In Vitro Fertilization (IVF)
Conceiving a child is not always as easy as you might think. When a woman is having difficulty getting pregnant, in vitro fertilization (IVF) can often provide a solution. IVF is the most successful fertility treatment currently available.
IVF is a procedure that involves retrieving a woman’s eggs and a man’s sperm sample and combining the two in a laboratory dish. A fertilized embryo—or sometimes more than one embryo—is then transferred to the woman’s uterus.
“We have a great team of physicians, nurses, clinical staff and embryologists,” says Lubna Pal, MBBS, director of the Yale Medicine Polycystic Ovary Syndrome (PCOS) Program. “We deal with complicated cases and offer individualized treatment. All of our clinicians are researchers, and we are constantly learning new things and applying advances for the benefit of our patients.”
The Yale Fertility Center works with infertile couples and individual women and men seeking fertility treatment, offering information, support and counseling. Our expert team of doctors, nursing staff and embryologists utilizes the the latest available techniques and advanced treatments to help our patients achieve their dream of building a family.
(Click here to see a video about IVF.)
What is IVF?
IVF is one of the most successful treatment options for managing infertility regardless of its cause. Here’s how it works: To create an embryo, doctors collect developing eggs from a woman’s ovaries (during a minor procedure performed under sedation). In the laboratory, the embryologists will then fertilize, or mix, the collected eggs with sperm from her male partner (or a donor).
The resulting embryos will grow in special incubators for three to five days, after which one or more of them will be transferred into the woman’s uterus using a simple (and gentle) technique. A few days following the transfer, the embryos will attach to the uterine lining (in a process called implantation). After about 10 days, the woman will take a blood pregnancy test to learn whether the process was successful, and if she is, in fact, pregnant. (To increase your chances of pregnancy, you may need to undergo multiple cycles.)
Who is a candidate for IVF?
IVF is the treatment of choice for a wide variety of infertility cases. Female partners who have blocked, damaged, or missing fallopian tubes, and male partners who have severe sperm abnormalities are ideal candidates for this treatment.
IVF may also be an option for couples with a long history of infertility, including unexplained infertility and those who have not been able to conceive with other infertility treatments. It’s also helpful for women with severe endometriosis, a painful condition in which tissue that normally lines the uterus grows outside of it, and on other organs.
When male infertility issues are considered the main cause of a couple’s infertility, a special procedure called Intracytoplasmic Sperm Injection (ICSI) may be recommended. During this procedure, a single sperm is injected into a mature egg to facilitate fertilization.
What is an IVF cycle?
An IVF cycle is a sequence of phases, each with separate steps. The phases are as follows: ovulation stimulation, egg retrieval, insemination and embryo implantation.
The treatment cycle typically begins on the first day of your menstrual cycle, or as close to it as possible. You will start by taking hormonal medications, which are usually injected. There are three different types of medicines, and each have different functions:
- Ovarian stimulation medications typically contain two common hormones found naturally in the body: follicle-stimulating hormone (FSH) and lutenizing hormone (LH), which prompt the ovary follicles (fluid-filled sacs, each containing one egg) to mature, enabling ovulation.
- Another hormonal medicine prevents ovulation from occurring until several eggs have properly matured.
- The third, called the “trigger,” stimulates a timely release of the egg so that it can be collected or retrieved.
Doctors will monitor your ovarian response to the medications. This is done by using a vaginal ultrasound and also measuring the blood levels of ovarian hormones (estrogen levels usually go up, but your progesterone levels should stay low).
Your physician will determine the best time to start the egg retrieval process, based on your blood hormone levels and the size and number of ovarian follicles visible on ultrasound. The “trigger” injectable medication—the timing of which is extremely important—should be administered about 34 to 36 hours before the egg retrieval process.
Male partners will accompany you on the day of the procedure and provide a sperm sample (unless one was frozen beforehand). After your paperwork is reviewed and all your questions have been addressed, the egg retrieval process will begin.
What happens during the egg retrieval procedure?
During egg retrieval, an ultrasound probe (with an attached needle guide) is placed into the vagina. (We use a combination of IV sedatives and local anesthetic to keep you comfortable during the procedure.) Once follicles are identified, doctors will pass a thin needle along the ultrasound guide through the wall of the vagina into the ovary. Doctors will collect eggs from the visible follicles and prepare them for embryo transfer.
How are embryos “transferred”?
Embryo transfer is a simple and painless procedure that typically occurs three to five days after egg retrieval. Here’s how it works: One of our trained staff members will perform an abdominal ultrasound scan, while your fertility specialist cleanses the cervix. The embryos are pre-selected based on a number of factors, including your age, your prior reproductive history and health profile, and the number and quality of the available embryos. They will be loaded into a catheter.
Guided by ultrasound, your doctor will insert the catheter through your cervix, depositing your embryos into the uterus. Afterwards, you will be kept in a reclined position for about 15 minutes. You can then go about your normal day.
After about two weeks, you’ll have a test that measures the levels of the hormone human chorionic gonadotropin (hCG) in your blood. If the hormone is detected, that means you are pregnant.
What stands out about Yale Medicine’s approach to IVF?
Our renowned multidisciplinary team of physicians, nurses, scientists and specialized staff is dedicated to helping you fulfill your dreams of building a family.
Our clinicians are internationally recognized for their clinical expertise and research contributions in the field of reproductive biology. Together with our highly trained and experienced nurses and laboratory staff, we strive to make the fertility treatment a stress-free experience for our patients.
Through a combination of clinical expertise and ongoing scientific rigor, our team strives to maximize your chances of a healthy pregnancy.