How is IVF Done – Step by step

Studies show that one in six couples struggle with the problem of infertility and it goes without saying that this causes significant emotional suffering to as many as 186 million people in the world.

If you are one of those couples that is ready to start a family or have another baby but have fertility problems, one of the most effective techniques that can help you get pregnant is In Vitro Fertilization (IVF).

This technique has revolutionized how infertility is treated, and for many people, IVF treatment has been successful with a nearly 50% live birth rate for women under the age of 35. But this doesn’t mean that it cannot be successful in women over 35.

When it comes to such kind of medical treatments, the more you know what to expect, the more in control you will feel. So, this article will explain to you all the general steps involved in this technique.

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What is IVF?

Basically, IVF is a scientific medical procedure that involves removing an egg from a woman’s ovaries and fertilized with sperm — in a laboratory — resulting in an embryo. The embryo is then frozen or transferred to the women’s uterus, and this usually results in pregnancy.

Although IVF is widely used, it is usually pursued only after other fertility techniques have failed. But it can be the first treatment if:

• An egg donor is being used.
• A surrogate is needed.
• In severe cases of male fertility.
• A woman has blocked fallopian tubes.
• Previously cryopreserved eggs are being used.

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Having said that, now let’s look at the step-by-step guide of how IVF works:

Step 1: Preparation for an IVF Cycle – Testing and Ovarian Stimulation

Before the IVF procedure commences, your uterus and fallopian tubes are evaluated so as to make sure that there are no issues that may require any sort of surgical repairs. Pre-cycle testing includes:

• Screening both partners for sexually transmitted infections.
• Hormonal evaluation so as to assess thyroid function and the ovarian reserve.
• Semen analysis of the male partner.

As part of the preparation, most women are recommended to take fertility drugs for ovarian stimulation. These drugs are usually taken for 8 to 14 days and sometimes it can be 10 to 11 days. This ovarian stimulation is done so as to mature multiple eggs for egg retrieval.

Suppose that you have normal ovulation, you will still be advised to take fertility drugs so as to produce more eggs because you have a high chance of getting pregnant with more eggs than with one. In most cases, 10 to 20 eggs are retrieved for IVF. But this doesn’t mean that all of them will mature appropriately mature.

For the best result, you will be injected fertility drugs and closely monitored using hormonal testing and vaginal ultrasounds. When the ultrasound indicates that your large follicles are sufficient and that your estrogen level is at the targeted level, you will receive a trigger shot of hCG. This then replaces the natural luteinizing hormone surge and it spurs the final stage of egg maturation.

Step 2: Egg Retrieval

36 hours after receiving the trigger shot, you will undergo a surgery that aims to remove the eggs from follicles in your ovaries. During this egg retrieval process, doctors are visually guided by ultrasound as they place a small needle through the top of the vagina into both ovaries. This procedure is done when the patient is under sedation, so there won’t be any sort of pain or discomfort.

Follicles are then entered using the needle and the gentle suction is used to remove the follicular fluid — that contains the egg — contents. It takes less than 30 minutes to complete the entire process. If you feel minor cramping, do not be alarmed as this is normal and they are expected to only last a day. Since the ovaries would have been expanded from the ovarian stimulation process, one might be feeling full; this is expected to last for weeks.

That follicles fluid (which contains the egg) is then suctioned by the IVF physician via a small tubing into a test tube. An embryologist is then given the test tube so that he looks for the egg using a microscope. Each and every egg detail is documented. The patient’s age, ovarian reserve, and ovarian stimulation response usually influence the number of eggs produced and removed.

Step 3: Fertilization

When the eggs are transferred to the laboratory, they will be examined so as to determine their maturity and quality. Those that are found to be mature; they are placed in an incubator and a few hours later, they are fertilized with the sperm. When fertilizing the egg, there are usually two methods used: conventional insemination or intra-cytoplasmic injection (ICSI). Although they have the same success rate, the method used depends on various factors related to the patient, but the ICSI is used 70% of the time.

Regardless of the method that your IVF team (physicians and embryologists) decide to go with, fertilization is checked the following morning.

Step 4: Embryo Transfer

If your IVF team discovers that fertilization happened, they will then consult you to determine when to do an embryo transfer. Supposed you have reached a decision on that; a biopsy will be taken from the embryo on either day five or six. In most cases, three to eight cells are sent for lab testing, while the embryos are frozen in the IVF lab. When the genetic test results come in, the selected embryo is then thawed and transferred to the uterus. This is usually between one or two months after the egg retrieval.

Step 5: Assisted Hatching

There are instances when further help is granted for women who are older or couples who have been unsuccessful with IVF before. The help given to them is known as assisted hatching —a micromanipulation procedure that involves making a hole in the flexible shell that surrounds the cells of the early embryo. Assisted hatching has very minor side effects, but it cannot always be relied on to enhance live birth rates.

Step 6: Pregnancy Test

A blood pregnancy test follows 12 days after the embryo transfer process. If one is found to be pregnant, there will be a series of blood tests, ultrasounds so as to reconfirm and to see whether there are multiple pregnancies. Patients are referred back to their obstetrician if the pregnancy is seen to be normal on week 9 and 10.

Cost in Turkey

For a number of years now, this Turkey has been the most preferred destination for foreign patients seeking to undergo a successful IVF procedure at a low cost. Like anywhere else, the cost of IVF in Turkey varies from one hospital to the other and they will depend on hospital location. But foreign couples that are having IVF in this European country will probably pay 30-40% less than what they will be required to pay in the US or UK. The average cost of IVF in Turkey is 2500 Euros.