pre-implantation Genetic Screening and Diagnosis Testing (PGS & PGD) look at embryos for specific genetic diseases that can be transmitted to a child from their parents. Both PGS and PGD have been shown to increase the chances of pregnancy, minimize risk of pregnancy loss, and afford the parents a chance to avoid undesired genetic traits.
PGS screens for an abnormal number of chromosomes, and is recommended more often by fertility specialists when discussing infertility due to advanced maternal age, repeated IVF failures, recurring pregnancy losses, or those with a history of genetically abnormal pregnancies.
PGD is used to diagnose a single gene defect in the embryo for couples known to have a single gene mutation, to ensure the child will not have the disease. Most commonly, this group of patients has a 25 to 50% risk of transmitting a significant medical illness to their child.
Based on your medical history, Dr. Weisberg may discuss this specialized testing with you at the time you are considering undergoing IVF.