Preliminary Stages of IVF

Once you have completed your assessments and your results have been reviewed, your fertility doctor may recommend you proceed with IVF treatment. To help understand the process, here are some steps you may need to do to prepare for IVF: 
 

• A discussion with your physician to formulate your IVF treatment plan.
• A meeting with your nurse to review all the information for each treatment stage. You’ll also receive your treatment calendar and medications and learn how to use them.
• If a male partner is present, he may consult the urologist to assess whether epididymal sperm aspiration or testicular sperm extraction is required. 
• Genetic testing, requiring a simple blood sample, may also be required
• To support your emotional well-being, we encourage meeting with a therapist or counsellor.
• For some situations, such as where a known sperm or egg donor or gestational carrier (surrogate) is involved, counselling may be required. 

1st Stage:
Ovarian Suppression

Ovarian suppression is accomplished by taking an oral contraceptive and/or a medication that restricts the pituitary gland function.  This suppresses ovarian hormones and prevents ovulation, which helps your eggs to mature at a more even rate during your IVF cycle.  This step is not required by all patients, and your fertility doctor will determine if it’s needed as part of your treatment plan. 

2nd Stage:
Ovarian Stimulation (superovulation) and Monitoring
 

This stage is also sometimes called Controlled Ovarian Hyperstimulation (COH). During a typical monthly menstrual cycle, one or the other ovary usually produces and releases a single, mature egg.  During an IVF cycle, medication is taken to stimulate the development of several ovarian follicles so we can retrieve an increased number of mature eggs.  This helps increase the chance of viable embryos.  

You will be monitored throughout your IVF cycle through bloodwork and transvaginal ultrasounds to evaluate follicular growth and determine the optimal time for mature egg retrieval.  For some patients, a trigger shot is administered 24-36 hours before retrieval to help with egg maturation.

3rd Stage:

Egg Retrieval (also referred to as Ovum Pick Up – OPU)

Eggs, otherwise known as ‘oocytes’, are retrieved transvaginally under ultrasound guidance. You are given a local anesthetic and a sedative through an i.v. (intravenous) infusion. Your IVF specialist will insert a needle, attached to the ultrasound probe, to retrieve mature oocytes. They are then given to the embryologist who will confirm how many eggs were retrieved. 

4th Stage:

In Vitro Fertilization

After retrieval, the eggs will be combined with the sperm in the laboratory to allow for fertilization. There are two types of IVF: 

• Traditional IVF – this technique consists of putting the harvested eggs in the presence of sperm to stimulate natural fertilization, all in a controlled environment.
• IVF with ICSI – an IVF technique in which the individual sperm are meticulously selected by the embryologist and inserted with a very fine needle directly into each retrieved egg. This is done under a microscope by one of our embryologists.

5th Stage:

Embryo Maturation

Fertilized eggs are monitored carefully in the laboratory.  Your medical team will advise whether a fresh transfer is recommended or if it would be advantageous to freeze all embryos to transfer in subsequent menstrual cycles.  If genetic testing is desired, the samples are sent away to test and all embryos are frozen while awaiting the results.

6th Stage:

Embryo Transfer

This stage involves transferring an embryo back inside your uterus.  Your uterine lining and hormone levels will be monitored starting at the beginning of your cycle to determine the optimal day for transfer. We use an abdominal ultrasound probe to perform the procedure and requires a full bladder for better visualization.

What's Next?

Finally, the most exciting stage of IVF: waiting for a positive pregnancy test. We will perform a blood test 12 days after your transfer to detect whether the pregnancy hormone, hCG, is present. We will call you the same day with the bloodwork results.