We have all heard about IVF, have experienced it ourselves or have an idea about the medical process. But do we really know how it works?
When starting a fertility journey, a thousand questions pop into our heads. Although the patient doesn’t need to experience it as something hard, it is a complex process. It partly depends on the medical and patient care team. So feeling well informed and in good hands is crucial.
A lot of new concepts appear: ovarian reserve? AMH? Follicles? Hormonal injections? Egg retrieval? Estrogen pills? Progesterone pessaries? Feeling irritated, sad, bloated?
Let’s dive a bit deeper into the technical details of IVF: how does it work?
How Does An IVF Treatment Work, Exactly?
First, the doctor will run some tests to check the patient’s general health state and the specific fertility status. The tests will look like a vaginal ultrasound scan to ensure that the ovaries and the uterine cavity look good and assess the antral follicle count.
The follicles are little boxes of liquid in which the eggs develop and mature (usually, just one egg in each cycle), and their number decreases with age (by now, we have all heard that we are born with the total number of eggs that we’ll have, and we lose them along the way). On the first days of the menstrual cycle, the gynaecologist can see how many follicles are shown in the scan.
Besides, some hormonal blood tests will complete the picture (the famous AMH, FSH, LH, estrogen, etc.), giving an idea of the ovarian reserve and potential response to IVF medication.
Once the preliminary tests are done and decided that IVF is the best option, the treatment will start.
The IVF treatment and process
The patient goes through ovarian stimulation: medication (usually a couple of injections per day) is administered to tell the ovaries to stimulate as many follicles as possible. As mentioned, the follicles contain and grow the eggs. In a natural cycle, usually, just one follicle grows, and one egg is produced. However, in the case of an IVF treatment, the aim is to stimulate as many follicles as possible, not just one. That way, more eggs will be obtained, giving a higher chance of them being fertilized and embryos being created in the lab.
The stimulation lasts for around 10-14 days. The medication is administered from day 1-3 of the menstrual cycle. After that, the patient needs to have regular scans and blood tests to check that everything is going well.
The goal is to have as many follicles as possible, growing at the same pace. Scans and blood tests are done regularly to make sure everything is going well.
At a certain point, medication is given to prevent any of the follicles from breaking, that is, to prevent ovulation. However, if ovulation happens, the body will produce the hormone progesterone naturally, which would disrupt the medicated cycle.
Once the follicles are a specific size, the egg retrieval is scheduled, and another medication is given to trigger ovulation.
A day and a half after the triggering of ovulation, the eggs are retrieved. Again, the patient would be under light sedation, and the procedure would take around 20 minutes.
At that exact moment, the sperm (the partner’s sperm or a donor’s sperm) is used to fertilize the eggs in vitro.
If the embryo transfer is happening right away, that is, if it is a fresh transfer, the patient is given another medication, generally progesterone pessaries, to prepare the body for embryo implantation.
The eggs are fertilized in the lab, and the embryos start developing and growing. It is natural that not all of the eggs retrieved become healthy embryos, but only some. The goal is to obtain healthy embryos that are 5 days old, that is, that become blastocysts.
When an embryo achieves that stage, it has excellent chances of implanting.
At this point, the transfer will be performed on day 5 (or sometimes 6), or the blastocyst(s) will be frozen.
The patient will have a frozen embryo transfer if the blastocyst is frozen. The blastocyst will be thawed on the transfer day after the patient has prepared her body through an endometrial preparation treatment, generally with estrogen pills.
The pregnancy test in the blood is done around 12 days after the transfer; it measures a hormone called Beta-hCG (β-hCG), produced in pregnancy.
Science gives the possibility to challenge infertility issues and the natural changes that arrive with age and time. It is not always a quiet and calm ride, but we are here to help find the best way to face it. At Redia IVF, we work with the best IVF clinics worldwide to achieve excellent results and ensure that patient care is excellent, so your journey is pleasant and rewarding.