Any kind of fertility treatment can seem full of confusing procedures and many couples feel that they are being swept along on a tide over which they have little control.  As with many things, a deeper knowledge can mean less apprehension and understanding the IVF process step by step can make a huge difference to how you approach the protocols.

Ovarian Stimulation

This first stage of IVF is aimed at producing at least 8 follicles which will provide quality eggs for retrieval.  Fertility drugs are required to artificially stimulate the ovaries in a similar way to the natural process.  However, the concentrated form of the hormonal shots are designed to promote the development of multiple follicles.  The hormonal treatments used can have side effects such as slight weight gain, pelvic discomfort, breast tenderness and mood swings.

Egg Retrieval

Correct timing is vital at this stage.  Prior to this stage you will have been monitored by your doctor who will confirm that the follicles are mature.  You will be given some form of anesthesia whilst the doctor retrieves the eggs by a procedure known as "follicular aspiration" whereby a hollow needle is inserted into the ovary via the uterus. Ultrasound will be used to guide the needle. The eggs are removed and rinsed and then stored in an IVF incubator until fertilization. 

Post Retrieval Meds

The IVF process step by step includes the taking of medications after retrieval of the eggs. You will normally be given antibiotics to prevent infection, steroids (if assisted hatching is part of your protocols), progesterone to help develop the uterine lining and you may also be prescribed low dose aspiring to prevent clotting in the tiny vessels leading to the uterus and promote healthy blood flow to the reproductive organs.

Sperm Retrieval

Whilst the eggs are being retrieved, the man will usually provide sperm through masturbation. If this is likely to cause problems at the clinic, arrangements may be made for the sample to be provided beforehand and then frozen for later use.  Surgical sperm removal may be performed when a man has had a vasectomy or where there is no sperm in the ejaculate. The sperm is then prepared for fertilization.

Fertilization and Development of the Embryo

You will return home after the sperm and egg retrieval and the clinic will combine the egg and sperm, generally two to six hours after retrieval.  This is where the IVF process step by step can vary a little depending on the clinic. This is then placed in a special medium containing salt, protein and antibiotics and left in an incubator for a few days. Regular checking is carried out by an embryologist and some clinics will begin transfer when the embryo has developed into 2 or 4 cells. Other clinics might leave the embryos to develop further and some will take into account your age and fertility history when deciding on timings.

Embryo Transfer

Prior to transfer, the clinic will have carried out some form of embryo screening. The format will depend on the clinic's own procedures and your own medical history. Current research indicates that 5 day old embryos at the blastocyst stage are likely to have a better chance of implanting and growing into healthy babies.  There is much debate over the number of embryos which should be transfered and the usual number is between two and four.  Certain countries impose their own restrictions though and some clinics will have their own limits.

The IVF process step by step now gets to the embryo transfer procedure.  This does not involve drugs and is usually done as an outpatient procedure.  You will usually be asked to drink extra fluid as a fuller bladder provides the doctor with a better view of the uterus.  The embryos will be suspended in a fluid and placed in a catheter.  The catheter is guided into the uterus and gently placed on the womb lining.  You will be asked to lie down for an hour or two following the transfer and although you should take things easy for a day or two, you should then resume normal activities.  Any unused remaining embryos can be frozen for the future or donated for research or to other couples.

The Two Week Wait

After embryo transfer comes the dreaded two week wait.  Medically, there is very little you can do at this point other than take the progesterone which you will have been given and try to relax.  Certain foods and supplements are thought to help the process.  You are advised to wait until the blood test for an accurate result rather than buying pregnancy tests which could potentially give a false result.

The tests are normally definite either way, but if you have a weak positive result, you will probably be advised to take another test a few days later.

Hopefully, this has broken down the IVF process step by step to give you a brief understanding of the stages involved.  If you would like detailed information of each step along with hints and tips to dramtically improve the success rates of IVF, please visit my website, How To Improve IVF Success