The day you get your period is when your treatment will officially begin. On the second day, you’ll be asked for blood tests to check the oestrogen levels in your body.
Ultrasound to check the size of ovaries and detect the presence of any ovarian cysts which may interfere with the treatment. In case there are ovarian cysts, doctors will either allow them to dissolve in a week’s time or take them out with needle.
Under natural conditions, one egg is released by the ovaries every month. However, to increase the chances of success in IVF treatment will be given to produce multiple eggs. Doctors will give injectable hormonal medication for 1 to 2 weeks for stimulating ovaries and produce multiple eggs.
You will be asked to come at least 8 to 9 times for monitoring appointments which will involve:
- Trans-vaginal ultrasound to measure the thickness of the lining of uterus as well as growth of the egg follicles in ovaries.
- Blood testing to measure the levels of estrogen which indicate development and maturation of eggs.
- Each time the test reports come, doctor will provide care instructions, progress information and any changes required in medicines.
Based on the monitoring results about the size of your follicles and oestrogen level, doctor will decide when to give you a trigger shot that will fully mature the ovaries and pave way for ovulation. Timing is very important in this stage because just before ovaries are going to ovulate egg has to be retrieved.
Roughly, 2 to 3 days after trigger shot you’ll be called to the lab for retrieving the egg. An anesthesia medication will be given to you and a needle will be inserted into each ovary to remove the egg along with the follicular fluid. This will be a small outpatient surgical procedure which will take around 30-45 minutes.
In case your ovaries are inaccessible through trans-vaginal procedure, then an abdominal surgery will be performed.
Your partner’s sperm will be collected and stored either earlier or on the same day of insemination.
If you are planning to use your partner's semen, then your partner will be asked to provide semen sample through masturbation. Surgical methods like testicular aspiration might be used in some cases.
Sperm is seperated from the semen in the laboratory.
Insemination & Fertilization
Egg retrieval and insemination occurs on the same day. Mature eggs and sperm are mixed and incubated overnight.
If there is a problem with quality of the semen, sperm injection (ICSI) may be used. A single healthy sperm will be isolated and then injected into the egg. This is done in the embryology lab of IVF clinic.
Once fertilization is complete, embryos began to develop. The growth of these embryos or blastocyst is closely examined by a specialist for at least 1 week.
Nearly on the fifth day after the egg retrieval, your appointment will be scheduled for embryo transfer. Depending on the quality of the embryos, your age and previous medical treatments, either one more embryos will be transferred. For females less than 37 years of age, undergoing first IVF cycle and with good quality blastocysts, doctors may opt for elective Single Embryo Transfer (eSET).
A catheter is used to insert embryo into the uterus.
You’ll have to wait for at least two weeks before pregnancy can be confirmed. You’ll be called for a blood test to check the hCG levels. If more than 25mIU/ml it is considered positive. Still, to be doubly sure doctor may ask for a beta test 2-3 days. If the level of hCG becomes twice after two days, it indicates a healthy pregnancy.
After 6-8 weeks, a vaginal ultrasound may also be done to check for foetal heartbeat and amniotic sac to confirm the positive development of your pregnancy.
For many females, the pregnancy may come out to be negative which would be very disappointing especially after so many weeks of efforts and enthusiasm but don’t let it cloud your hope. Discuss with your IVF specialist who will guide you on next steps.