In Vitro Fertilization (IVF)

In vitro fertilization is an accepted medical treatment for many causes of infertility.  IVF is considered a “first line” therapy for conditions such as fallopian tube disease, moderate to severe male infertility, older women, in those who have failed other treatments, such as IUI, and other cases as deemed appropriate by the doctors.

“In vitro” literally means “outside of the body” which is where fertilization occurs in IVF.  IVF involves many steps, the first of which is the production of numerous eggs.

A women undergoing IVF receives follicle stimulating hormone (FSH; Gonal-F, Follistim, Bravelle, etc.) by subcutaneous injection during the first phases of her menstrual cycle. FSH stimulates the development of the ovarian follicles, each of which contains an egg, a process termed ovulation induction. Many eggs are needed for the IVF processes as some are unavoidably damaged during handling and sometimes not all eggs will fertilize.

While undergoing ovulation induction, the patient must regularly come to our office for monitoring.  Monitoring consists of estradiol hormone measurements and vaginal probe ultrasound.  The physician can visualize the follicles, ovaries, and endometrium using ultrasound.  Estradiol levels confirm healthy follicular development and help avoid potential drug side effects.

Once the follicles are judged mature, an injection of hCG is given and the egg retrieval is scheduled.  Egg retrieval is conducted under conscious sedation as an outpatient using transvaginal guided ultrasound retrieval.  A small “needle” is used to withdraw the eggs from the follicles.

After the eggs are withdrawn, they are immediately passed to the embryologist where they are separated from the follicular fluid and prepared for fertilization with the husbands, or donor’s sperm.