IVF Treatment is a Series of Steps That Starts with Ovulation Regulation and Ends with a Pregnancy Test
IVF treatment is the “big guns” of the fertility world and is used only after other, less invasive, methods have been tried and failed. The IVF procedure is expensive and time consuming but worth it. The good news is that, on average, the live birth rate for women on their first in vitro fertilization cycle is 30%. This compares very favorably with the rate for couples with normal fertility on a natural cycle. So, how exactly does this IVF treatment work? Here’s a rundown on the process.
- Predicting Ovulation
Predicting when you will ovulate is the starting point because ovulation has to be regulated for the IVF process to work. You will either use an ovulation prediction method or be put on birth control pills to regulate your cycle. After ovulation patterns are established your doctor will put you on a GnRH antagonists, like Ganirelix, or a GnRH agonist, like Lupron, to control ovulation so eggs aren’t released before it’s time to retrieve them.
Getting Your Period
On the second day of your period, your doctor will probably order blood work and a transvaginal ultrasound. This is your baseline bloodwork and your baseline ultrasound that will be used throughout your IVF treatment. The bloodwork is so your doctor can look at your E2 or estradiol estrogen levels to make sure your ovaries are actually “sleeping” like they are supposed to be since you were taking the GnRH antagonists. The ultrasound is to check the size of your ovaries and look for ovarian cysts.
- Stimulating and Monitoring the Ovaries
In order to stimulate the ovaries, you will be injecting yourself with gonadotropins (fertility drugs) daily for a week to 10 days. During this time, your doctor will be monitoring the growth of the follicles in the ovaries. Every few days the doctor will want to monitor your estradiol levels through bloodwork and oocyte (eggs in the ovaries) growth by ultrasound. When the largest follicle gets to 16-18mm in size your doctor will want to see you daily.
- Oocyte Maturation
The next step is to trigger the oocytes so they finish maturing, they must be fully developed before they can be retrieved. This is accomplished with a shot of human chorionic gonadotropin (hCG) that must be timed perfectly. The doctor will tell you exactly when to do this shot based on the planned retrieval time. Most protocols call for this shot to be given when four or more follicles are 18-20mm in size with estradiol levels at 2,000 pg/ML or greater.
At this point, the IVF procedur