IVF treatment is a long journey. It includes multiple steps; in most cases, a patient might require to repeat a particular step too.
Step 1: Beginning of your treatment
The IVF treatment journey begins with the doctor determining the best time during your menstrual cycle. IVF treatment requires several eggs to mature.
Step 2: Ovarian stimulation
This step is where the doctor stimulates the ovaries to promote the growth of the follicles that contain the eggs. The common hormones in the medications that are used to stimulate the follicles are Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH). Once injected, the IVF doctor along with the team monitors how the ovaries respond to the medications.
Step 3: Trigger Injections
Once the doctor sees that the egg follicles in the ovaries are enough, the ovarian stimulation would be ended. During this phase, the doctor would stop the LH and FSH injections and would recommend the time when you need to administer trigger injections. The trigger injection includes injecting human chorionic gonadotropin (hCG) to mature the eggs and help them get released from the ovarian follicle wall.
Step 4: Egg retrieval
This step is also known as the ‘egg picking stage.’ This is a daycare procedure, done under general anesthesia, and is considered the only painful phase in IVF. During the procedure, the doctor inserts a fine needle with an ultrasound-guided probe through the vaginal canal of the woman to retrieve her mature eggs. The procedure generally does not take more than 30 minutes. On average, 8-15 eggs are collected during this process. Once the eggs are retrieved, the patient is allowed to go home and rest. It is best if the patient is accompanied by her partner or someone else who can help her drive and reach home safely.
Step 5: Sperm collection
After retrieving the eggs, the IVF doctor will need to collect the sperm from the male partner. At this stage, the male partner will be asked to produce his semen specimen. Every IVF lab will have a dedicated room where the male can masturbate and give his sperm/ semen specimen. The male partner can produce his semen specimen at home or at the clinic where the semen specimen would be stored. In case the couple wants to use donor sperm or frozen sperm, the IVF team will get it ready in the lab.
Once the sperm is collected, it will be washed with medicine under a microscope to get rid of all sorts of dirt and debris. This is an important step of IVF as it gives the perfect sperm which will have a fair chance to fertilize the eggs retrieved from the female. A perfect healthy sperm is one that is not very long and not too short either, not too fat or not too thin.
Step 6: Fertilization
Once the sperm is washed and concentrated, it is placed in an incubator along with the eggs for fertilization. The process is very similar to that of natural fertilization where ‘sperm meets eggs’ inside a human body.
Step 7: Embryo development
The eggs that would be fertilized by the egg would then turn into an embryo. The IVF specialist will collect the embryo, place it in a special incubator and monitor its growth for the next 4-6 days. The developed embryo would be mixed with amino acids to its growth. If the growth of the embryo is consistent, it is likely to turn into a 4-8 cell embryo by the 4th day.
Step 8: Embryo transfer
In the simplest description, embryo transfer refers to the process where the developed embryo would be transferred from the incubator and implanted in the uterine wall. This process is quick, does not take more than 20 minutes, and can be done at the clinic of the doctor. During the process, the woman would be asked to lie down on her back and spread her legs. The doctor will collect the embryo with a very soft, flexible, and thin catheter. Using a speculum, the doctor will open the cervix and insert the catheter through the cervix into the uterus.
An abdominal ultrasound is conducted to make sure that the tip of the catheter places the embryo at the best location for the embryo implantation. After the embryo implantation, the woman will be asked to remain in the lithotomy for some time, so that the embryo doesn’t come or fall out. She can head home once the process is over.
Step 9: Pregnancy check
The woman would be called to the clinic after 2 weeks for a blood test that checks the presence of hCG in the blood. If the blood test shows the presence of hCG in it, the pregnancy is successful. If the results are positive, the doctor would suggest the best pregnancy care tips to the woman and encourage her to limit strenuous physical activities.