In Vitro Fertilization (IVF)

What is IVF?

In vitro fertilization involves removing eggs from the ovaries, fertilizing them in the laboratory and then replacing the embryos into the uterus where they implant and mature.

Who qualifies for IVF?

IVF was originally designed to help women with blocked or absent fallopian tubes. Today, IVF has proven successful for couples with unexplained infertility, ovulation disorders, endometriosis and male factor problems.

What is the history of IVF?

This procedure was pioneered in England by the late Dr. Patrick Steptoe and Dr. Robert Edwards. They successfully delivered Louise Brown in 1978, the world's first test tube baby.

What is the success rate of IVF?

Modern fertility medicine has come a long way. In 2001, about 29% of patients undergoing IVF (or ICSI) achieve a pregnancy in Canada. Fast forward seven years and that number is almost 40%. This percentage is significantly better than a normal fertile couple trying to achieve pregnancy in any one cycle, and even better for couples with unexplained subfertility. Furthermore, at TCART, we are striving to provide results better than this Canadian average. Please come in for an appointment to discuss our latest statistics, and how they may apply to you.

What are the risks of IVF?

Multiple pregnancy is the most common complication occurring in about 20% of IVF cases. However, in most cases the pregnancy is a singleton.

In 1-3% of cases, there is a risk of ovarian hyperstimulation syndrome, which is characterized by ovarian enlargement accompanied by fluid accumulation in the abdomen.

As with any surgical procedure, there are certain risks involved. These may include bleeding, infection and allergic reactions. Please consult your physician for further information.

THE PROCEDURE:

Ovarian Stimulation

Various hormone medications are administered in the treatment cycle. Their purpose is to:

Enhance the growth and maturation of several follicles, thereby improving chances for fertilization
Control the timing of ovulation so eggs can be retrieved before they are spontaneously released

Monitoring

IVF cycles are monitored by vaginal ultrasound and by blood hormone tests. Monitoring is necessary to assess the growth and development of the follicles and to avoid the possibility of Ovarian Hyperstimulation Syndrome.

Through ultrasound, your physician can count and measure each developing follicle. As follicles get larger, the ultrasound provides an indicator of approaching ovulation.

As follicles develop, they secrete increasing amounts of estradiol (E2). In general, the higher the E2 level, the more follicles develop.

Egg Retrieval

The patient is awake for the procedure, however, they are given medication that will make them slightly groggy. To collect the mature eggs, an ultrasound probe is placed in the vagina. A needle is attached to this probe and passed through the vaginal wall into the ovaries. The fluid from each follicle is aspirated to collect all the eggs.

In Vitro Fertilization

The semen specimen is collected prior to egg retrieval and prepared for insemination. The eggs are inseminated with the sperm and incubated for 48 hours.

Embryo Transfer

Approximately 3 to 5 days after retrieval, if the eggs have fertilized and are developing normally, embryo transfer will take place. This is a simple procedure and requires no anesthesia. A catheter is inserted into the uterus, through the cervix, and the embryos are injected into the uterine cavity under ultrasound guidance.