In Vitro Fertilization (IVF)

In Vitro Fertilization, or IVF, is a procedure in which a doctor harvests eggs (ova) from a woman’s ovaries; fertilizes them in the laboratory with her partner’s sperm; and then places the fertilized eggs (embryos) back into the woman’s uterus. Compared to other infertility treatments, IVF has the highest rate of success. However, the process is more involved physically and emotionally than other infertility treatments, and is also more expensive. That’s why at New England Fertility we work closely with patients undergoing IVF, as well as with their partners, providing medical as well as emotional support to better improve the odds of a positive outcome and reduce stress.

The Four Most Common Reasons for IVF

Tubal Factor Infertility
A complete or partial blockage or other malfunction of the fallopian tubes is the most common reason for IVF. In fact, IVF was originally developed to treat women with abnormal or missing fallopian tubes. The IVF process bypasses the absent/damaged tubes. With IVF, fertilization of the eggs and early embryo development occurs in the laboratory. The fertilized eggs are then placed directly into the uterus. For this reason, that is, when IVF is done because the cause of infertility is damaged or abnormal tubes, the chance of success – that is, a full-term pregnancy – is high. In addition, the risk of a tubal pregnancy, which is a common concern with tubal disease, is dramatically reduced.

Male Factor Infertility
The second most common reason for IVF is abnormalities in sperm number or function. When a patient is diagnosed with male factor infertility, the treatment options largely depend on the severity of the problem. The most typical infertility procedure in such cases involves placing the sperm directly into the uterus using a small catheter. In more severe cases, when sperm count, motility, or morphology is poor, the only option is IVF.  Following the egg harvesting, sperm is injected directly into the eggs, bypasssing the zona pellucida (or egg shell). This procedure, known as ICSI, for intra-cytoplasmic sperm injection, allows for fertilization to occur even in cases when the sperm parameters are extremely poor, and has revolutionized the treatment of male factor infertility.

Age-Related Infertility
As women age, so do their eggs, lowering the chances of becoming pregnant and increasing the risk of a miscarriage or birth defects. That’s why IVF, due to doctors’ ability to select the most viable eggs and embryos, is often recommended when treating women over 35 who are struggling with infertility. In some cases, genetic testing of the embryos (PGD) is also recommended, to further help in the selection of the most viable embryos, thus  improving the chances of a full-term pregnancy and a healthy, live birth.

Unexplained Infertility
Unexplained infertility, a couple’s inability to conceive despite normal testing results of all male and female causes of infertility, is common and very frustrating. When more conventional treatments, such as ovulation therapy and IUI fail, doctors typically recommend that couples try IVF. That’s because the success rate of IVF in couples with unexplained infertility is quite high, even after other therapies have failed. In addition, the IVF process often allows doctors to identify the cause(s) of infertility, giving them the insight they need to administer the infertility treatment(s) that has the greatest chance of being successful and leading to healthy pregnancy and baby.

The Five Steps of IVF at New England Fertility

Ovarian Stimulation
Fertility drugs are administered in order to induce the ovaries to produce multiple eggs. This step requires monitoring by blood tests and ultrasounds. Timing of the egg harvest is based on these measurements.

Egg Retrieval 
A minimally invasive procedure performed in the surgical suite in our Stamford, Connecticut, location under sedation. The eggs are retrieved trans-vaginally using a needle that is guided into the ovary using ultrasound.

Fertilization/Embryo Development: 
The eggs are evaluated in New England Fertility’s Stamford, Connecticut, laboratory and fertilization is achieved by mixing eggs with sperm (standard) or by injecting a single sperm into each egg (ICSI). The fertilized eggs become embryos and these are grown in the laboratory under controlled temperature and humidity for three to five days.

Embryo Transfers 
The embryo/s is/are placed in the uterus using a flexible catheter. The procedure is painless, does not require anesthesia, and takes approximately 10 minutes to perform. The number of embryos transferred is determined after a discussion between the couple and the physician. In general, two to three embryos are transferred.

Additional (extra) embryos can be frozen and stored for extended periods. The frozen embryo transfer (FET) can then be performed at a later date.