The following is a general overview of what a step-by-step IVF timeline looks like. These times can vary slightly according to your particular infertility diagnosis, and your body’s hormone levels and its response to the various treatment steps.
While IVF does involve manipulation of the ovaries and the use of fertility injections to stimulate egg maturation and release, we still work with your body’s natural menstrual cycle and hormone production. Thus, your IVF cycle will begin on the second or third day of the menstrual period closest to from when you scheduled your IVF treatment.
Now that your ovaries and hormones are in sync, you’re ready to begin the ovarian stimulation process. For this, your clinician will use a single hormone or a combination of hormones in order to get multiple follicles awake, maturing and ready for use. On an average, the ovarian stimulation process lasts for about 8 to 12 days. During this period, you will be monitored via ultrasound scan to see exactly how those egg follicles are doing. When everything looks just right, your doctor will give you a shot of human chorionic gonadotropin (HCG), which officially stimulates the eggs’ release.
Timing is of the essence at this point. Once your doctor has given you the HCG injection, you will need to be back at the clinic in 36-38 hours so the eggs can be retrieved. Egg retrieval is done using anaesthesia because it is mildly invasive.
Depending on what was decided ahead of time, your partner has already provided a recent sperm sample or he may provide one while your eggs are being retrieved. The eggs are fertilized within hours of their retrieval using ICSI or IVF.
Yahoo! You are finally ready for embryo transfer and this part is pretty simple. You won’t even need to be anesthetized as the doctor uses a tiny, slender tube to transfer an embryo into your uterus. If you have surplus viable embryo the remaining embryos will be cryopreserved for your future use.
The tiny embryo will float around in your uterus and depending on the day of transfer take a few days to officially implant or attach itself to the uterine lining. Implantation stimulates the pregnancy hormones required to signal you are pregnant. In the meantime, you and your partner have to hold tight and try to remain calm. We will have you tested on a specific day after the embryo transfer to see whether or not your embryo is safely implanted. If you aren’t pregnant, we will begin exploring the next steps. While IVF success rates continue to improve, it can often take more than one IVF cycle for a healthy, full-term pregnancy to commence.
Sadly, IVF does not always work. There are multiple steps involved in an IVF cycle, and complications may occur at any point in the process. Here, we’ll take a look at some of the things that may go wrong. I am not trying to discourage you, but it’s always better to enter into something knowing both sides of the story.
Issues can occur right from the stimulation phase when medications are used to mature multiple eggs to allow for egg retrieval. There are several different protocols that are used, and one woman’s body can respond differently from other women. It is possible too few or too many eggs matured. An over-response with too many eggs means the egg quality may not be ideal. A poor response to the medications can result in a low number of eggs being retrieved, meaning a slimmer chance of creating embryos that survive. It is also possible that there are no eggs to retrieve at all. Even if a response to medication is typical, there are additional factors that can complicate the cycle. Hormone levels can be off. Many of these situations can result in a delayed or a cancelled cycle. With so many variables, stimulation is tricky to control. Like they say, there are no guarantees in life!
After a successful retrieval, when at least one mature egg has been retrieved, the sperm will be introduced in the hope that fertilization will occur (or intracytoplasmic sperm injection might be used), the embryo will grow and reach a stage where it can be transferred back to the woman’s uterus. The time between egg fertilization and its transfer has a high attrition rate. This attrition combined with a low number of eggs retrieved can mean that no embryos make it to transfer.
The next step is preparing the uterine lining for implantation. Again, medications are used to stimulate the uterus to grow a lining for the embryo to implant in. Sometimes the hormones used to stimulate the lining to grow don’t work, leaving the lining too thin or too thick. In this case, the embryos will not be transferred and would be cryopreserved.
What are the issues in IVF, During Implantation?
If a suitable uterine lining is achieved and an embryo transferred, the embryo needs to successfully implant itself onto the lining. This is one of the most mysterious points in IVF as there is little that can be done to assist in implantation; it is simply a waiting game to see if implantation will be successful or not. A blood test will be taken at some point after the transfer (the exact time frame differs from doctor to doctor, but usually between 10 – 14 days after). If the blood test comes back positive for the hormone human chorionic gonadotropin (hCG), implantation has been successful, and pregnancy has been achieved. The level is often monitored every few days for two or three more blood draws to make sure the levels are rising appropriately. If the levels do not increase accordingly, a chemical pregnancy may have occurred, meaning the embryo implanted for a short time, but did not continue to grow. This can happen even with “naturally” achieved pregnancies, but these are often missed because the pregnancy ends before the woman even realizes she was pregnant in the first place. A chemical pregnancy can be a difficult experience because there is often no specific reason to indicate why the pregnancy didn’t continue.
There have been amazing advances in reproductive technologies and though there are still limits, IVF is a powerful tool that has helped many women achieve successful pregnancies. Human conception has multiple variables, many of which remain a mystery but knowing what you are up against is a step in the right direction that will help you decide if IVF is for you.