For Patients

In vitro fertilization (IVF) is a multi-step process used to assist with conception. The protocol for IVF treatment may vary depending on the individual’s medical history, the cause of infertility, and the fertility clinic’s approach. However, here’s a general outline of a standard IVF protocol:

Ovarian Stimulation (Stimulation Phase)

Goal: Stimulate the ovaries to produce multiple eggs (oocytes) to increase the chances of fertilization.

Medications: Gonadotropins (FSH, LH): Injected daily to stimulate the ovaries.

GnRH agonists: Prevent premature ovulation by suppressing the body’s natural hormones.

Monitoring: Regular blood tests and ultrasounds to monitor the ovaries, hormone levels, and egg growth.

Duration: 10-14 days, depending on the response of the ovaries.

Triggering Ovulation

Once the eggs are mature (usually 18-20mm in diameter), a TRIGGER SHOT of human chorionic gonadotropin (hCG) is given to initiate the final maturation of the eggs.

Timing: The trigger shot is typically given 34-36 hours before egg retrieval

Egg Retrieval (Aspiration)

Procedure: Under sedation, a thin needle is inserted through the vaginal wall and into the ovaries to collect the eggs. This procedure is done transvaginally under ultrasound guidance.

Timing: 34-36 hours after the trigger shot.

Sperm Collection

On the same day as egg retrieval, sperm is collected from the male partner or a sperm donor. The sperm is then processed and prepared for fertilization.

Fertilization

Conventional IVF: The eggs and sperm are combined in a laboratory dish and left to fertilize naturally.

Intracytoplasmic Sperm Injection (ICSI): A single sperm is injected directly into each egg, often used in cases of male infertility.

Embryo Culture

The fertilized eggs (embryos) are cultured for several days, typically 3-5 days, while they develop.

Monitoring: Embryologists monitor the embryos for development and quality.

Embryo Transfer

The best-quality embryo(s) are selected and transferred into the woman’s uterus.

Procedure: The transfer is done under ultrasound guidance, and it’s typically painless or minimally uncomfortable.

Number of embryos: The number of embryos transferred is determined by various factors like the woman’s age, embryo quality, and the clinic’s guidelines.

Luteal Phase Support

Medications: Hormonal medications like progesterone are given after the transfer to support the uterine lining and help with embryo implantation.

Methods: Progesterone can be administered via injections, vaginal suppositories, or oral tablets.

Duration: Luteal phase support usually continues until a pregnancy test is done (around 10-14 days after embryo transfer).

Pregnancy Test:

Blood test: Approximately 10-14 days after the embryo transfer, a blood test is performed to check for pregnancy (hCG levels).

If positive, follow-up ultrasounds are done to confirm the pregnancy and check for a heartbeat.

Post-IVF Care:

If the IVF is successful, additional ultrasounds and monitoring are conducted to track the pregnancy.

If the IVF is unsuccessful, further discussions regarding the next steps (like another IVF cycle or alternative treatments) may occur.

Additional Considerations:

Cryopreservation: Extra embryos can be frozen for future use in case of failed cycles or for future siblings.

Genetic Testing: Some patients may opt for pre-implantation genetic testing (PGT) to screen embryos for genetic conditions.

This protocol is a general overview, and specifics may vary. The fertility specialist will tailor the treatment plan based on individual needs and conditions.