According to ASRM, infertility is a disease of the reproductive system that impairs one of the body's most basic functions: the conception of children.What is endometriosis?
Endometriosis occurs when endometrium (the tissue that lines the uterus) grows outside of the uterus on other organs or structures of the body. There is a correlation between endometriosis and infertility.What is DOR (Diminished Ovarian Reserve)?
Diminished Ovarian Reserve (DOR)--also called Premature Ovarian Aging (POA)--is a condition when a woman's supply of eggs is prematurely low. For some, both the quality and quantity of eggs may be low, although the condition primarily refers to a diminished quantity.What is an IUI?
An IUI is an Intra-Uterine Insemination. With an IUI, medication is often used to help stimulate the growth of follicles and trigger ovulation. On the day of ovulation, a catheter is used to place the husband's washed sperm directly into the woman's uterus.What is an IVF?
An IVF stands for In-Vitro Fertilization. With IVF, medication is used to help stimulate the growth of follicles, trigger ovulation, and maximize the uterus for implantation. Eggs are retrieved surgically and fertilized with the husband's washed sperm outside of the woman's body. After fertilization, three-day- or five-day-old embryos are placed directly inside the uterus.What are the steps for an IVF?
Any research will tell you there are four steps: Stimulation, Monitoring, and Triggering; Egg Retrieval; Fertilization; and Embryo Transfer. Our NP broke them up in different ways, though, so I'm going to use what she said:
- Suppression: This is the first step in the process, and it definitely feels like you're headed in the wrong direction. Before any stimulation of the follicles occur, you are put on birth control or other medications to encourage suppression of the follicles. This is because each month, there is usually one follicle (potentially mature egg) that is a little bigger and that sucks all the follicle-stimulating hormone (FSH) the body produces. We want all the follicles to be the same size when starting so that more than one will get to grow because of the FSH.
- Stimulation: After a cycle of birth control, you are ready to begin the real process! Follicles are stimulated by injecting FSH into the body. This is something our bodies produce naturally each cycle, but we want more than one mature egg. Naturally, just like in a normal situation, eggs may "die" or fertilization may not occur, so the goal is to get a good number of mature eggs. This step also includes a medication that triggers ovulation. Timing is everything, whether fertilization is occurring inside or outside of a clinic! This "trigger shot," as it's called, ensures when the woman ovulates. Once ovulation has been triggered, it's time for egg retrieval.
- Retrieval (Aspiration) and Fertilization: Because IVF means that an egg and a sperm are coming together outside the body, the egg has to be retrieved. In the case of IVF, there are multiple eggs being retrieved. Now, we can't see eggs -- they are smaller than a single piece of dust. Basically, the fluid from the follicle (which we can see in an ultrasound) is withdrawn and examined through an ultrasound-guided trans-vaginal surgery. At that point, the embryologist can see if the egg was retrieved, its size, and even its health! This is done one-by-one with the embryologist examining each bit of fluid and ultimately each egg. The woman, by the way, is completely sedated, so she doesn't feel any pain and often doesn't remember anything. The eggs are then placed in an incubator. Within a couple of hours, the eggs are fertilized using the cleaned sperm sample.
- Embryo Transfer: The fertilized eggs, now embryos, "grow" for a few days. A typical IVF places three-day-old embryos in the uterus, but it is possible--and higher success rates come--from giving the embryos a couple more days to grow. At five to seven days after fertilization, the embryo is called a blastocyst. Different factors may go into whether a three-day-old or five-day-old embryo is placed inside the uterus. The transfer is straight-forward: the embryos are placed inside the uterus at the appropriate time, and the woman is on bed-rest for 24 hours. Roughly fourteen days after the transfer, a blood test lets everyone know whether the IVF was successful...and hopefully it was!