In vitro fertilization (IVF) offers another pathway to parenthood for patients seeking alternatives to traditional conception, such as people struggling to become pregnant or same-sex couples. At NewYork-Presbyterian, our clinical experts in gynecology and reproductive medicine offer comprehensive and up-to-the-minute care for individuals who wish to become pregnant.
What is In Vitro Fertilization (IVF)?
In vitro fertilization is the process in which an egg is fertilized by a sperm in the embryology lab. After fertilization, the embryos grow in a lab for approximately one week. The five steps involved in IVF are outlined in the following section.
The IVF Process
In vitro fertilization can be broken down into five distinct steps:
Step 1: Stimulation (superovulation)
- Typically a woman will release one mature egg from an ovary each month
- Fertility drugs are given to increase the number of eggs the woman produces. These drugs may be taken by mouth or with self-administered injections.
- The patient is monitored with transvaginal ultrasounds and blood tests for hormone levels
Step 2: Egg retrieval
- Eggs are retrieved from the ovaries through follicular aspiration, a minor surgery that is conducted in the doctor's office. Pain medication is given to ensure the patient's comfort.
- A needle is inserted through the vagina and into each ovary where the eggs have matured in their sacs (also called follicles) during the procedure. Gentle suction is applied to remove the eggs.
- Patients may experience some cramping, which will usually disappear within 24 hours
Step 3: Fertilization
- Once the eggs are retrieved, they are fertilized with sperm from the male partner or sperm donor
- Fertilization of the egg may happen in two different ways:
- The sperm and egg are placed into a controlled chamber, and the sperm enters the egg without assistance, known as conventional insemination
- A single sperm is injected directly into each egg in a process called intracytoplasmic sperm injection (ICSI)
Step 4: Embryo culture
- Once the fertilized egg divides into additional cells, it becomes an embryo. For three to seven days, the embryos are monitored to ensure that they are developing properly.
- In some cases, the embryos are screened for specific genetic conditions that might be passed along from the parents. Through genetic testing, embryos can also be screened for the number of chromosomes.
Step 5: Embryo transfer
- Three to five days after egg retrieval, a healthy embryo is placed in the woman's uterus (or womb)
- As with egg retrieval, this involves a brief procedure in the doctor's office. The embryo is inserted into the uterus via a thin tube passed through the vagina and cervix (opening the uterus). Pregnancy results when the embryo implants in the lining of the uterus.
- Eggs and embryos that are not used during the IVF cycle may be frozen for future use
How Long Does IVF Take?
IVF requires a two-week time commitment. An IVF cycle often begins at the start of the menstrual cycle, and an embryo transfer may be performed approximately three weeks later. This timeframe does not include testing performed before stimulating the ovaries.
Risks and Side Effects of IVF
Patients undergoing IVF may experience mild to moderate discomfort at various stages of the IVF cycle.
IVF risks associated with fertility drugs include:
- Bruising at the injection site
- Abdominal pain
- Headache and mood swings
- Ovarian hyperstimulation syndrome (OHSS) is a painful swelling of the ovaries
Risks related to egg retrieval include:
- Infection and damage to surrounding tissues
- Reaction to anesthesia
Patients who undergo IVF are more likely to have multiple babies if more than one embryo is implanted. Multiple fetus pregnancies are associated with a greater chance of premature birth and lower weight at birth.
How Successful is IVF?
Since the first successful IVF birth in 1978, in vitro fertilization has resulted in millions of babies worldwide. Several factors can influence the success of an IVF cycle, including the underlying cause of infertility and the mother's age. At NewYork-Presbyterian, our success rate is at or above national levels.
In Vitro Fertilization at NewYork-Presbyterian
At NewYork-Presbyterian, a full range of reproductive assistance treatments is available for hopeful parents and their partners. For those who choose in vitro fertilization, our highly experienced clinicians deliver compassionate care through every step of the IVF process. In addition, many team members are at the forefront of new research in the field that is designed to enhance IVF success rates. To find out how IVF may play a role in your path to parenthood, contact us to make an appointment.
Integrative Health and Wellbeing Program
Treatment with IVF requires a considerable physical, emotional, and financial commitment. For some women, especially those coping with fertility issues over time, the process can be stressful. The interdisciplinary team at NewYork-Presbyterian's Integrative Health and Wellbeing Program can help with care that includes:
- Nutritional guidance
- Massage therapy