What is In Vitro Fertilization (IVF)?
In vitro fertilization involves the fertilization of an egg by a sperm outside of the body.
In vitro fertilization is a well-established treatment for infertility thanks to its efficiency and effectiveness in leading to a pregnancy. In Ontario, there is government funding available for IVF cycles for those concerned about in vitro treatment cost.
This phase takes an average of 10 to 14 days. It involves daily injectable medications comprised of hormones to grow, recruit and mature multiple follicles. Frequent blood work and ultrasound tests at the clinic are needed to monitor follicular growth and hormone levels. Once the follicles reach an adequate size, an injection is used to induce ovulation and the Egg Retrieval is scheduled.
This is a procedure performed in the operating room by a physician, where the eggs are removed from the follicles within the ovaries. The patient is placed under conscious sedation to provide pain relief and comfort throughout the whole procedure.
Once the egg retrieval is done, the eggs are combined with the sperm sample in hopes of achieving fertilization. There are two different methods of fertilization for in vitro fertilization in Canada:
Conventional In-Vitro Fertilization- An optimal concentration of sperm is placed into a dish containing the eggs, and it is up to the sperm to penetrate the egg and fertilize naturally.
Intracytoplasmic Sperm Injection (ICSI)- Lab techniques are used to select one sperm to inject directly into the egg. This guarantees that the sperm will penetrate the egg, but it does not guarantee that it will fertilize.
The embryos are stored in incubators and monitored for fertilization after 24H, then again on day 3 and 5 for progression. Once they have reached a blastocyst stage, the embryos can be transferred or frozen. Transfer can also be done on day 3, but this is less frequent.
Pre-Implantation Genetic Testing (PGT)
Prior to an embryo freezing, patients have the option to genetically test their embryos. PGT can screen for chromosomal abnormalities (i.e. Down Syndrome), structural rearrangements (i.e. balanced translocations) and single-gene genetic disorders (i.e. Cystic Fibrosis, Sickle Cell Anemia). Transferring a chromosomally normal embryo increases your chances of pregnancy and greatly decreases the risk of miscarriage during in vitro fertilization.
A fresh, untested embryo transfer can occur 3 or 5 days post egg retrieval. If the conditions are not optimal for embryo transfer or if a patient chooses to pursue genetic testing, the embryos are frozen and stored for a future transfer date.
The embryo transfer is a procedure done by a physician with ultrasound guidance. The embryo is placed in a thin, flexible catheter, inserted through the cervix, and released near the top of the uterus. The transfer procedure is painless and takes around 10-15 minutes to complete. You will be required to maintain a full bladder for this procedure.
From Day 1, Dr.'s Dzineku and Roumain were very approachable, knowledgeable, professional, resourceful and genuine.