Many hopeful ‘parents to be’ struggle with understanding the IVF treatment process and stages. Many wonder how long is the ivf process start to finish? If you find yourself in those same shoes, you’re not alone.
Although the process can feel overwhelming, being both scientifically and medically complex, we’ve done our best to break down the process in a way that is easier to comprehend and follow.
In vitro fertilization (IVF) is a common fertility treatment path chosen by couples and their medical provider to assist with achieving a healthy pregnancy.
Before beginning IVF, your fertility doctor will evaluate your medical history, fertility tests, and more to determine which options may be best for your unique case. Your doctor will walk you through the process and together determine if IVF is a good fit as part of your fertility plan.
This evaluation includes an exam of your fallopian tubes and uterus to ensure that they are structurally sound and in good health. Pre-cycle hormonal panels and evaluation are also necessary to assess ovarian reserve and thyroid function, as is STD screening of both partners. The male partner will also be required to undergo a semen analysis to ensure sperm motility, health and counts.
NOTE: Please be advised that every woman’s physiology and cycle is unique. As such, timelines described herein may vary from patient to patient. This guide discusses averages of a common cycle/timeline.
*You may require medication or injections before the first day of the cycle.
What is Ovarian Stimulation and Why is It Important?
Under normal circumstances, the ovaries only produce one egg at a time. In order to increase the chances of fertilization, it is necessary to harvest multiple eggs for retrieval.
How Are the Ovaries Stimulated?
For between 8-14 days, the woman receiving IVF will be given fertility drugs designed to stimulate the ovaries. This process often results in the production of 10-20 eggs that are retrieved for IVF purposes. However, it is important to note that not all eggs retrieved will be healthy and viable for use.
How are Fertility Drugs Administered?
Your fertility specialist will provide you with a prescription for medication, typically in the form of injections. A standard protocol may consist of 1-2 injections per cycle, or 1-2 injections per day. Although many find this process initially uncomfortable, your fertility nurse will be there to assist in teaching you and your partner how and where to administer the drugs. Most couples find that with a little practice, the process becomes second nature.
The Most Commonly Prescribed Hormonal Medications Include:
*As mentioned, this process typically lasts between 8-14 days.
Throughout the administration of fertility drugs, you will be undergoing continual monitoring in order to ensure the greatest possibility of optimal results. This monitoring includes both regular hormonal panels as well as vaginal ultrasounds.
What is a Trigger Shot?
A “trigger shot” is a shot, typically of hCG, that is designed to replicate and/or replace the natural luteinizing hormone surge that is the catalyst driving the final stages of egg maturation, enabling eggs to reach a level of maturity that prepares them for fertilization.
When is a Trigger Shot Administered?
The trigger shot will be administered when your estrogen has reached proper levels and a vaginal ultrasound has confirmed that you have an adequate number of follicles that have reached the proper size.
What Is Egg Retrieval?
Egg retrieval refers to a surgical procedure during which mature eggs are removed from follicles in your ovaries.
When Does Egg Retrieval Happen?
Egg retrieval is usually scheduled for between 34-36 hours post-trigger shot (prior to ovulation).
What Does the Process Entail?
During the procedure, a small needle will be used to pass through the top of the vagina and into each individual ovary one by one. This needle will be precisely guided with the help of ultrasound visualization, allowing your clinician to carefully and reliably retrieve mature eggs from each ovary.
Follicles, along with associated follicular fluid, will be gently suctioned into the needle bringing the egg along for the ride, through specialized tubing and into a test tube. Once in the test tube, each individual egg will be analyzed under a microscope and documented by an embryologist
How Many Eggs Can Be Retrieved?
The average number of eggs that are retrieved for most women ranges between 8-15 in total. Prior to the procedure, your fertility specialist can typically give you a good idea of how many eggs may be available based on ultrasound observations. Factors that may influence the number of eggs available include but are not limited to age, physiological response to ovarian stimulation efforts, ovarian reserve, and in some cases, accessibility with the needle.
Will it Hurt / Will I Need Anesthesia?
The procedure is carried out while under IV sedation, and monitored closely by an anesthesiologist. As such, you will not experience any pain or discomfort throughout the process.
What is the Recovery Period Like?
The egg retrieval process is short in duration, lasting around one-half hour or less. Post-procedure it is not uncommon to feel mild cramping or discomfort that typically subsides within 24-hours.
You may also experience a feeling of gentle pressure or fullness as a result of ovarian expansion due to stimulation. This feeling of pressure or fullness may persist for up to a few weeks.
As an outpatient procedure, you will be able to walk out on your own, with post-operative anesthesia generally wearing off within a 30-minute window of time. However, you will be unable to drive, and as such, it is advised to bring along a support person who can help arrange for or handle transportation.
Once the eggs have been harvested, they are examined for quality and maturity before being placed into a specialized medium where they can thrive. From there the eggs are placed into an incubator, after which they will promptly (within 3 hours) be fertilized with sperm.
Two processes for fertilization exist:
You and your IVF team will determine together which method of fertilization is best suited to produce results in alignment with your goals. Although both methods have similar clinical success rates, ICSI is used in the majority of situations where fertilization may be impaired by previous IVF failure or poor semen quality.
Regardless of the process chosen, the eggs are checked the following day (24-hours) to determine if successful fertilization has taken place.
Following successful fertilization, your IVF team will monitor progress in order to determine the optimal timeframe for transfer of the embryo. This typically takes place between day 1-6 post-fertilization, or 3-5 days post egg retrieval.
Once the healthiest embryo has been selected for transfer, a soft, thin and pliable catheter is used to implant the embryo into the uterus. This transfer is guided with the use of an abdominal ultrasound to ensure optimal placement for implantation.
The procedure is safe and typically free from pain or discomfort, with many women describing the feeling as similar to that of getting a pap smear done.
Additional healthy embryos not used for transfer are typically frozen for future use if so desired and/or if this IVF cycle is unsuccessful.
Around 2-weeks post transfer of the embryo, you will be scheduled for a simple blood test in order to measure your levels of human chorionic gonadotropin (hCG). The presence of hCG is indicative of a positive pregnancy.
If a pregnancy is confirmed, you will be scheduled for follow up blood tests, as well as ultrasounds to track and further confirm the viability of your fertilized embryo and to identify multiple pregnancies if present.
At around the 9-10th week mark, presuming the pregnancy continues to look normal, you will be referred back to your regular obstetrician for ongoing follow-ups and care leading to birth.
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