In Vitro Fertilization (IVF)
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In-Vitro Fertilization
- Use oral and/or injectable drugs to grow extra eggs
- Retrieve eggs with ultrasound guidance
- Fertilize in the Petri Dish
- Transfer embryo into uterus
Egg Retrieval
- On day 1 of your menstrual cycle, call WFI to schedule your day 3 baseline visit
- Day 1 consists of the first day of bright red, full flow
- Your day 3 baseline visit will consist of the following:
- Blood work
- Transvaginal ultrasound
Letrozole or Gonal F or Follistim
- Injected days ̴3-14 of cycle in the lower abdomen
- Allows the ovaries to grow extra eggs
- Gonal-F and Follistim are refrigerated
Menopur
- 75-150 IU injected days ̴3-14 of cycle in the lower abdomen
- Allows the ovaries to grow extra eggs
- Refrigerate after mixing
Omnitrope
- Injected days ̴3-14 of cycle in the lower abdomen
- Allows the ovaries to grow extra eggs
- Gonal-F and Follistim are refrigerated
Ganirelix or Cetrotide
- Injected in the lower abdomen
- SAME EXACT time in the morning
- Stops early ovulation
- Cetrotide is refrigerated
Novarel
- Usually need to mix with 5 ml of diluent
- Injected in the lower abdomen
- Improves egg quality
- Can also be used for as a “trigger” medication
- Refrigerate after mixing
Follicles Near Trigger Day
Triggers:
Lupron, Novarel, Ovidrel or a combo!
- Injected to prepare the follicles for egg retrieval
- ( ̴day 12 of the cycle)
- We will tell you how much to inject and EXACT timing
Cabergoline
- Vaginally: once or twice per day, starting the night of trigger
- 8 days total
Egg Aspiration
Don’t worry, you are asleep and comfortable during this part!
Antibiotics
- Taken orally, twice per day for 5 days
- Starting with your first meal after egg retrieval
- Take with meals!
Egg
Egg & Sperm
ICSI (Inject Sperm Into Egg)
The Embryo Grows
Fertilized Egg = Embryo
Day 3 Embryos
Day 5/6 Embryos: Blastocysts
Assisted Hatching
- Taken orally, twice per day for 5 days
- Starting with your first meal after egg retrieval
- Take with meals!
Pre-Implantation Genetic Screening/ Diagnosis
- Look at chromosome number and XX or XY
- (Example: Down’s syndrome and gender)
- Look at a single gene disorder
- (Example: Cystic Fibrosis)
Pre-Implantation Genetic Screening
- Looks for normal chromosome number, ensures no extra pieces, & gender
Pre-Implantation Genetic Diagnosis
- Look for specific single gene defect
- Example: Cystic Fibrosis
Embyro Freezing
- Happens on embryo day of life 3 or 5/6 after retrieval
- If doing genetic testing? Tissue removed then embryos frozen at WFI
- The next month, transfer happens
Embyro Transfer
- On day 1 of your menstrual cycle, call WFI to schedule your day 3 baseline visit
- Day 1 consists of the first day of bright red, full flow
- This will likely occur 5-10 days following your retrieval
- Day 1 consists of the first day of bright red, full flow
- Your day 3 baseline visit will consist of the following:
- Blood work
- Transvaginal ultrasound
- Mock embryo transfer
- Please arrive with a full bladder for this appointment
Embryo Transfer
- Estrogen for ̴10 of days
- Once lining is ready, add IM Progesterone
- Also need antibiotic & prednisone
Embryo Transfer
Empty Bladder
Full Bladder
Full Bladder
Pregnancy Test
- Blood test to confirm
- (Might repeat test each few days)
- Vaginal ultrasound for head count
Nine Months Later:
