Step-by-Step Guide to IVF

When someone begins to research their upcoming IVF journey, it may be confusing as to what a potential timeline may look like. Here is a guideline for what to expect.

 

Consultation with your Fertility Specialist

The first step is to have a consultation scheduled with a fertility specialist to discuss the IVF process and treatment plan for each individual case. This consultation would be when more specific questions about your unique experience could be addressed. For example, you might want to ask your specialist about why screening tests are needed and what can be uncovered.  Another question may be, is there an illness in your family history that could be of concern? The more communicative you and your partner are with your specialist, the more you will be able to determine what is needed for your journey to be as successful as possible.

 

Financial Consultation

Your Coordinator will guide you through the pricing options after your initial consultation with our physician. Each clinic will have a variety of options for individuals to choose from, so you can decide if you want to focus on reducing your cost or paying a little extra for more peace of mind.

 

Cycle Monitoring: 1 Week

It is important to know what types of tests your physician requires and what types of medications will be ordered for you during your IVF process. At fertility clinics, physicians typically order blood tests to check female patients’ ovarian reserve and look for any abnormalities. Male patients will also go through blood tests, and a semen evaluation is usually required prior to starting the IVF treatment. These pre-cycle tests can be done at your preferred fertility clinic.

Here are sample of tests needed for female patients below:

• AMH (Anti-Mullerian Hormone)
• AFC Ultrasound (Antral Follicles count)
• TSH (Thyroid-stimulating hormone)
• Prolactin
• Hepatitis B Core antibody
• Hepatitis B Surface antigen
• Hepatitis C antibody
• Antibody Screen
• Syphilis
• HIV 1/2
• Chlamydia
• Gonorrhea

Here are sample of tests needed for male patients below:

• Semen evaluation
• Hepatitis B Core antibody
• Hepatitis B Surface antigen
• Hepatitis C antibody
• Syphilis
• HIV ½
• HTLV-I/II Antibodies
• Chlamydia
• Gonorrhea

The results for the above lab tests usually take less than 2 days to finalize.

Types of Ultrasound Scans for Women Experiencing Infertility

• Abdominal Ultrasound – An abdominal ultrasound is a medical imaging test that uses sound waves to see inside the belly (abdomen) area.
• Transvaginal Ultrasound – A transvaginal ultrasound is an imaging procedure that allows your provider to see your pelvic cavity and the organs inside your pelvis.
• Antral Follicle Count – This ultrasound measures of egg supply for the future (ovarian reserve) and help predict chances for successful IVF treatment.
• Sonohysterogram – This ultrasound looks at the inside of the uterus.

 

Genetic Carrier Screening: 2-3 Weeks

When you are preparing to become pregnant, you want everything to go right. While most babies are born healthy, with every pregnancy there is a chance of having a baby with a genetic disorder. With genetic carrier screening, you can learn your risk for passing an inherited genetic disorder to your child and may be able to reduce it.

Genetic carrier screening is a type of genetic test that analyzes your DNA to provide specific information about your child’s risk for certain genetic disorders. The results can allow you to make more informed reproductive choices.

This test is usually ordered during the beginning of your IVF journey and is usually performed as part of the pre-cycle lab work before creating the embryos.

 

Medications

During IVF cycles, fertility specialists prescribe various fertility medications to their female patients as part of the treatment process. These fertility medications trigger the release of various hormones that stimulate egg production and maturation while also regulating ovulation.

By taking these medications, women are essentially made more fertile during the possible egg retrieval and embryo transfer procedure, which improves the chances of a successful pregnancy.

There are different kinds of fertility medications, as well as different dosages that may be prescribed for IVF. Your specialist will decide the medication protocol based on your unique individual case.

Below are the examples of medications that may be used for your IVF cycle:

• Follicle-Stimulating Hormone (FSH): or Gonal F
• Human Menopausal Gonadotropin (hMG): Menopur
• Human Chorionic Gonadotropin (hCG): Lupron or Novarel

Medications typically used for a Frozen Embryo Transfer cycle are the below:

• Progesterone
• Estradiol

 

Egg Retrieval Stimulation Timeline

After your specialist reviews all your pre-cycle lab results and orders your medications, you are now ready to start the egg retrieval stimulation cycle. Injections usually start from day 2 or day 3 of your menstrual cycle.

The average time for the egg retrieval stimulation cycle ranges from 10-14 days, but each case may vary depending on how the patient’s body reacts to the medications. This timeframe starts when the patient begins medication used for ovarian stimulation for the egg retrieval procedure.

 

Fertilization and PGT-A Testing

The day after the eggs have been fertilized, we will provide a fertilization report.  The fertilized embryos will be cultured for 5-7 days, and then be biopsied and sent for PGT-A (preimplantation genetic testing). Once the embryos have been fertilized and biopsied, it takes around two weeks to receive the genetic testing results. After we know the embryo’s results, you will then be ready to prepare for an embryo transfer cycle.

 

What is PGT-A Testing

The PGT-A tests all 23 pairs of chromosomes for structural/numerical abnormalities. To learn if you are a candidate for PGTA testing, please click here.

 

Preparing FET (Frozen Embryo Transfer) Cycle

After embryos are created, you will be ready to prepare a Frozen embryo transfer cycle.

When it comes to a FET cycle, each case may vary due to several factors.  The embryo transfer procedure occurs and is followed by a pregnancy blood test approximately 12-14 days post-implantation. Fertility clinic specialist and staff continue to follow up with the pregnancy until the 10 weeks OB ultrasound. Typically, after 10 week’s OB ultrasound, you will then be discharged to OB’s care and will continue with the fertility care through their prenatal program.

 

When to Try Again if an Egg Retrieval Cycle Fails?

Not all the cycles are successful for the first attempt. Lots of patients achieve success within a few attempts. If your first cycle outcome is not ideal, you can try again after speaking to your specialist.

You will expect a period to start 1-2 weeks after the egg retrieval procedure, your ovaries will need to rest for that period. The soonest time to try again will be starting with the next following period but consult with your specialist on the best time.

 

When to Try Again if a Frozen Embryo Cycle Fails?

Successful embryo transfer outcome depends on many factors such as endometrium lining thickness and embryo grading. If the first attempt fails, don’t be discouraged as you can try again. You will expect a period to start about a week after a negative HCG test. After you speak to your specialist, you can decide when to try again.

Contact your preferred fertility clinic to get started and learn more about your fertility treatment options with IVF.