This is the first installment in our IVF Series. For the rest of the series, check out the links below.
What is IVF?
In vitro fertilization (IVF) is a type of assisted reproductive technology (ART) that helps you get pregnant by combining an egg and sperm in a lab to create one or more embryos that are injected directly in your uterus to increase the chances of pregnancy. If the embryo(s) successfully implants in the lining of your uterus you will become pregnant (1).
The first baby conceived through the IVF process was born in 1978, and since then the technique and technology has advanced significantly, along with the success rate. Today, IVF is successful in about 50% of women under 35 years of age and 1-3% of babies born in the U.S. and Europe every year are conceived using IVF (2).
IVF is an intense process that can be emotionally taxing, invasive, and costly, and is often pursued only after other fertility methods have been tried.
Steps to Expect with IVF
If you will be using your own eggs (as opposed to donor eggs), you will take injectable hormones, such as follicle-stimulating hormone (FSH) and/or luteinizing hormone (LH) to induce your ovaries to develop more than one egg at a time. When the follicles (fluid-filled sacs in your ovaries that contain immature eggs, or oocytes) are developed and ready for retrieval, you will take a human chorionic gonadotropin (HCG) to help the follicles mature. Other medications may be prescribed that prevent your ovaries from releasing the eggs too soon. Typically this process takes one to two weeks (3).
Your doctor will perform an ultrasound and/or blood tests to determine if and when the follicles are ready for retrieval. Retrieval is typically done using transvaginal or abdominal ultrasound to guide a needle connected to a suction device to remove the eggs from the follicles. Patients are sedated and given pain medication during this procedure, which usually takes less than a half hour (3).
Your partner will provide a sperm sample on the day of your egg retrieval, or donor sperm may be used. The sperm are “washed and spun” to separate them from the semen fluid and identify the healthiest candidates for fertilization (4). Fertilization is attempted by mixing the healthy sperm and eggs and incubating the mixture for several hours, or through intracytoplasmic sperm injection (ICSI). In ICSI, a single sperm is injected directly into a mature egg. ICSI is used when semen quality is an issue or after unsuccessful fertilization during previous IVF cycles (3).
To help prepare the lining of your uterus to be most receptive to implantation of an embryo, progesterone supplements are required after egg retrieval. Three to five days after a successful fertilization, your doctor will transfer the healthy embryo(s) into your uterus using a thin tube threaded through your vagina and cervix and into your uterus. Multiple embryos may be transferred at one time depending on your age, number of cycles attempted, and other factors (4).
If the embryo successfully implants in your uterine lining, about 2 weeks after the transfer, your doctor may confirm pregnancy through a blood test.
Cost of IVF
Depending on your location and other factors, the price of just one IVF cycle is steep: $10,000-15,000 (5), and it often takes up to three IVF cycles (6) to result in a successful pregnancy. Do your homework to find out whether your health insurance covers IVF. Currently, only 17 states require insurance coverage of infertility benefits by law (7).
Even with coverage, you may need to go through some hoops. Your insurer may ask you to try other fertility methods first, such as intrauterine insemination (IUI), before authorizing IVF.
The fertility journey can be confusing and lonely. If you are looking for support and a community who knows what it’s like, there may be some groups your doctor can recommend or there are also online communities; check out our Kindara community — our users write to us regularly on how helpful it was to them.
Part I: IVF The Basics of the IVF Process (you are here)