IVF (In Vitro Fertilization) has become the gold standard of fertility treatment options. It provides the highest live birth rate, the lowest risk of pregnancy related complications and provides for the most useful information to guide future treatment efforts. More recently studies have even shown that most couples save money by moving to IVF treatment instead of the old standard of Ovulation Induction/Intra Uterine Insemination (OI/IUI).
IVF involves stimulating the ovaries to produce multiple eggs; removing those eggs and combining them with carefully selected sperm and observing the fertilized embryos until they are ready at the stage when they are ready to implant. At that point they can either be frozen for later use or transferred back into a woman’s uterus to become a healthy pregnancy.
At Conceptions, planning your cycle is critical step. We order only those tests that are necessary to individualize your IVF treatment plan. Once your testing is complete, you will meet with your doctor to discuss your options and explain our recommendations. You will also have many opportunities for additional discussion as your treatment plan moves forward.
During this phase of your treatment, you will be placed on a specific combination of medications that your team has created based upon your pre-cycle testing and your history. This protocol will be explained to you in as much detail as you prefer. You will be monitored by both ultrasound and blood tests to optimize your ovarian response. This phase of your treatment can take several weeks but you will be seen frequently throughout this time period. All labs and office visits are included in your package plan.
When the follicles have matured, you will be scheduled with one of our physicians to have your egg retrieval. Under anesthesia, a thin needle is used with ultrasound guidance pass through the vaginal wall and into your ovaries. Each follicle is drained in order to recover as many mature eggs as you produced. Under the guidance of vaginal ultrasound, a physician will extract the mature eggs. Our anesthesiologists make sure that you are comfortable throughout the procedure which typically takes about 20 to 30 minutes. Once you are awake and fully recovered, you will be able to go home after you have been told how many eggs we retrieved.
After your eggs have been collected, our experienced team can go to work. After the eggs are collected, they are given several hours to complete their maturation process. During this time, our team will focus on preparing the sperm. Later that day, one sperm will be carefully selected for each mature egg that you’ve produced. The sperm will then be carefully injected. Within 24 hours you will be notified of how many eggs successfully fertilized. Fertilization means the sperm DNA and the egg DNA have combined and started to activate. For the next five to six days, your embryos will be nurtured to insure that as many as possible with grow and develop to the blastocyst stage.
Your embryos that grow to the blastocyst stage have demonstrated that they have the minimal characteristics necessary to potentially implant. In order to more carefully select only the embryos that are likely to become a healthy child, we may recommend Complete Chromosomal Screening (CCS). This screening is done for each embryo that makes it to the blastocyst stage. Our embryologist will remove a few cells from what will become the placenta for embryo testing.
Our embryo screening platform is superior to other embryo screening platforms. We use a SNP microarray technique that evaluates 300,000 sites of the genetic code. It compares the results with parental samples (the people that produced the sperm and eggs) and integrates the information with known data from the Human Genome Project. This unique process allows for a percent confidence—a measure of precision—across all 24 chromosomes that is typically in the 96-99.9% range. When an abnormal embryo is identified, this test tells whether that error came from the egg, the sperm or both which can be helpful in creating future treatment plans
Each embryo that has been biopsied will then be frozen using an ultra rapid process called vitrification.
In 2011, a landmark paper reviewed 11 studies and demonstrated that pregnancies are healthier after a frozen transfer (using modern freezing techniques like vitrification) than after a fresh transfer. Specifically, this plan has demonstrated to have less pre-delivery bleeding during pregnancy, a lower risk of preterm birth, decreased risk for small for gestational age baby/low birth weight and a lower infant mortality. It is believed that by splitting the egg retrieval from the embryo transfer, your uterus is a better environment for implantation; creating a healthy placenta to nourish your pregnancy. Your FET is included in the Colorado Conceptions IVF.
Each genetically normal (euploid) embryo that we identify has an average live birth rate of 70%.The Colorado Conceptions IVF Program virtually eliminates miscarriage, abnormal amniocentesis during pregnancy and afflicted birth or identifies the genetic reason that your cycle failed. Our testing method includes diagnosis of all of the most common chromosomal disorders (including aneuploidy, autosomal recessive, autosomal dominant and translocations.
The following are additional techniques that can be used to increase the effectiveness of your IVF cycle. We have created an optimal IVF protocol using some of these techniques called the Conceptions CCS IVF program. Click here to learn more.
Intracytoplasmic Sperm Injection (ICSI) ensures fertilization and is recommended for male infertility, or for couples that have failed fertilization in a prior IVF cycle. ICSI involves the microscopically guided injection of a single sperm into a mature egg.
Blastocysts, or fertilized embryos in their fifth day of development, may offer a viable alternative to Day 3 embryo transfer for some IVF patients.
Depending on the patient's age, diagnosis and the quantity and quantity of embryos available, our team of embryologists may recommend waiting until Day 5 instead of Day 3 for embryo transfer. Embryos which are capable of progressing to the blastocyst stage of development typically result in higher implantation and pregnancy rates with fewer transfered embryos, reducing the risk of higher order multiple gestation.
This technique is typically used for patients who respond well to ovarian stimulation and produce numerous healthy eggs. Your embryologist will review your case personally to determine if you may be a candidate for this procedure.
Microscopic epididymal sperm aspiration (MESA) is a technique used for the retrieval of sperm for males experiencing azoospermia, or an absence of living sperm in their semen. This condition is common in men with a blocked or no vas deferens, a testicular duct that carries sperm to the penis. It may also be indicated for men who have had a vasectomy.
This procedure is performed by urological specialists trained in the field of male infertility. Often, one retrieval yields enough sperm to have some cryopreserved. Your physician will discuss any minor risks of the procedure with you in detail.
To enhance the likelihood of achieving pregnancy during your IVF cycle, a combination of medications will be administered. Based on your individual circumstances, your physician will determine the type, timing and dosage that best suits your needs, then closely monitor your body's response.
Some common infertility medications and their uses include:
Antagonists - Prevents premature ovulation and the midcycle hormonal surge that can result in cycle cancellation.
Doxycycline - When taken by the male, reduces levels of seminal bacteria that could interfere with sperm performance during an IVF cycle. When taken by the female, decreases the risk of infection following egg retrieval.
GnRH Agonists - Encourages the growth of multiple, high quality eggs during an IVF cycle.
Gonadotropins - Stimulates the fluid-filled sacs, or ovarian follicles, to develop multiple eggs. (Gonal F is listed as a preferred medication for some United Healthcare (UHC) plans. UHC preferred medications fall under UHC's lowest copay tier. UHC Member's may consult with their physician to determine if Gonal F is appropriate for their treatment plan)
hCG - Encourages the eggs' final development prior to retrieval.
Medrol - Prepares the uterus for embryo implantation.
Progesterone - Ensures adequate amounts of progesterone are in the body following egg retrieval until the placenta begins producing its own.
OHSS is a rare complication of the controlled ovarian hyperstimulation needed for IVF. Your ovaries will be purposely hyperstimulated in order maximize egg production, however on rare occasions the ovaries over-respond to the medications. Rarely, hospitalization may be required for intravenous fluids and close monitoring of your vital signs and symptoms. Unfortunately, this complication is worsened or prolonged by the pregnancy itself.
There have been many articles in the medical literature evaluating the association between the use of fertility drugs and ovarian cancer. These drugs have been used for over 30 years in the treatment of infertility. It is important to know that most of the articles published have shown no increase in the risk of ovarian cancer with the use of these drugs.
A thorough analysis of all studies has been conducted by the American College of Obstetrics and Gynecology and the American Society For Reproductive Medicine. Further studies are ongoing and will help clarify any possible association. Another important point for any patient with infertility to know is that having a baby reduces your risk for ovarian cancer by over 50%.
Selecting the best infertility treatment center for your needs can be a time-consuming and confusing process. Since your decision may affect the rest of your life, it is wise to base it on more than success rates alone. In addition to IVF success rates, consider the entire picture - clinical expertise, psychological support, guiding philosophies, treatments available, treatment cost and insurance participation.
To help you compare clinic success rates, stability and experience, the Centers for Disease Control has published a comprehensive report based on annual statistics submitted to the Society for Reproductive Medicine (SART). It provides valuable information about infertility programs nationwide, including pregnancy rates by age, miscarriage rates, number of cycles, male factor data and more.
When evaluating programs individually, be sure to obtain a comprehensive statistical analysis of all assisted reproductive technologies performed and their outcomes from each clinic you are considering. Conceptions updates this information annually for patient review. You may contact us to request this information by mail, or view our IVF results, donor egg results or frozen embryo results online.
When you are ready, your next step is to schedule a consultation with one of our fertility specialists. Your initial consultation will provide us the opportunity to learn more about your medical history, answer your questions, and develop a personalized treatment plan designed to help you bring home a healthy baby.