Pregnancy and Childbirth How Does In Vitro Fertilization Work? An In-Depth Guide for Potential Patients By UPMC Magee-Womens Hospital, October 18, 2017 When you’re having trouble conceiving, it can be difficult to sort through the treatments available to you. Add the emotional stress fertility issues bring and you may not be getting all the information you need, especially when it comes to in vitro fertilization (IVF). To find out if IVF is right for you, talk to your doctor or contact us at Magee-Womens Hospital of UPMC. Your first step should be to ask your doctor if IVF is a good choice for you and your partner. Women who have difficulty conceiving naturally, including infertile couples, women wanting to get pregnant independently, and LGBT couples, can use IVF. Women who are not ready to conceive can also consider freezing their eggs for future use through IVF. Read on to find out more about what to expect from this treatment. How IVF Can Help In vitro fertilization involves fertilizing an egg outside a woman’s body and then implanting the embryo in the woman’s uterus. A few of the reasons women or their partners might experience infertility can include: Sperm issues. If a man has a low sperm count or slow-swimming sperm (low motility), it’s difficult for the sperm to reach and fertilize an egg. Blocked fallopian tube. For a woman, the issue may involve one or both of the fallopian tubes, the tunnels connecting the ovaries and the uterus. If the fallopian tube is blocked, sperm can’t reach the egg. Endometriosis. This is a condition where uterine tissue grows outside the uterus. For a variety of reasons, endometriosis can cause fertility problems. Ovulation problems. If a woman isn’t ovulating regularly (or at all), it’s difficult to get pregnant. Egg quality. Sometimes a woman’s eggs do not fertilize well. In such cases, donor eggs are an option. Who Is a Good Candidate for IVF? Doctors typically recommend that couples try to conceive naturally for six months before considering IVF. IVF is also a good option for a person or couple who need to use donor eggs or sperm to conceive. Success rates per IVF cycle are correlated to a woman’s age. A woman age 35 or younger has a 35 to 50 percent success rate per cycle; a woman who is 40 or older has about a 10 percent chance of success. How Does In Vitro Fertilization Work? The IVF process IVF follows a woman’s menstrual cycle. If your doctor determines that you’re a good candidate for IVF, here’s what you can expect: Ovarian stimulation Before or at the beginning of each IVF cycle, you’ll start receiving injections of hormones to coax your ovaries into producing additional mature eggs and to keep your body’s ovulation schedule on track. At the beginning of your menstrual cycle, you’ll get blood work done, along with a baseline ultrasound. You’ll continue getting blood work and ultrasounds done so your doctor can monitor your developing follicles (fluid sacs that hold the eggs in your ovary) as well as egg maturity. When your doctor verifies that you have several mature follicles, you’ll be given a different hormone to help the eggs mature. Egg retrieval A day or so after the follicles are deemed mature, your doctor will remove eggs from your ovaries with the help of an ultrasound and needle inserted through your vagina. The procedure takes less than a half hour and is done under conscious sedation, which means you’ll be awake but won’t feel anything. Fertilization Your doctor will then determine if your eggs are mature. If they are, your harvested eggs and your partner or donor’s semen will be combined, allowing the sperm to fertilize the eggs. If your partner’s sperm is low motility, your doctor will inject the sperm directly into the eggs for a better chance at fertilization. Embryo transfer The last stage of this cycle is the transfer. Once your doctor determines which eggs — now called embryos — were successfully fertilized and which look healthiest, you’ll return to the office for implantation. Your doctor uses an ultrasound to guide a catheter (a small, thin tube) into your uterus to place the embryos. The process doesn’t usually require anesthesia. Progesterone After the transfer, you’ll be given a hormone called progesterone daily for the best chances of maintaining pregnancy at this early stage. About two weeks after the embryo transfer, you’ll get a pregnancy test. If it’s positive, you’ll continue the progesterone. A week or two later you’ll have an ultrasound. If the IVF procedure has been successful, your pregnancy will be monitored. If it’s unsuccessful, the process starts over. IVF offers couples who want to have a baby naturally the opportunity to do so. The process and technology behind IVF is well tested and has resulted in many healthy babies. To find out if IVF is right for you and to learn more about the procedure, talk to your doctor or contact Magee-Womens Hospital of UPMC.