- \n
- In vitro fertilization (IVF) is a powerful fertility treatment that can treat infertility due to male or female factors.<\/li>\n\n\n\n
- Many patients try IUI before moving on to IVF. The main differences between IVF and IUI are the procedures, effectiveness, and price.<\/li>\n\n\n\n
- In vitro fertilization success rates vary based on the age and quality of the sperm and eggs, as well as the contributing factors to infertility. It\u2019s generally considered the most effective option for creating a pregnancy with a couple\u2019s own genetic material.<\/li>\n\n\n\n
- IVF can be pricey \u2014 around $12,000 or more. Some health insurance may assist with in vitro fertilization costs.<\/li>\n<\/ul>\n\n\n\n
What is in vitro fertilization?<\/h2>\n\n\n\n
In vitro fertilization (IVF) is an assisted reproductive technology<\/a> (ART), a medical procedure used to help create a healthy pregnancy. During IVF, eggs and sperm are combined in a lab to promote fertilization. Then, the fertilized eggs \u2014 called embryos \u2014 can be tested, frozen, or implanted into the uterus to attempt pregnancy.<\/p>\n\n\n\n
In vitro fertilization (IVF) is a powerful treatment with good success rates, but it can be expensive. Those facing challenges with fertility may try IVF if other methods have been unsuccessful.<\/p>\n\n\n\n
A step-by-step guide to the in vitro fertilization process<\/h2>\n\n\n\n
An in vitro fertilization (IVF) cycle \u2014 AKA one treatment period \u2014 generally takes about 3 weeks. But, there\u2019s also preparation that needs to happen prior to the cycle for maximum success. Let\u2019s review what the IVF process looks like.<\/p>\n\n\n\n
![\"\"](\"https:\/\/www.givelegacy.com\/wp-content\/uploads\/2023\/02\/IVF-Guide_Graphic1_V2-1-510x1024.png\")
<\/figure>\n\n\n\nIVF step 1: Preparing for an IVF cycle<\/h3>\n\n\n\n
Before beginning IVF, both patients \u2014 the person who\u2019s producing the sperm, and the person who\u2019s producing the eggs \u2014 should do some necessary testing and prepare their bodies for treatment. While some factors, like genetics, are hard to avoid, implementing healthy lifestyle changes can improve in vitro fertilization success rates.<\/p>\n\n\n\n
Important testing prior to in vitro fertilization (IVF) includes:<\/p>\n\n\n\n
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- STI testing<\/a> and other infectious disease screening<\/li>\n\n\n\n
- Semen analysis<\/a>, to ensure sperm is healthy enough for IVF<\/li>\n\n\n\n
- Ovarian reserve testing, to estimate how many eggs will be retrieved during the IVF cycle<\/li>\n<\/ul>\n\n\n\n
Typically, in vitro fertilization (IVF) is planned as part of ongoing treatment with a reproductive endocrinologist<\/a> (infertility specialist). Therefore, most people or couples planning for IVF will have already had a consultation and\/or completed the above testing.<\/p>\n\n\n\n
While some factors, like genetics, are hard to avoid, implementing healthy lifestyle changes can improve the chances of successful IVF treatment. <\/p>\n\n\n\n
Prepping for IVF treatment can involve:<\/p>\n\n\n\n
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- Eating a healthy balanced diet<\/li>\n\n\n\n
- Reaching or maintaining a healthy weight<\/li>\n\n\n\n
- Avoiding smoking and drinking<\/li>\n\n\n\n
- Taking vitamins<\/a>, such as prenatal vitamins and\/or male fertility supplements<\/a><\/li>\n<\/ul>\n\n\n\n
If you\u2019re planning to try IVF, your reproductive endocrinologist will let you know about anything else you should do in advance to maximize your chances of success.<\/p>\n\n\n\n
Finally, you\u2019ll make a plan of action for your cycle with your doctor. This will include deciding on your medication protocols, cycle timing, etc. Cycle timing will likely be based on the female patient\u2019s natural menstrual cycle. If they have an irregular cycle or want to adjust the timing of their treatment, they may be on birth control pills for a period of time prior to their IVF treatment.<\/p>\n\n\n\n
IVF step 2: Monitoring and ovarian stimulation<\/h3>\n\n\n\n
The \u201cactive\u201d part of the IVF cycle begins on the first day of the female patient\u2019s menstrual cycle, also known as \u201cday 1.\u201d<\/p>\n\n\n\n
At this point, two things start: ovarian stimulation medication, and a series of appointments to track the progress of the medication, known as monitoring.<\/p>\n\n\n\n
Controlled ovarian stimulation involves using injectable hormone medications that stimulate the ovaries to produce eggs. Typically, a person with ovaries will produce a single egg during a menstrual and ovulation cycle (or rarely, two). Ovarian stimulation<\/a> helps improve in vitro fertilization success rates by increasing the number of eggs that are matured and released during one cycle.<\/p>\n\n\n\n
Typically, ovarian stimulation medications are prescribed for 8\u201311 days. During that time, the patient will be expected to complete office visits for an ultrasound and bloodwork every 1\u20132 days. These visits, known as \u201cmonitoring\u201d appointments, allow medical providers to keep track of how the medication is affecting the ovaries, to ensure a patient isn\u2019t making too few \u2014 or too many \u2014 eggs.<\/p>\n\n\n\n
IVF step 3: Egg retrieval and semen collection<\/h3>\n\n\n\n
Both the male partner\/person providing sperm and the female partner\/person providing eggs will have a role in this step of the in vitro fertilization (IVF) process.<\/p>\n\n\n\n
The egg retrieval is the culmination of the ovarian stimulation process, performed when enough eggs are mature. During an egg retrieval, an outpatient surgical procedure, the patient is sedated. Using ultrasonography to guide their way, the doctor will carefully remove the eggs from the ovaries using a needle. The eggs go directly to the lab, and are cultured in an incubator until semen is collected.<\/p>\n\n\n\n
The second part of this step is semen collection. The male patient will masturbate to produce a semen sample. In some cases, this process is done before egg retrieval, and sperm can be frozen<\/a> for use during IVF.<\/p>\n\n\n\n
IVF step 4: In vitro fertilization and embryo development<\/h3>\n\n\n\n
In this step, the sperm is combined with the cultured eggs. If the sperm count is high enough, the embryologist \u2014 or lab scientist \u2014 can simply place the eggs and the sperm in a lab dish, and allow them to fertilize naturally.<\/p>\n\n\n\n
The fertilized eggs, or zygotes, are incubated and monitored for several days to ensure they enter the blastocyst stage. Blastocysts have over 100 cells and some distinct cell layers.<\/p>\n\n\n\n
Once embryos reach the blastocyst stage, the embryologist and\/or reproductive endocrinologist can assess the quality of the embryos<\/a>, based on how much they\u2019ve expanded and differentiated into sections and structures.<\/p>\n\n\n\n
The grading system for embryo quality is as follows:<\/p>\n\n\n\n
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- Grade A: <\/strong>Embryos with excellent quality and high chances of successful implantation.<\/li>\n\n\n\n
- Grade B: <\/strong>The quality of embryos are good, with a decent chance of implantation.<\/li>\n\n\n\n
- Grade C: <\/strong>These embryos are considered average, with a lower chance of implantation.<\/li>\n\n\n\n
- Grade D:<\/strong> Embryos with poor quality and probability of implantation.<\/li>\n<\/ul>\n\n\n\n
Choosing embryos based on these characteristics can help select the most robust embryos with the highest chances of survival after implantation. However, this is not as accurate as preimplantation genetic testing when it comes to determining which embryos are most likely to result in a healthy pregnancy.<\/p>\n\n\n\n
Optional step: ICSI<\/h4>\n\n\n\n
If the sperm count is low or sperm motility (AKA movement) is poor, a reproductive endocrinologist may recommend intracytoplasmic sperm injection (ICSI).<\/p>\n\n\n\n
ICSI is an IVF technique in which a single sperm cell is inserted into the center (or nucleus) of the egg using a needle. This method was created to help increase the chances of fertilization for men with a low sperm count or motility, or those who have been unsuccessful with IVF, and may improve in vitro fertilization success rates.<\/p>\n\n\n\n
IVF step 4: Embryo transfer, testing, and\/or freezing<\/h3>\n\n\n\n
In most cases, embryos are transferred at the blastocyst stage, around day five. The transfer is a simple non-surgical procedure that does not require sedation or anesthesia. A doctor will load an embryo into a catheter that\u2019s inserted through the female patient\u2019s cervix and into the uterus, often using ultrasound to guide them. The doctor then uses the plunger at the end of the catheter to \u201cflush\u201d the embryo into the uterus, where it will hopefully implant and create a pregnancy.<\/p>\n\n\n\n
In modern IVF cycles, the \u201cgold standard\u201d is to transfer one high-quality embryo at a time. If a patient or couple doesn\u2019t have many high-quality embryos, the doctor may recommend transferring two at a time.<\/p>\n\n\n\n
Optional step: Embryo freezing<\/h4>\n\n\n\n
Additional embryos can be frozen for future use. Embryo freezing, or cryopreservation, allows the option to attempt pregnancy again or have additional children.<\/p>\n\n\n\n
If you need additional time to prepare to attempt pregnancy \u2014 if, for example, you have a thin uterine lining or have lingering side effects from your IVF cycle \u2014 you may also be advised to freeze all of your embryos and attempt your first embryo transfer after a month or so.<\/p>\n\n\n\n
Optional step: Embryo genetic testing<\/h4>\n\n\n\n
Some patients or couples may choose to do genetic testing on their embryos at this point in the IVF process. Instead of immediately transferring the embryos, an embryologist can do an \u201cembryo biopsy,\u201d in which a small piece of tissue \u2014 just a few cells \u2014 is removed from the embryo for genetic testing.<\/p>\n\n\n\n
Embryo genetic testing can tell your healthcare provider one of two things:<\/p>\n\n\n\n
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- Whether the embryo(s) have the proper number and arrangement of chromosomes, making them \u201ceuploid\u201d (genetically healthy) and more likely to result in a healthy child<\/li>\n\n\n\n
- Whether the embryo(s) contain certain genes or genetic mutations associated with a specific disease, such as cystic fibrosis, that the parents may carry<\/li>\n<\/ul>\n\n\n\n
If embryo genetic testing is performed, the embryos will be frozen while they await the results of the testing. Then, you may thaw one or more embryos to attempt pregnancy in a future embryo transfer.<\/p>\n\n\n\n
IVF step 5: hCG pregnancy blood test<\/h3>\n\n\n\n
The final step of an in vitro fertilization (IVF) cycle is a hormone chorionic gonadotropin (hCG) blood test two weeks post-embryo transfer. This test measures the amount of hCG or \u201cpregnancy hormones\u201d in the body.<\/p>\n\n\n\n
Taking a pregnancy test early can result in a false positive, which is why healthcare providers recommend patients wait the entire two weeks. If the test is positive, the patient will take another test two days later to confirm the hCG levels are rising appropriately.<\/p>\n\n\n\n
Who should consider in vitro fertilization (IVF)?<\/h2>\n\n\n\n
In vitro fertilization (IVF) is a good choice for:<\/p>\n\n\n\n
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- People with blocked fallopian tubes.<\/li>\n\n\n\n
- People with advanced endometriosis.<\/li>\n\n\n\n
- People with moderate to severe male-factor infertility.<\/li>\n\n\n\n
- People using sperm retrieved directly from the testes<\/a>.<\/li>\n\n\n\n
- People with limited amounts of frozen sperm and no \u201cfresh\u201d sperm option.<\/li>\n\n\n\n
- People who want to or need to do genetic testing on their embryos (such as couples who carry certain genetic illnesses).<\/li>\n\n\n\n
- People who have tried multiple IUI cycles without success.<\/li>\n<\/ul>\n\n\n\n
Is in vitro fertilization (IVF) a good choice for male-factor infertility?<\/h3>\n\n\n\n
In vitro fertilization, especially with the addition of intracytoplasmic sperm injection (ICSI), can be a powerful treatment for those dealing with male-factor infertility. IVF without ICSI is generally an option for those with a total motile sperm count of 5 million or more. IVF with ICSI requires only a single sperm per egg, so can be used even when sperm is scarce or has very low or no motility.<\/p>\n\n\n\n
Not sure what your total motile sperm count is? We offer at-home semen analysis<\/a> kits that test male fertility<\/a>, including sperm concentration<\/a>, sperm volume, sperm motility, sperm morphology<\/a>, and total motile sperm count, giving you and your medical team a picture of your likelihood to conceive with IUI. Learn more about how at-home sperm testing works<\/a>.<\/p>\n\n\n\n
If you receive abnormal semen analysis results<\/a>, those results may be used to give you a male-factor infertility diagnosis<\/a>. You can talk to your doctor or a urologist<\/a> about ways to improve your sperm health<\/a> and improve your chances of success with intrauterine insemination (IUI) or other fertility journeys.<\/p>\n\n\n\n
Should I do sperm freezing before in vitro fertilization?<\/h2>\n\n\n\n
Many couples or patients choose to do sperm freezing<\/a> prior to IVF. Freezing sperm prior to fertility treatment ensures that you have a back-up plan for your in vitro fertilization (IVF) cycle. If you have frozen sperm, you can have a successful IVF cycle even if the male patient cannot produce a sample on the day of the egg retrieval, or if the sample produced doesn\u2019t have enough motile sperm.<\/p>\n\n\n\n
Using frozen sperm for IVF won\u2019t affect won\u2019t affect the in vitro fertilization process<\/a>. Studies demonstrate that frozen sperm is equally as successful as \u201cfresh,\u201d never-frozen sperm when used in IVF cycles. Learn more about <\/em>sperm freezing<\/em><\/a>.<\/em><\/p>\n\n\n\n
Legacy offers a sperm testing and freezing kit<\/a>, which saves a trip to a sperm bank or fertility clinic. Learn more about how at-home sperm freezing works<\/a>.<\/p>\n\n\n\n
In vitro fertilization success rates<\/h2>\n\n\n\n
In vitro fertilization success rates vary depending on the age of the biological parents. According to the CDC, in vitro fertilization success rates are as follows:<\/p>\n\n\n\n
- Grade B: <\/strong>The quality of embryos are good, with a decent chance of implantation.<\/li>\n\n\n\n
- Grade A: <\/strong>Embryos with excellent quality and high chances of successful implantation.<\/li>\n\n\n\n
- Semen analysis<\/a>, to ensure sperm is healthy enough for IVF<\/li>\n\n\n\n
- STI testing<\/a> and other infectious disease screening<\/li>\n\n\n\n
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