In Vitro Fertilization: While everyone knows the process isn’t simple, it does seem fairly straightforward, right? You retrieve some eggs, fertilize them with sperm, transfer a healthy resulting embryo into the uterus and – if all goes well – a baby is conceived. There are, of course, a myriad of steps that comprise that “straightforward” procedure and when all is said and done, the average IVF cycle takes around four to six weeks, depending on how things progress.
The IVF Cycle: A Step by Step Timeline
Here is a more detailed outline of what a step-by-step IVF cycle timeline actually looks like:
Step 1. You start your period. Not surprisingly, the start of your menstrual cycle will trigger the start of your IVF cycle as your body gears up for its natural ovulation process. Depending on what was diagnosed and/or decided at your fertility treatment consultation, you may take birth control pills for a while to control the timing of the cycle more precisely and to prevent the growth of cysts, which can also affect ovulation. These oral contraceptives are typically taken for two to four weeks.
During this same step, often overlapping the contraceptives, you will start using a daily injection of a medication called Lupron, which complete the pre-stimulation ovarian suppression. Lupron injections are used for two weeks.
Step 2. This is the part everyone is familiar with – ovarian stimulation. It’s time to get those ovaries primed to release multiple viable eggs as possible in order to create healthy embryos. Ovarian stimulation is done using an injectable fertility med that is determined by your fertility specialist – varied according to what your individual body needs. The most common injectable meds are Follistim, Menopur, Gonal-F, Bravelle, Repronex or a combination as your doctor sees fit. Lupron doses will be continually lowered during this time. Ovarian stimulation lasts from between 8 and 12 days.
Throughout this step, your progress will be monitored via estrogen levels and ultra-sound. When the egg follicles are mature, you will receive an injection of human chorionic gonadotropin (HCG) to stimulate the eggs’ release. Timing is essential at this point since your eggs need to be retrieved 36-hours after your HCG injection.
Step 3. Now it’s time for the eggs to be retrieved. The official name for this is ultrasound directed follicular aspiration (UDFA). The process is performed under anesthesia, so you will not feel any discomfort. When you wake up, we are usually able to tell you exactly how many eggs were retrieved.
Of course, we need sperm to fertilize those eggs. If you are using your partner’s sperm, he will have either already provided a sperm sample the day or two before, or may be scheduled to do so the same day as your eggs are retrieved.
Step 4. Your eggs will be fertilized within hours of their retrieval. It takes three days for embryos to mature to the point that they can be tested for genetic viability and/or gender testing. The results of these tests are available between 24 and 48 hours afterwards. If there is a viable embryo, you will be scheduled for your exciting embryo transfer.
Step 5. This is where it really gets exciting. At this point, your viable embryo (typically one, as multiple births increase the chances of pregnancy complications) will be transferred to your uterus. This typically occurs around Day 5 of embryo growth. Embryo transfer procedures require no anesthesia. The teeny little embryo will be inserted into your uterus using a very small tube. Some patients elect to have a mild sedative administered so they can relax.
If there are additional viable embryos, they will be cryogenically frozen so they can be used for future IVF transfers as needed.
You will be tested for pregnancy at days 9 and 12 after the transfer to see if the embryo has implanted. During this time, you will use a progesterone suppository (the first of which was administered after the embryo transfer). If you are pregnant (hurray!), it is recommended that you continue using the progesterone supplements throughout the first trimester.
Are you and your partner ready to get started? Contact RRC to schedule a consultation.
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