The process of In vitro fertilization - How is IVF done?

1. Basic screening tests are performed on both partners at all IVF clinics. In general, some testing of "ovarian reserve" should be done on the female prior to starting the injections. We use day 3 FSH testing as well as antral follicle counts for this purpose. The results of these tests give some ability to predict whether her ovaries will respond well to the drugs (make sufficient follicles and eggs). The number of follicles that develop when we stimulate the woman correlates with the number of eggs that we get at the egg pickup (aspiration, retrieval) procedure. The number of eggs retrieved correlates strongly with IVF success rates.
2. Consents are signed by all parties.
3. The woman is stimulated with injected medications to develop multiple follicles in the ovaries. Each follicle contains a microscopic egg. These injections continue to stimulate follicle and egg growth and development for about 8 - 10 days.
4. Blood and ultrasound testing is done every 1-3 days to monitor the development of the follicles (egg-containing structures) in the ovaries. We need to get a minimum number of 3 follicles to develop to maturity in order to be able to proceed with the egg retrieval. About 90% of women under 40 with a normal FSH and normal antral follicle counts will develop at least this minimum number of follicles. If this many mature follicles can not be obtained from the stimulation process - we will "cancel" the cycle (not proceed to egg retrieval). Criteria for cancellation can vary between IVF centers.
5. When a sufficient number of the woman's follicles are mature, a transvaginal ultrasound-guided egg retrieval (egg aspiration) procedure is performed to remove the eggs from the follicles. At our partner IVF clinics, the average duration of the egg retrieval procedure is under 10 minutes, with a range of about 2-15 minutes. Powerful anesthesia medications are used so that the woman is "out" during this procedure and does not feel or remember anything. The eggs are then fertilized in the laboratory with her partner's sperm. If the sperm (or the eggs) are of poor quality, the ICSI procedure might be used to aid in fertilization.
6. The embryos are cultured in the IVF laboratory for 2-6 days.
7. The embryo transfer procedure is done which places the embryos in the woman's uterus where they will hopefully implant and develop to result in a live birth. This is like a Pap smear for the woman. There should be no discomfort.
8. If there are leftover embryos (of sufficient quality) beyond the number that is transferred, many couples prefer to have them frozen (cryopreserved) for use in a future cycle. Embryo cryopreservation can be used for another attempt at having a baby if the "fresh" cycle fails - or as an attempt to have another child if the fresh cycle is successful.

IVF live birth success rate statistics: