What Is IVF Anyway?

Hey Readers!

This post is specifically for those who are not in the infertility community.

Disclaimer: I am not a fertility specialist, doctor, or nurse. This post and information is based on my personal experience and how I understand and interpret and understand the process of IVF.

When we first found out the only way to have biological children was through IVF, we felt completely overwhelmed. So many questions ran through our minds: how long will this process take? How much is this going to cost? What are the odds of it actually working? And so many more.

In this post, I will be talking about OUR process of IVF and explain each step OUR process consists of. Please note that not all IVF processes are like ours and I am explaining our process how I understand and interpret it.

So what does IVF stand for?

IVF is an assisted reproductive technology (ART) to help those who are trying to conceive but are unable to for many different reasons, including PCOS, endometriosis, male infertility, and many more. IVF stands for In Vitro Fertilization. In Vitro is latin for in glass or in petri dish, I believe. First during IVF treatments, a semen analysis will be done, and the female will undergo bloodwork and preliminary vaginal ultrasounds to see if the environment is suitable for an embryo and then start the process of maturing her eggs, and distribute the trigger shot. After, the doctor will retrieve as many eggs as he can, fertilize them in a petri dish, and then transfer the number of embryo's desired (fresh transfer) or freeze the embryo's to transfer at a later date (frozen transfer). IVF does not happen over night, and can actually take months depending on circumstances.

Semen Analysis

During the semen analysis, the doctor will collect a sample and look at the number of sperm, the shape, movement (sperm motility), pH, and volume, and probably a lot of other things but these are the ones I can remember. And that's it for the guys, they have it pretty easy. 😉

Vaginal Ultrasounds

The female will undergo many vaginal ultrasounds prior to starting injections. The doctor takes a look at her ovaries, eggs, follicles, cervix, uterus and uterine lining. In my case, I had to have a procedure called a hysteroscopy and a cervical dilatation/ uterine "scratch" because my cervix was pretty thick. In my previous post, you can read all about my hysteroscopy experience, but as a reminder, a hysteroscopy is where they remove polyps or fibroids that may be attached to the uterus that could potentially get in the way of retrieval and transfer. They also "scratch" a section of my uterine lining that will help the embryo implant. Most women do have this procedure done, but some do not.

Next, the doctor takes a look at how many follicles the female patient has. Follicles, as described to me, are like little water balloons inside your ovaries that hold your eggs. Women can have anywhere from 1-20 follicles. The nurse described to me that the more follicles you have, the more places eggs can be retrieved, and the more eggs retrieved, the more will fertilize. In our case, I have 15 follicles at our baseline appointment (the first appointment before starting injections)! That is a great number, and we are truly blessed.

Maturing Her Eggs

Once the female patient is given the green light, she can start her hormonal injections. These injections are given in the lower abdomen of the belly, just below the belly button, also known as Subcutaneous Injections. The injections I am currently taking are called Menopur and Follistim. Menopur is a combination of stimulating follicles that stimulate the ovaries to produce eggs, while Follistim stimulates follicles to develop and mature in the ovaries.

A week into the injections, she will go back for a follow up appointment, the doctor will check on the follicles and ovaries, and then have her start another injection. In my case, the injection is called Ganirelix, which is used to stop natural ovulation from occurring. During the next week, she will go back for follow up appointments, and then be given the OK to have her trigger shot. The trigger shot medication I am going to take is called Pregnyl, and is injected near my "love handles" or "muffin top" of my backside, also referred as Intramuscular Injections. This will trigger my ovaries to ovulate the matured eggs from the follicles that were being stimulated. The trigger shot basically prepares the eggs for retrieval.

Now this all sounds great and quick, but things can go wrong during these weeks of injections. One in particular called Ovarian Hyperstimulation Syndrome (OHSS). Basically when taking these injections, the ovaries are going to grow and become tender and fragile. Adding hormones into your body can sometimes make your body reacts aggressively to it and can cause severe side effects. Some include bloating, nausea, diarrhea, weight gain, abdominal soreness, vomiting, darker urine, dry skin, and more. Sometimes, the cycle has to be canceled due to OHSS and you have to start the process of IVF over again, as I understand it. Hopefully, we won't have to cross that road!

Retrieval

With injections complete (as of now), it's time to retrieve those eggs. A day or two prior to retrieval, the trigger shot will be distributed.

During retrieval, the doctor will go in and retrieve as many eggs as he can. Our clinic will try and at least get 10, but they will get more if they can!

The same day of retrieval, your partner or sperm donor will produce a sample to use that day.

Fertilization

Once the doctor has the eggs retrieved, he will place them in a petri dish. He will then use a technique called Intracytoplasmic Sperm Injection (ICSI). Our clinic uses this technique for every IVF cycle they do, but not all clinics use this technique. This is where they pick the best-looking, healthiest sperm and place it in the petri dish with one egg. They will do this to each egg retrieved in separate dishes. Not all eggs will fertilize, so that is why they collect as many as they can.

The fertilization stage takes about 5-6 days. The embryo's will reach the blastocyst stage prior to transfer and implantation. The embryologists will grade each embryo based on its size and maturity, and place the healthiest one(s) on transfer day. They either freeze the embryo's to transfer at a later date (frozen transfer) or keep them as-is to do a fresh transfer. In our case, we are doing a fresh transfer, and are keeping the number of embryo's transferred a secret. We are going to freeze the extra embryos so we can transfer them later when we want to expand our family.

When couples or a patient decides to do a frozen transfer, they usually do so because they would like to have Preimplantation Genetic Testing (PGT) done on their embryos. This is where they embryologist sends out their embryos usually to an outside lab to have genetic testing done. This can take up to 7-14 days to complete. During PGT, you can also find out the sex of your embryos. PGT is usually suggested for those who have had miscarriages in the past, or are older patients. In our case, we decided not to do PGT because we have not had past miscarriages and we are considered to be on the younger side of IVF patients. If our first round of IVF is not successful, we will most likely do PGT in our next cycle.

Transfer Day!

This is the biggest most exciting day of IVF. With the best and healthiest embryo(s) picked, the doctor will transfer the embryo(s) back into the uterus so the embryo(s) can implant. For the next couple of weeks, the women goes through what is called "the two week wait" to see if the embryo "sticks". During those two weeks, she will get her blood drawn frequently to see if her HcG hormone increases. If it does, that means that she is officially pregnant.

Additional instructions on injections and medications may be given by the doctor.

And that's IVF (from how I understand it).

baby dust,

s.