In Vitro Fertilization (IVF) is the process in which oocytes (eggs) are fertilized outside the body. There are several steps required for IVF. The first step is ovulation induction in which medication is taken in order to produce multiple follicles and eggs. The next step in the process is oocyte retrieval, where the matured oocytes are removed from the ovaries. In a process called insemination, the oocytes are exposed to sperm to fertilize the eggs in order to generate embryos. Embryos are then transferred back to the uterus. The time period after oocyte retrieval and embryo transfer is the luteal phase. Extra embryos are typically cryopreserved, according to each individual’s wishes.
During the egg retrieval, the male partner will collect a semen sample by masturbation. He should abstain from ejaculation for two days prior to the egg retrieval. Occasionally, if necessary, sperm can be removed from the epididymis or testicle.
For an in vitro fertilization (IVF) procedure, approximately 50 thousand sperm are combined with each egg. In cases of abnormally low sperm count, motility or for sperm that appear normal, one individual sperm will be injected into each egg in a process called intracytoplasmic sperm injection(ICSI). Usually, approximately 70 percent of eggs fertilized, become embryos.
The day after egg retrieval, our embryologist will determine if fertilization has occurred. Two days after egg retrieval, embryos will start to divide, reaching two to four cells. Three days after egg retrieval, embryos ideally will reach the eight cell stage. Five or six days after egg retrieval, the embryos will ideally reach the blastocyst stage.
It is not uncommon to have a small amount of bleeding during the post transfer luteal phase. As the embryo implants in the endometrium, blood vessels may leak. It is also not unusual to have symptoms of pregnancy that come and go during this two week period.
Two weeks after the embryo transfer, the patient will return to our office for a blood test to determine if pregnancy has been achieved.
Since 1981, many healthy babies have been born worldwide using frozen embryos. The chance of achieving pregnancy and delivering a healthy baby following transfer of cryopreserved embryos is approximately 30 to 40 percent per transfer.
Dr. Freedman was responsible for the first pregnancy from a frozen embryo in the Mid-Atlantic region.