In-Vitro Fertilization (IVF)
In-Vitro Fertilization is a specialized and highly successful treatment option for assisted reproduction. In this procedure, the eggs and the sperm are fertilized in the laboratory and then one or more embryos are placed in the uterus.
CReATe West Fertility has a team of fertility specialists that will provide you the right guidance and share your chances of success, based on your test results and medical history. The team of specialists work closely with one of Canada’s leading and largest IVF centers – CReATe Fertility Toronto – to provide you with the optimal medical expertise and knowledge to make your dreams of parenthood a reality.
When is In-Vitro Fertilization (IVF) recommended?
IVF is typically the line of treatment recommended when natural fertility treatment and Intrauterine Insemination (IUI) both have failed to provide successful results of pregnancy. IVF may also be the first line of treatment for the following reasons:
- When a gestational carrier (surrogate) is needed.
- When a donated egg is being used
- If a woman’s fallopian tubes are blocked
- Severe case of male infertility
- When previously frozen (cryopreserved) eggs are being used.
- When a woman has ovulation disorders (infrequent or no eggs for fertilization), uterine fibroids, endometriosis, or a genetic disorder
IVF success can depend on numerous factors such as age and cause of infertility. It is a time-consuming, invasive, and expensive procedure. It is important to discuss details with your fertility specialist, such as potential risks and if this is the right line of treatment for you.
What are the risks associated with In-Vitro Fertilization (IVF)?
In-Vitro Fertilization is a specialized and high success treatment line for assisted reproduction; however, it has few risks associated with it too. Since it is an invasive, expensive, and time-consuming procedure you need to have an informed discussion with your fertility specialist. Some of the risks are:
- Multiple pregnancies: Most IVF cycles involve the transfer of one viable embryo (single-embryo transfer). However, there are times when the medical specialist will determine that a transfer of more than one embryo is warranted. In these cases, there is a risk that more than one embryo will implant and become viable. Multiple pregnancies carry a high risk of early labor and low birth weight as compared to single fetus deliveries.
- Risk of premature and low birth weight infants: A pregnancy with multiple fetuses carries a high risk of early labor and low birth weight as compared to single fetus deliveries.
- Ovarian hyperstimulation syndrome: The use of fertility drugs can make your ovaries swollen and painful. Abdominal pain, bloating, nausea, and diarrhea can last up to 1 week or even longer in case of conception.
- Egg retrieval procedure complications: while egg retrieval you may experience bleeding, infection, or damage to the bladder, blood vessels, or bowel.
- Ectopic pregnancy: In some rare cases, the fertilized egg may implant itself outside the uterus, in the fallopian tube. In this situation, the egg can’t continue to survive and hence the pregnancy needs to be medically terminated.
- Stress: Since it is a time-consuming, expensive, and invasive procedure, it can take a toll on your and your partner’s mental health.
What is the In-Vitro Fertilization (IVF) success rate?
IVF is an established successful line of treatment for assisted reproduction. According to a study of approximately 156,000 women, the average live-birth rate for the first cycle was 29.5%.1 This is comparable to the success rates for a natural cycle in couples with healthy fertility.
Your best odds for success may come from repeated treatment cycles. This same study found that after six IVF cycles, the cumulative live-birth rate was 65.3%. These six cycles usually took place over 2 years.
Age does play an important role in your success, as does the reason for your infertility. Using an egg donor can also affect your success.
CReATe West Fertility has a team of fertility specialists that will provide you with the right guidance and share you the best chances for success, based on your condition and medical history. The team of specialists works closely with one of Canada’s leading and largest IVF centers – CReATe Fertility Toronto – to provide you with the best medical expertise to make your dreams of parenthood a reality.
What to expect during an In-Vitro Fertilization (IVF) procedure?
In-Vitro Fertilization (IVF) is a combination of various steps - ovarian stimulation, egg retrieval, sperm retrieval, fertilization, and embryo transfer. These steps can take more than 2-3 weeks and in some cases, more than one cycle might be required for success.
1. Ovulation Induction
If you are using your eggs in IVF, in this process, medication will be prescribed to you to stimulate your ovaries to produce more eggs. Your doctor will work with you to determine which medications to use and when to use them. You will be provided medication for:
- ovarian stimulation for egg production
- egg maturation
- medication to prevent premature ovulation
- medication to thin the lining of the uterus to make it more receptive to implantation of embryo
To determine if your eggs are ready for retrieval your doctor may recommend a vaginal ultrasound and some blood tests.
Due to a few reasons, the egg retrieval step may be canceled or delayed:
- Development of too few or immature follicles
- Premature ovulation
- A high number of follicle development, increasing the risk of ovarian hyperstimulation syndrome (OHSS)
- Other medical conditions
Your doctor may ask you to repeat the ovarian induction again or may also recommend opting for a donor egg.
2. Egg Retrieval
This step is simple and can be performed at CReATe Fertility Toronto. This step must take place with the careful timing of ovulation in order to ensure that there are mature eggs available for retrieval.
- You will be sedated with anesthesia on the examination table
- A transvaginal ultrasound is used to identify the follicles and with the help of a thin needle the ultrasound guides through the vagina into the follicles to retrieve the eggs. In certain cases, an abdominal ultrasound may also be used.
- The eggs are removed through aspiration and a suction device. This process can take up to 20 minutes.
- After egg retrieval, you may experience cramping and bloating
- The collected mature eggs are then placed in a culture medium, incubated artificially, and made ready to be fertilized with the sperm.
3. Sperm Retrieval
If your partner is providing the sperm then he will have to provide a sperm sample on the day of the egg retrieval. In certain cases, sperm may also be collected through a needle or a surgical procedure to extract sperm directly from the testicle. Donor sperm may also be used. The collected sperm is then washed and separated from its fluid in the laboratory and is prepared for fertilization.
In this step, the retrieved egg(s) and the collected and processed sperm are put together in a petri dish for fertilization. This process can be done in two ways:
- Conventional insemination: Collected and processed sperm is mixed with the mature eggs and incubated overnight.
- Intracytoplasmic sperm injection (ICSI): In this, a single sperm is injected directly into each mature egg. If the sperm quality or count is an issue or if the previous IVF cycle has failed, then this procedure is preferred.
Post fertilization and before embryo transfer, your fertility specialist, may recommend Preimplantation Genetic Testing. In this procedure, the embryos are allowed to incubate and reach a stage when a small amount can be tested for genetic diseases and chromosomal disorders. Embryos that don’t contain affected genes or chromosomes can be transferred to your uterus. While preimplantation genetic testing can reduce the likelihood that a parent will pass on a genetic problem, it can’t eliminate the risk. Prenatal testing may still be recommended.
5. Embryo transfer
- Your doctor will request you to lie down on an examination table and will use a speculum to gently open your vagina and view your cervix.
- The laboratory-processed fertilized embryo is then passed through the cervix and placed into the uterus with the help of a long thin tube.
- You will be requested to stay at the examination table for 10-30 minutes.
- You may also be prescribed some medicines to maintain the hormone levels to assist pregnancy or conception
12 days after the egg retrieval, your doctor will test a sample of your blood to detect whether you’re pregnant. If you’re pregnant, your doctor will refer you to an obstetrician or other pregnancy specialist for prenatal care. If not, you may be recommended to go through another IVF Cycle or evaluate other procedures for assisted reproduction.
Smith ADAC, Tilling K, Nelson SM, Lawlor DA. Live-Birth Rate Associated With Repeat In Vitro Fertilization Treatment Cycles. JAMA. 2015;314(24):2654-2662. doi:10.1001/jama.2015.17296
- Tests to Diagnose Infertility in Women
- Tests to Diagnose Infertility in Men
- Intrauterine Insemination (IUI)
- In-Vitro Fertilization (IVF)
- Intracytoplasmic Sperm Injection (ICSI)
- Cycle Monitoring
- Counseling for Infertility