Since the world’s first baby was born through in vitro fertilization in England in 1978,  tens of thousands of IVF babies have been born all over the world.  Considering all the attention to IVF in the news over the years, it would seem that everyone understood what it really means, but that is not really the case.  We still regularly see patients who are not really sure what it involves, why we recommend it when we do, and so on.  You can see a great deal of info about IVF and related topics in our “Patient Education” area on our website, but  in a somewhat simplified “nutshell,”  here’s what it’s about.

IVF was originally conceived to overcome infertility due to damaged or absent Fallopian tubes,  and while that’s still a common indication, IVF now is probably most commonly used to overcome serious “male factor,” or sperm problems, and indeed very effectively. There are many other indications as well, including so-called “unexplained” infertility, endometriosis, etc.

We start by stimulating a patient’s ovaries with the same hormone (FSH) her pituitary gland normally produces to stimulate ovulation, but in larger doses, to overcome her natural tendency to produce just one egg at a time.  We monitor that process with an occasional ultrasound and estrogen measurement, and on a certain day–perhaps 7 or 8 days later, we give a final hormone (hCG) to initiate the final stages of ovulation.  Precisely 36 hours later we collect the eggs, vaginally, by ultrasound, under some mild anesthesia, and within a few hours the eggs are inseminated with sperm and the next morning we see how many have fertilized.  Ideally we will have multiple embryos to grow in culture in the lab to about day 5, when they are a hollow ball of cells called a blastocyst.

Depending (mostly) on the patient’s age, we would then plan to transfer one or two blastocysts into her uterus.  This is done under ultrasound guidance and is painless, requiring no anesthesia.  And then we wait, about two weeks, before a pregnancy test can be performed.

Any extra blastocysts can be frozen, or “cryopreserved,” and can be used in a month or two for another attempt if the patient fails to achieve a pregnancy, or perhaps in a couple of years if she does!  Frozen embryo transfers are much simpler, and much less expensive, than the original, “fresh” cycle.