Many couples achieve their dream of starting a family through in vitro fertilization (IVF). The earliest IVF cycles were done in the late 1970’s. Eggs are cultured on a plastic dish then fertilized by sperm. Placing the fertilized eggs into the female’s uterus is called embryo transfer. This is helpful for people facing a variety of fertility problems, including those who did not have success with artificial insemination.
Stimulating and Monitoring the Development of Follicles
The first step is administering fertility medications to boost the development of multiple eggs sacs in the women. Having more eggs is preferable because some eggs will not fertilize after being retrieved. Every few days the progress is monitored through blood tests and ultrasound.
A minor surgical procedure is performed to retrieve the eggs. The patient is under sedation while an ultrasound probe guides a hollow needle into the ovary. The fluids and egg are aspirated and forwarded to the IVF laboratory. Usually the procedure takes about 15 minutes. The woman may feel cramps or pressure for a few days afterward. Donor eggs may also be used for IVF. The donors go through a detailed screening process.
Usually the sperm is obtained through ejaculation. Minor surgical procedures can also be used to directly get sperm to combine with the retrieved eggs. Donor sperm is another option for IVF. Donors are carefully screened.
Combining the Eggs and Sperm
The eggs and sperm are put in incubators in the lab then watched for signs of fertilization. Sometimes sperm is directed directly into an egg. The embryos are observed and tended for up to 5 days.
Transferring Embryos Into the Uterus
Usually embryos are transferred into the uterus with ultrasound guidance. A speculum is put into the vagina, exposing the cervix, and a thin tube is advanced to the uterus. The embryos are gently placed. Within 12 days of the transfer, a blood test is done to see if implantation and pregnancy have happened. This is when the woman discovers whether IVF has worked during this cycle. In some instances, the procedure might not take. Women can talk to their fertility doctor about when they can repeat IVF to try to conceive a child. However, many candidates successfully get pregnant with the help of IVF.
Basics about PGD and PGS
Preimplantation Genetic Diagnosis (PGD) and Preimplantation Genetic Screening (PGS) is a way to performing genetic tests on embryos before they are placed in the uterus. Various methods are used to do this testing. The tests determine certain genetic disorders such as Tay-Sach’s disease, missing chromosomes and cystic fibrosis. Several new testing methods have been developed to make the process more efficient. Usually genetically normal embryos are preferred. They have a better chance of being successfully implanted in the uterus. Additionally, the resulting pregnancies have a lower risk of ending in a miscarriage. Some people do not have these procedures because they can cost thousands of dollars in addition to the cost of IVF. They are recommended for people who have a family history of genetic disorders or who have had several miscarriages.