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What to Expect
Patients considering IVF will schedule an initial consultation with a fertility specialist. In order to better understand any barriers to achieving a successful pregnancy and delivery, the specialist will order blood work and perform a thorough physical examination.
Do I need IVF Treatment?
Patients are often recommended for IVF based on a number of factors, including:
- Age
- Genetic disease
- Recurrent miscarriage
- Medical history
- Issues related to sperm or egg quantity or quality
Once any issues have been identified and addressed, the specialist will recommend an appropriate treatment plan and a cycle can be scheduled.
The IVF Process
IVF cycles are closely monitored and consist of several key steps. Learn about each of the steps in the IVF process below.
1
Ovarian Stimulation
The patient will undergo daily injections of various medications over 8-12 days to stimulate multiple eggs in the ovaries. Once the egg(s) reach the proper size, the patient receives a final injection of hCG (human chorionic gonadotropin) to spur final maturation of the eggs.
2
Egg Retrieval
Thirty-six hours after the hCG injection, the eggs are removed from the ovaries. Egg retrieval is a thirty minute procedure performed in a doctor’s office during which anesthesia is administered to ensure patient comfort. Guided by an ultrasound probe, the doctor directs a needle into the follicles of the ovary to retrieve the eggs.
Most women are able to return home an hour or so after the procedure. Following retrieval, the patient begins injections or vaginal delivery of progesterone to prepare the uterus for implantation.
3
Extended Embryo Culture
Developing embryos are allowed to grow in the IVF laboratory for five to six days until they reach the blastocyst stage of development – growing to about 200 cells. RMA is an exclusive blastocyst stage culture IVF laboratory. Published data supports improved implantation rates and outcomes with extended embryo culture.
4
Frozen Embryo Transfer (FET)
After the embryo has grown (the blastocyst stage of development) and the woman’s uterus is ready to receive the embryo, the embryo is transferred back to the uterus to implant and hopefully become a healthy pregnancy and delivery. While the embryo waits for the uterus to be ready – and while geneticists perform genetic testing on the embryo – the embryo is frozen awaiting transfer. This is called frozen embryo transfer, and at RMA, is the standard of care for all IVF patients.
FET has been shown to increase implantation rates and improve obstetrical outcomes. FET is also considered a healthier implantation process in that it allows for a better connection between the placenta and the mother. In addition, frozen cycles, versus fresh transfer cycles, show higher birth weight deliveries and lower risk of prematurity. FET also allows for optimal timing and a more natural transfer experience since the embryo can be cryopreserved or “frozen” until the patient’s hormone levels return to a more natural, receptive state, usually on their next cycle.
5
Nex-Gen Comprehensive Chromosome Screening (NexCCS)
As an option for IVF patients, NexCCS allows a more evidence-based approach to selecting embryos to transfer during IVF. With Next-Generation Comprehensive Chromosome Screening (NexCCS), a doctor can identify the healthiest embryos for transfer in advance of implantation. Embryos that are imbalanced, with too few or too many chromosomes, often result in a failed IVF cycle or miscarriage.
RMA only uses The Foundation for Embryonic Competence, a non-profit reference laboratory, for embryonic screening.
6
Embryo Biopsy
If a patient opts for genetic screening, a sample of genetic material must be biopsied from the embryo for analysis. Embryo biopsy is a highly technical process and requires a skilled embryologist to perform the biopsy. Since 2010, RMA only performs blastocyst stage embryo biopsy. Published data supports that blastocyst stage biopsy at the trophectoderm layer of the embryo is a safer method than cleavage stage embryonic biopsy.
IVF Success Rates
Each fertility clinic reports their IVF success rates to the Society for Assisted Reproductive Technology (SART). To learn about the success rates for the RMA clinic closest to you, please select your office from the list below.
A comparison of clinic success rates may not be meaningful because patient medical characteristics, treatment approaches, and entrance criteria for ART may vary from clinic to clinic.
