In vitro fertilization (or IVF) is a highly successful assisted reproductive technology. There are four basic steps in an IVF treatment cycle:

Egg Retrieval
Egg retrieval is a minor surgical procedure that can be performed on an outpatient basis at Boston IVF’s surgery center. It typically takes about 10-15 minutes and requires IV sedation.

Fertilization and Embryo Development
The retrieved eggs are placed in a petri dish with a special solution for 2 to 3 hours. During this time, the male partner provides a semen sample. The sample is delivered to the lab where it undergoes a clarifying process referred to as “washing”. The washed sperm are incubated and placed in the petri dish with the eggs. After 18 hours, the eggs are examined. If fertilization occurs, then two to four of the resulting embryos are selected for transfer back to the female.

Embryo Transfer
Embryo transfer is a simple procedure that does not require anesthesia. The selected embryos are inserted into a thin tube and guided toward the female’s uterus, where it is hoped they will continue their natural fetal development. Transfer typically takes place three days after egg retrieval, or five to six days after retrieval in the case of blastocyst transfer. Rest and recovery are recommended for 24 to 48 hours.

Other advanced fertility treatments:

Embryo Freezing: Embryo freezing permits high quality embryos that are not immediately used for IVF to be frozen for the couple’s later use. Approximately half of all frozen embryos remain viable after thawing and can be successfully used in IVF treatment. If the frozen embryos are no longer needed, they can be sometimes donated to research, donated to other infertile women or discarded.

High Implant Potential (HIP) Embryos: Through ongoing research, Boston IVF scientists have developed methods for identifying the highest quality embryos – those most likely to implant and lead to a pregnancy. These high implantation potential embryos are twice as likely to implant as non-HIP embryos. HIP embryos are rated on the number of cells and the quality of cell growth.

Blastocyst Transfer: In a typical IVF cycle, fertilized eggs are returned to the uterus after two to three days of maturation. In the past, in vitro culture media could not sustain embryo growth beyond this time. Today it is possible for embryos to mature in vitro for up to five days, at which point they develop into blastocysts. Only the healthiest eggs will make it to the blastocyst stage. Blastocyst transfer is not appropriate for all patients. Talk to your Boston IVF doctor about whether it is right for you.

Preimplantation Genetic Diagnosis (PGD): Pre-implantation genetic diagnosis (PGD) allows embryos developed through IVF to be screened for certain genetic disorders. PGD provides particular benefits to patients at risk of passing on inherited genetic diseases, such as cystic fibrosis and muscular dystrophy. PGD is performed in the lab on the third day of embryo maturation. A single cell is removed from each of the embryos and tested.

Genetic Counseling: Dr. Catherine Nowak and her team of genetic counselors will see patients every FIRST Friday of each month. Please call 888.300.BIVF to schedule a consultation at our Waltham Center.

Why Schedule a Genetic Consultation? Concerns about genetic screening results: (chromosome translocations, +CF screen, +TS screen, etc.) A family history of a known or suspected genetic disorder (eg. tuberous sclerosis, NF, muscular dystrophy, hemophilia, etc.) Advanced maternal age: Discuss risks, options (PGD, egg donation) and management (ERA, CVS, amnio, U/S, etc.) Maternal medication exposure: Some women require medication during their pregnancy (eg. epilepsy, high bp) Maternal/Paternal anxiety over familty or personal history.

Assisted Hatching: There is a phase in embryo development during which the embryo must be released, or "hatched" from its hard outer covering. Infertility results when natural dissolution of the shell fails to occur. Assisted hatching can be performed using lasers, mechanical techniques or chemicals.

Gamete Intra-fallopian Transfer (GIFT): Gamete Intra-fallopian Transfer (GIFT) is an alternative to IVF. GIFT is recommended for women who have a problem with the cervix (that prevents embryos from being placed back into the uterus). It involves the first two steps of IVF treatment: ovulation induction and egg retrieval. In contrast to IVF, the GIFT procedure places the eggs and sperm in the fallopian tube, allowing the tube to be the natural incubator.