Over the course of the last several decades, fertility specialists have learned the most successful IVF rates occur when we mimic Mother Nature’s ovulation–fertilization–implantation cycle as closely as possible.
Your fertility specialist will work with you to choose the ideal timeline and schedule for you, and – ironically – birth control pills may become part of the process as they minimize the chances of developing cysts and can sync ovulation with your desired schedule.
Before we commence, you’ll come in for a pre-cycle testing and consultation, where the following is covered in greater detail.
Typical Schedule for 5 IVF Steps
The typical IVF schedule mimics a 28-day menstrual cycle, so we can time everything as nature intended.
Step One – Syncing your schedule and egg retrieval
Yes, you’ll use fertility medications to promote the release of more than one egg for fertilization, but we’ll schedule those fertility medications with respect to your natural cycle. If your schedule is unpredictable, hormone balances are irregular, you are prone to developing cysts, and/or your ideal conception would take place differently from your own schedule, we’ll use birth control pills to time your period.
The first day of the period you have before you want to conceive is Day 1 of your IVF cycle. You’ll be given an injectable fertility medication (usually Lupron) which is administered daily, probably around the Week 2 although exact timing varies from patient to patient.
Step Two – Ovarian follicle stimulation
At around the two week point, when hormones and ovaries are in sync, we’ll tailor a fertility medication cocktail to your infertility diagnosis. This round of fertility meds stimulates multiple follicles, in the hopes we’ll retrieve multiple eggs. Medications include of one or more of the following:
Injectable fertility meds pack a powerful punch, and often initiate a range of side effects, sort of like a big bout of PMS. Your doctor will go over all of these with you beforehand (and provide printed material as well), letting you know which ones are normal and which ones should trigger a call to our office to check in. Our doctors are on call during this time so you’ll be able to reach someone anytime of the day or night. During this phase, your Lupron dosage will be reduced.
This “stimulating cocktail” injection phase lasts about 8 to 12-days, and you are closely monitored via estrogen testing and ultrasound to see when the eggs are ready. When the follicles are deemed “ready” you’ll be given an injection of human chorionic gonadotropin (HCG) – which triggers the eggs’ release.
Step Three – Egg retrieval
Once you’ve received your HCG shot, you’ll come back to the office within the next 36-hours for the egg retrieval process. You’ll need someone to drive you as mild anesthesia is provided to you, so you can relax, and to minimize any discomfort. Then, using ultrasound and a special needle, your doctor will go in through your vagina and cervix to aspirate (gently suck) each mature egg out of the follicle.
Since eggs are microscopic, an embryologist stands by to verify the egg is in the tube, carefully storing it. Once all the eggs are retrieved, they’re transferred to the embryology lab. When you wake up from the anesthesia, the doctor will let you know how many eggs we have.
Unless scheduling dictates otherwise, or you’re using a donor egg, your partner contributes the sperm sample during this same window.
Step Four – Fertilization
Eggs are fertilized within hours of retrieval. It takes about one or two full days to know whether or not viable blastocysts (fertilized eggs) have resulted, and you’ll be contacted and informed. If you’ve chosen to have PGS or PGD performed, it’s done around Day 5 after fertilization.
Step Five – Embryo Transfer
Talk about an exciting day! While you won’t be anesthetized, we offer a sedative if you need to relax. At this point, one or two embryos (maybe more, depending on your diagnosis, your choice and the doctor’s recommendation) are transferred into your uterus. Any remaining embryos are frozen and securely stored for future IVF cycles.
Go Home & Relax for the Next Two Weeks
Ha! As if!?! We highly recommend doing all you can to relax. You have 14-days to wait – dubbed The Two Week Wait (2WW) and it isn’t always easy. However, if all goes well, your patience is rewarded with positive pregnancy test results.
Interested in learning more about IVF and whether or not you’re a candidate? Contact us here the Fertility Center of Dallas.