In Vitro Fertilization (IVF) is a well-established and effective treatment option for infertility with over 160,000 IVF cycles reported in the US in 2012. With a 65% delivery rate in women under 35*, RMANJ’s IVF success rates are among the highest in the US.
While there are many other ART (Assisted Reproductive Technologies) treatment options available, IVF success rates are much higher than other options like Intrauterine Insemination (IUI) and may shorten the time to a successful outcome in many cases. Additionally the combination of comprehensive chromosome screening (www.select-ccs.com) and single embryo transfer (SET) with IVF can reduce many of risks and costs associated with multiple deliveries which occur more than 30% of the time in IVF.
There are several factors that may lead your RMANJ physician to recommend treatment with IVF including:
- Blocked fallopian tubes
- Male factor
- Unexplained infertility
- Genetic/Chromosomal factors
Your RMANJ care team will work with you to design a customized IVF treatment plan that addresses the clinical and/or physical factors and barriers to achieving a successful pregnancy and delivery. Once a comprehensive work-up of your hormone levels and physical examination have been conducted, your care team will start your IVF cycle.
Daily subcutaneous gonadotropin injections are given to stimulate production of multiple oocytes (or eggs) rather than the single egg normally produced by the body each month. The stimulation process may continue for 7-10 days, during which your RMANJ care team monitors your progress personally with ultrasound examinations and blood work over several days. Once the follicles containing eggs have reached an appropriate size, typically around 18mm, a single and critically timed injection of hCG (human chorionic gonadotropin) is used to help final maturation of the eggs and spur ovulation.
Thirty-six hours after the hCG injection, the eggs are removed from the ovaries. The process of egg retrieval is a short 30 minute procedure performed in our office. Anesthesia is administered to ensure patient comfort during this process. Doctors direct a needle into the follicles of the ovary, guided by an ultrasound probe, to retrieve the eggs. Most women are able to return home an hour or so after the procedure.
The patient starts injections or vaginal delivery of progesterone following retrieval to prepare the uterus for implantation of the embryo about 5-6 days later.
At this point eggs are mixed with sperm provided by the partner or donor to initiate fertilization of the egg and embryo development. In cases where male factor has been identified, a single sperm can be injected into each egg by a process called Intra-Cytoplasmic Sperm Injection (ICSI). Over the next few days, your RMANJ team will keep you updated as embryos develop.
Where fertilization has been successful and an embryo(s) have developed, genetic testing and biopsy of embryos may be indicated using the SelectCCS platform. Only at Day 5 or blastocyst stage is it safe to biopsy the embryo to collect genetic material for any testing. Based on scientific evidence, RMANJ only performs blastocyst biopsy.
Once the embryo development process is complete and viable embryos have been selected, you will come back to the office for your embryo transfer 5-6 days after retrieval.
Learn more about Select CCS.
RMANJ will transfer no more than two embryos into your uterus using a catheter, which is inserted through the cervix. Doctors use ultrasound to help guide the catheter to ensure appropriate placement. Single Embryo Transfer (SET) is increasing at RMANJ based on effective embryo screening technologies.
After the embryo transfer, you will continue progesterone therapy until about 14 days after egg retrieval, when a pregnancy test is done. If a pregnancy is confirmed, you will continue progesterone for another three to four weeks until your placenta begins to produce enough progesterone to support the pregnancy on its own.
Learn more about Single Embryo Transfer (SET).