If you’re considering IVF, you’ve probably got a million questions. The road to fertility can be demanding, and many patients come to us with stories of frustration, confusion, heartache, and helplessness. Our role is to support you both medically and emotionally right from the start, and one of the best ways we can do that is through education. If we can give you a clear understanding of all the treatment options available, it will be easier for you to feel confident and in control throughout the whole process.

Chances are that you already know at least one person who has used IVF to get pregnant. While IVF is now a common fertility treatment, not everyone understands how it works or who it can help. While some questions can only be answered in a one-on-one consultation with your doctor, this guide should get you started. With the highest success rate of any ART (Assisted Reproductive Technology) available today, IVF has helped millions of people realize their dream of growing their family. It might be the answer for you, too.

Introduction: What is IVF?

First, the basics. IVF stands for In Vitro Fertilization. “In Vitro” is Latin for “in glass,” meaning that the fertilization of ova and sperm occurs outside of the body, in a lab. IVF allows us to “stack the deck” in your favor by creating ideal circumstances for the successful fertilization and growth of healthy embryos.

IVF is not a single procedure: it’s an entire journey with several distinct steps which take place over the course of a cycle. This is where strong relationships with your IVF team make all the difference. Trying to have a baby is one of the most personal and emotional processes in the world, and turning to IVF for help doesn’t change that.

Here’s what your IVF journey may look like:

For women:

1. A typical IVF cycle begins with a course of follicle stimulating hormone (FSH) to encourage your ovaries into producing more ova, or eggs. This is a series of injections that you give yourself at home, but don’t worry, we will walk you through the injection process in our office. Why are these medications necessary? We want to help you to produce as many eggs of the highest quality possible, which will increase your chances of fertilization.
2. You will be monitored throughout your treatment with ultrasounds and blood tests to check on the development of the eggs. Once your eggs are mature enough, we will have you come in for the egg retrieval procedure. This is a minor outpatient procedure which takes place under light sedation and the actual procedure only takes about 15 to 20 minutes, though you should plan to take it easy for the rest of the day.
3. Next, your collected eggs will be combined with your partner’s or donor’s sperm in the lab. After a period of 16 to 20 hours, the eggs are examined to determine whether fertilization has taken place. In some situations, the eggs may be individually injected with sperm, a procedure known as intra-cytoplasmic sperm injection or ICSI. The fertilized eggs are allowed to grow for up to six days in the lab before the transfer. This gives them a good head start and lets us keep an eye on their development.
4. In some cases, you may be given hormones to help your uterus prepare for implantation: these medications will stimulate the growth of your uterine lining, essentially creating a nice cushy environment for the embryo when it is transferred.
5. On the day of the transfer, the highest quality embryo is selected and carefully placed into the uterus with the use of a catheter. This is a very simple and fast procedure which doesn’t usually require sedation. Once your doctor places the embryo, you’re officially pregnant, but actual implantation can take between 1 and 5 days. In this crucial time you may be given more medication to support the embryo, and we will watch your progress closely.
6. Two weeks after transfer, we will perform a pregnancy test to see if implantation was successful. We will monitor you for the first 10 weeks of your pregnancy and then your care will be handed over to your obstetrician until delivery.

For men:

You will be asked to contribute a fresh sperm sample around the same time as the egg retrieval. The sperm goes through a special washing and spinning process which separates out the most active and healthiest sperm for use in fertilization. Donor sperm is thawed and then treated in the same way before use.

Who can benefit from IVF?

The ideal IVF candidate is in overall good health. Beyond that basic requirement, it’s really a question of your individual situation. The good news here is that IVF is effective in treating many, many different causes of infertility. It’s often a good option for:

Couples who have been trying to conceive for more than 6 months. Couples who haven’t been able to get pregnant on their own after half a year are often very successful with IVF. Women at all stages of their reproductive years have gotten pregnant using IVF, using their own or donor eggs.

Women who have been unsuccessful with other fertility treatments, including fertility medications and IUI (intrauterine insemination). It can be extremely discouraging and painful to try several different ART treatments without success, but IVF often offers hope where other methods have failed.

People suffering from most types of infertility, including:

• Tubal factor infertility. If you have scarred, blocked, damaged or missing fallopian tubes, IVF is an excellent option, as the IVF process bypasses the fallopian tubes entirely. It’s often a more effective (and less invasive) alternative to surgical solutions.
• Endometriosis. IVF can offer a way forward for patients who have been affected by endometrial scarring.
• Polycystic Ovarian Syndrome (PCOS).  IVF is considered a highly effective treatment for infertility caused by PCOS.
• Male factor infertility. Low sperm count or issues with sperm quality can often be addressed by IVF and ICSI (intra-cytoplasmic sperm injection) if necessary.
• Unhealthy eggs/sperm or the inability to carry a pregnancy. With the help of donors and/or a surrogate, IVF can provide a path to a baby even when the odds are stacked against you.

People who want control over the genetics of the baby. Preimplantation genetic screening (PGS), allows doctors to screen IVF embryos for chromosomal abnormalities. If patients are at risk for certain hereditary disorders, preimplantation genetic diagnosis (PGD) can be used as a specific screening process to ensure that only healthy embryos are implanted.

Couples who may be able to conceive either on their own or via low-tech treatment within 2 to 3 years but don’t want to take risk of waiting to discover that they are not pregnant.  If you’re ready to start your family now and have decided you don’t want to take your chances, IVF can offer you a measure of control over your fertility that you won’t get from a “wait and see” strategy.

Couples or women who want pregnancy on demand. LGBT couples and single women who want to have a baby may turn to IVF to have a baby on their terms and their timescale.

Who might not benefit from IVF treatment?

Women who don’t produce healthy eggs and don’t want to use a donor. Low ovarian reserve and problems with egg quality can make fertilization difficult even under ideal conditions in the lab, but that doesn’t mean IVF is totally off the table. The more willing you are to use donor eggs, the higher your chances of success.

Women with certain conditions which can interfere with IVF success. If infertility is caused by fibroid tumors, uterine abnormalities, or ovarian dysfunction, IVF may not be the right course of treatment. These conditions don’t always rule it out, though, so you should consult with your doctor. In some cases, other treatments or surgery before you begin IVF can help you overcome these roadblocks.

Severely obese patients. Many infertility treatments, including IVF, can be less effective for severely obese women. A very high BMI can affect egg quality, and fertility medications may act differently in the body of an obese patient. There have been some studies which suggest that it may be easier for obese women to have a successful IVF cycle with donor eggs. As always, every body is different, and obesity may not be a barrier in every case. Your doctor will be able to help you decide what’s right for you.

Whether or not you ultimately decide that you want try a course of IVF treatment, you should feel supported and empowered by your fertility experts. A close and trusting relationship with your doctor is absolutely essential as you explore your options. Above all, don’t feel alone.

Our clinical team is here to help. Feel free to ask as many questions as you need to, and to touch base with any concerns or ideas you might have, even after hours.