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IVF 101: In Vitro Fertilization Explained

Written by Michelle Cassidy

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What Happens in a Typical IVF Cycle?
Since in vitro fertilization has to be coordinated with a woman’s menstrual cycle, a typical IVF cycle is about 30 days long. About three weeks after the start of menstruation (or two weeks after taking a low-dose birth control pill) a patient starts injections of a drug (usually Lupron, but sometimes a newer drug such as Antagon or Cetrotide) to suppress the ovaries. After 10 days of Lupron, the patient returns for an ultrasound scan and estrogen test level. If the results show that the suppression was successful, the cycle begins. The following schedule, adapted from Dr. Wisot’s book, is approximate, since fertility doctors and clinics have their own preferred protocols.

Day 1
Patient begins injections of gonadotropin drugs (follistim, gonal-f, bravelle, and/or pergonal or Repronex) to stimulate the ovaries. Lupron injections continue.

Day 6
After five days of stimulation, the doctor checks to see whether there are enough follicles developing to continue the IVF cycle. If so. . .

Day 10 (depending on the patient’s progress, this stage can occur anywhere from day 7 to 12)
The woman receives an injection of human chorionic gonadotropin (hCG) to trigger ovulation.

Day 11 (or one day after hCG)
The patient returns to the clinic for an ultrasound to check on the status of the follicles.

Day 12 (35 hours after hCG)
With the patient lightly sedated, the doctor retrieves the eggs by guiding a needle into the ovary through a tube inserted into the vagina. Around the same time, a sperm specimen is collected. The eggs and sperm are combined in a culture dish.

Day 13
Doctors check to see how many eggs have been fertilized, and what their quality is. If there are more good-quality embryos than can be transferred, some may be frozen.

Day 15 or 17 (depending on the clinic, day 3 to 5 after fertilization)
The cells—now called embryos rather than fertilized eggs—are transferred to a woman’s uterus, using a thin catheter. Two days of bed rest follow, after which normal activity is allowed.

Days 28-30
The final step: the pregnancy test!

A version of this article originally appeared in the Winter 2005 issue of Conceive Magazine.