What is IVF?

In Vitro Fertilization (IVF) is the most widely used assisted reproductive technology. IVF is the process of fertilization by manually combining an egg and sperm in a sterile laboratory environment. With the IVF procedure, doctors can bypass common causes of male and female infertility and help women achieve pregnancy.

Assisted reproductive technology booklet

Am I ready to start a family using IVF

If you’ve been trying to conceive for at least 1 year without success (or at least 6 months if you are over 35), it’s time to seek help from the experts. The doctors and staff at Arkansas Fertility and Gynecology are here to guide you through the process and help you reach your goal…getting pregnant!

Knowledge is Power

Undergoing IVF treatment is a very emotional experience. There’s a lot riding on one procedure. That’s why learning all you can about In Vitro Fertilization is important to put your mind at ease—so you can focus on getting pregnant and adding to your family. Below you will find a breakdown of the entire process from start to finish.

Pre-IVF Evaluation

One of the physicians at Arkansas Fertility will review your medical history including any prior fertility testing or treatment. A physical exam, pelvic exam and transvaginal ultrasound will be performed. It will be important to evaluate your ovarian reserve (egg count) prior to starting the IVF process. This will consist of blood tests to measure anti-Mullerian hormone (AMH), FSH, LH and estradiol. An ultrasound examination of your ovaries will measure your antral follicle count, which is another indicator of ovarian reserve. These tests will predict how you will respond to the fertility medications and allow us to determine the best ovarian stimulation protocol. 

We will evaluate your uterine cavity to make sure there are no abnormalities that would adversely affect embryo implantation. This may be done with an x-ray (HSG), hydrosonography (saline infusion ultrasound) or hysteroscopy. A “trial embryo transfer” will be done to make sure we will not have any difficulty placing the embryo back into your uterus. 

It is very important that if you have any co-existing medical problems such as hypertension or diabetes, these be under good control prior to starting the IVF stimulation. We will review all medications you are taking, both prescription and over the counter, and discuss with you the safety of these drugs in pregnancy. If you have significant medical problems we may recommend a pre-conceptual evaluation by a high risk (maternal fetal medicine) OB specialist before you start treatment.

• Step 1- Controlled Ovarian Hyperstimulation You’ll begin your IVF journey by starting fertility drugs (gonadotropins) to stimulate the ovaries to produce multiple eggs. The stimulatory drugs are usually given for 7-10 days. During this time, you will return to the office every few days for blood tests and ultrasounds to monitor the response of the ovaries. When these tests indicate the eggs are mature, you’ll be given an injection of hCG (Ovidrel) to induce final maturation of the eggs.
• Step 2- Egg Retrieval Approximately 36 hours after the Ovidrel injection, we will retrieve the eggs transvaginally under ultrasound guidance. This procedure is performed in our clinic under intravenous (IV) conscious sedation. You will be heavily sedated, but not asleep. You should experience no pain during this procedure. The egg retrieval usually takes about 30 minutes to complete. Afterwards, you will recover for about two hours before going home. You will start progesterone supplementation the following day if you are having a fresh transfer.
• Step 3- Fertilization of the eggs and embryo culture We will need a sperm sample from your spouse shortly after the egg retrieval. The sperm and eggs are then mixed together in our laboratory and incubated overnight. The next morning, we will evaluate the eggs for signs of fertilization. On average, approximately 60-70% of the eggs will fertilize normally. The fertilized eggs are then placed in new culture media and placed back in the incubator where they will remain until the day of embryo transfer.
• Step 4- Embryo Transfer Embryos are transferred either on the 3rd (cleavage stage) or the 5th day (blastocyst stage) after the egg retrieval. Embryo transfer is usually a painless procedure and does not require any sedation. The embryos are loaded in a small catheter, which is placed through the cervix and into the uterine cavity. The number of embryos that are transferred depends on several factors including the embryo quality and the age of the woman. Your IVF physician will discuss this with you and together you will make an informed decision as to the number of embryos to transfer. In our program, we typically transfer 1-2 embryos. Any additional embryos may be frozen for later use. After you are discharged, we recommend bed rest for the next two days.
• Step 5- Follow Up After two weeks, we will preform a pregnancy test to see if implantation has occurred. Hopefully, you will have a positive result and it will be time to start preparing for your little miracle.
• Step 6- Follow Up In some patients we may recommend freezing all embryos and delaying the transfer until the next cycle. This may be done in women who are at high risk for ovarian hyperstimulation syndrome (OHSS), have suboptimal endometrial development, have endometriosis or having genetic testing performed on the embryos.