Fertility Treatments

IVF - In Vitro Fertilization

In Vitro Fertilization (IVF) is the gold standard of fertility medicine and the most effective fertility treatment available. IVF treatment offers the highest success rates and quickest time to pregnancy of any Assisted Reproductive Technology (ART).

ICSI ICSI

MINI IVF MINI IVF

NATURAL IVF NATURAL IVF

FET FET

ESET ESET

INVOCELL INVOCELL

CONVENTIONAL IVF CONVENTIONAL IVF

Reciprocal IVF Reciprocal IVF

ICSI

A special fertilization technique whereby sperm are loaded into a micro needle and injected directly into the egg.

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MINI IVF

IVF treatment with a reduced medication protocol designed to recruit fewer, but higher quality eggs than standard stimulation.

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NATURAL IVF

An IVF cycle with no medications to retrieve one egg. Not often recommended.

+Natural IVF

FET

The transfer of a previously frozen embryo from an IVF cycle. Often with similar or better success than fresh transfers.

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ESET

The practice of transferring only one embryo. Same success rates, reduced risk to mother and fetuses associated with multiples pregnancies.

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INVOCELL

An IVF fertilization alternative where sperm and egg are placed in a thumb sized medical device and inserted into the vagina for fertilization and early development.

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CONVENTIONAL IVF

Sperm and egg are left in a petri dish after retrieval and collection to fertilize “naturally.” An ICSI alternative.

Reciprocal IVF

An IVF variation for lesbian (or trans men) couples in which embryos made from one partner’s eggs are put into the other partner’s womb.

+Learn more

ICSI

A special fertilization technique whereby sperm are loaded into a micro needle and injected directly into the egg.

+Learn More
MINI IVF

IVF treatment with a reduced medication protocol designed to recruit fewer, but higher quality eggs than standard stimulation.

+Learn More
NATURAL IVF

An IVF cycle with no medications to retrieve one egg. Not often recommended.

+Natural IVF
FET

The transfer of a previously frozen embryo from an IVF cycle. Often with similar or better success than fresh transfers.

+ Learn More
ESET

The practice of transferring only one embryo. Same success rates, reduced risk to mother and fetuses associated with multiples pregnancies.

+ Learn More
INVOCELL

An IVF fertilization alternative where sperm and egg are placed in a thumb sized medical device and inserted into the vagina for fertilization and early development.

+ Learn More
CONVENTIONAL IVF

Sperm and egg are left in a petri dish after retrieval and collection to fertilize “naturally.” An ICSI alternative.
Reciprocal IVF

An IVF variation for lesbian (or trans men) couples in which embryos made from one partner’s eggs are put into the other partner’s womb.

+Learn more

IVF Treatment Process

In Vitro Fertilization has hundreds of steps, but can be drastically simplified down to just a few.

Stimulation

Medications are taken to improve number and quality of eggs.
Retrieval & Collection

Eggs and Sperm are retrieved and collected.
Laboratory

Eggs are Fertilized and developed inside our embryology laboratory.
Transfer

Embryo(s) are transfered into a woman’s uterus.

Continue Below For Detailed Explanation of Main Steps

IVF Process: Step 1

Ovarian Stimulation

The first step of IVF treatment is ovarian stimulation. During ovarian stimulation, most women take hormone-based medications that encourage the ovaries to develop multiple follicles, each of which contains an egg. The simple idea here is more follicles = more eggs = more embryos = higher chance of implantation and a live birth. In fact, many In Vitro Fertilization cycles will result in a handful of embryos that can be frozen and stored for future use (in case the first transfer is unsuccessful or for use after a successful pregnancy).

Ovarian stimulation typically begins on days 2-4 of a woman’s cycle after a baseline appointment to designate your uterine lining, follicular, and hormonal baseline. Stimulation usually involves taking daily injectable medications for around ten days and will be followed closely with monitoring appointments every few days to track uterine lining, follicular, and hormonal development.

Once the egg-containing follicles reach the appropriate size, a final “trigger” medication will be used to promote the final maturation of the eggs.

IVF Process: Step 2

The Egg Retrieval and Sperm Collection

Egg Retrieval

The second step of IVF treatment is the egg retrieval. The Egg Retrieval Procedure is a minor outpatient procedure done to collect the developed eggs from the woman’s ovaries so that they can be fertilized in a laboratory. It is performed 35 hours after the “trigger,” by a physician at one of our offices under light anesthesia for comfort and lasts approximately 5-10 minutes.

During the procedure, the physician uses a tiny hollow needle with suction capabilities to pierce through the vaginal wall and drain the fluid from the follicles which contain the developed eggs.

The follicular fluid containing the eggs is immediately transported about 20 steps to our IVF laboratory and sorted through by one of our embryologists who will find, isolate, and nurture your eggs in media as they await fertilization.

The number of eggs retrieved will depend on your age, history, fertility diagnosis, medication protocol and response to medications.

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Sperm Collection

If the sperm is being provided by a male partner, it is most often collected through ejaculation into a sterile cup the morning of the egg retrieval. If necessary, sperm can be collected using more advanced sperm retrieval procedures like a PESA, TESA, or TESE. Sperm can also be collected ahead of time, frozen, and then thawed the morning of the retrieval – this is particularly useful if the male partner will not be able to present at the office the day of the procedure. Sperm may also be provided by a donor.

Once the andrology lab receives the semen, the andrology team will clean and concentrate the sperm from the larger sample of semen. After this first step of isolation, the sperm is washed and suspended in a solution that mimics the environment of the Fallopian tubes in the female reproductive tract.

Once this process is complete, the concentrated motile sperm will be transferred to the embryology lab where fertilization will take place.

IVF Process: Step 3

The Laboratory - Fertilization

The third major step of IVF treatment takes place inside the embryology lab. It takes about 4-6 hours after the retrieval for the eggs to reach final maturity. At this point, the eggs and sperm will be ready for fertilization. There are generally two methods of fertilization.

Conventional IVF Fertilization

Self-employed penetration of the egg by sperm inside a petri dish.
ICSI - Intracytoplasmic Sperm Injection

Individually injected eggs with a micro manipulator and hollow needle.

The Laboratory - Embryo Development

After fertilization, the embryos are grown in nourishing media that mimics the internal environment of a fallopian tube (where early embryonic development naturally occurs) for 3-5 day or until the embryo reaches a cleavage or blastocyst stage.

If an embryo is grown to a blastocyst stage, it can then be genetically tested. While this may be beneficial for some, it is not recommended for everyone.

IVF Process: Step 4

Embryo Transfer

The final step of IVF treatment is the embryo transfer. After the early development period in the lab, the embryos are ready to be transferred to the woman’s uterus. During an embryo transfer, one or two embryos are loaded into a catheter, gently inserted past the cervix and offloaded onto the endometrial lining of the uterus to implant and further develop. If the embryo sticks, pregnancy results.

Any remaining embryos that are not transferred can be frozen and used for a subsequent Frozen Embryo Transfers.

Establishing and Maintaining Pregnancy

Post Transfer Considerations

Following an embryo transfer, most women will likely take progesterone along with other medications to thicken the uterine lining to help the embryo implant and receive the nourishment it needs to flourish.

About two weeks after transfer, a blood test will be performed to determine if the pregnancy has taken.

If the pregnancy test is positive, an ultrasound will be scheduled two weeks later to determine the implantation site and often detects a heartbeat. The heartbeat should be seen by four weeks after a positive pregnancy test. Once a heartbeat is detected, there is a 90-95% probability that the pregnancy will continue to a live birth.

Risks of In Vitro Fertilization

In Vitro Fertilization, like most medical procedures come with some risk. That said, most risks that come with the treatment are minimal and can be greatly avoided with proper care by your fertility care team. There are however two risks that everyone should be made especially aware of – but even these can be all but eliminated given proper treatment.

Ovarian Hyperstimulation

The hormone medications (FSH + hCG and or Lupron) given to stimulate the ovaries in the attempt to produce an abnormally high number of eggs during IVF leads to a risk of Ovarian Hyperstimulation Syndrome (OVHSS). OVHSS is painful and can causes nausea, dizziness, vomiting, and in especially serious cases, hospitalization, organ failure, or worse. The risk is significantly more apparent in specific demographics (young women or those with high AMHs as well as those with PCSO). However, this risk of OVHSS can be substantially reduced with careful monitoring, appropriate protocol dosing, and the use of Lupron (instead of hCG) to trigger. With the close attention given by CNY Fertility providers to the various risk factors, OVHSS can be avoided in most instances.
Multiple Gestation

The risk that IVF results in a multiple gestation pregnancy and birth can rise from 1 to upwards of 30% when transferring multiple embryos. Multiples results in an exponentially greater risk for a number of serious insidences like cerebral palsy, excessive bleeding during delivery, premature birth (and associated cognitive issues) and infant mortality. Fortunately, this risk can be virtually elimintated by transferring one embryo at a time. Transferring one embryo at a time may lower the odds of the first transfer working very slightly, but has no effect on the odds of a live birth resulting from the IVF cycle itself (by using Frozen embryo transfers form the same IVF stimulation).

Learn more about the Cost of IVF

Must Reads on IVF

Other Helpful Resources

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Fertility Treatments