In vitro fertilization, has enabled thousands of infertile couples,
who otherwise had no chance of creating genetically related children,
vitro" literally means "outside of the body", which
is where fertilization occurs in IVF. The IVF
team needs numerous eggs to work with because some are invariably
damaged during retrieval, culture and transfer. Additional eggs
may also enable the creation of extra embryos, which can be used
in future "non drug stimulated" IVF cycles.
female's hypothalamus gland produces gonadotropin-releasing hormone,
which instructs the pituitary gland to release follicle-stimulating
hormone (FSH), ultimately causing the recruitment and development
of eggs within the ovarian follicles. In an IVF
cycle, additional FSH is given by injection, causing the development
of numerous eggs.
IVF patient also receives Lupron,
Antagon, or Cetrotide, which "down regulates" her
hormonal system thus ensuring that ovulation, does not occur before
her eggs are mature. Once the eggs are mature, an injection of human
chorionic gonadotropin is given and the egg retrieval is scheduled.
two partners arrive at the clinic on the day of egg retrieval. The
male is asked to provide sperm by masturbation for use in the IVF
procedure. Egg retrieval is performed under mild sedation using
transvaginally guided ultrasound. A small needle is passed through
the back of the vagina into the ovarian follicles. As the eggs are
withdrawn, they are immediately passed to the embryologist, who
separates them from the follicular fluid.
eggs are combined with sperm in Petri dishes and then placed in
incubators. If micromanipulation procedures, such as intracytoplasmic
sperm injection, are scheduled they will be performed prior to placing
the embryos in the incubator.
embryos will be incubated until ready for transfer, which is usually
three to five days. Embryos that can be cultured to five days are
termed blastocysts. Blastocysts are hardier than day three embryos
and less need to be transferred back to the uterus. However, it
is not always possible to retain embryos to the blastocyst stage.
the embryos mature, the couple will be notified to come to the clinic
for the embryo transfer procedure. A small catheter is loaded with
the embryos, and they are placed inside the uterus. This is a painless
procedure that usually takes approximately 10 minutes. The female
is advised to rest for the next 24 hours.
indications include blocked or damaged fallopian tubes and moderate
to severe male factor infertility. In an IVF cycle, the eggs are
removed from the ovaries and mechanically exposed to the sperm,
therefore passage through the fallopian tubes, is not necessary.
with PGD may be performed when there is a known risk of genetic
disease. In PGD, a biopsy of the embryo is taken prior to placing
it into the mothers uterus. Chromosome disorders include anueploidy
or an abnormal number of chromosomes or "unbalanced chromosomes"
caused by a translocation or inversion. Read
more about IVF PGD.
cases of moderate male factor infertility,
the sperm can usually be specially prepared and concentrated from
the ejaculate. In more serious cases, intracytoplasmic sperm injection
is utilized. It is possible to obtain viable sperm from the male's
reproductive tract even though there is none in the ejaculate.
the female cannot produce eggs that will fertilize and develop due
to her age, genetic factors, disease, or other conditions. In these
cases an egg donor can be utilized.
rates for donor egg IVF cycles are usually very high regardless
of the age of the gestational mother. Success rates are equal to
the donor's age group. For example, if eggs from a 24-year-old are
placed in a 42-year-old, the chance of pregnancy for the 42-year-old
is equivalent to the 24-year-old age group.
IVF cycle is an artificial cycle of hormonal stimulation effect
on the endometrium, lining of the uterus where the embryos implant.
Because the receptiveness of the endometrium is so critical to the
success of a pregnancy, I recommend a MOCK cycle. It usually is
performed the cycle immediately preceding the one during which embryo
transfer is contemplated. (READ
IVF center is located in Houston, Texas.
We provide directions with Map Quest point to point driving instructions
on our locations page.