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In Vitro Fertilization (IVF) in Indiana

Because of its high success rates, in vitro fertilization (IVF) is one of the most popular and common forms of assisted reproductive treatment. From infertility to third-party reproduction, IVF can make it possible for you to achieve your dreams of having a child. At Indiana Fertility Institute, we have used IVF to help many couples and individuals make their dreams of parenthood into a reality for over 30 years.

  • When Is IVF Recommended?

    IVF is a successful treatment option in a wide variety of scenarios. It’s often recommended as the standard fertility treatment for couples and individuals who are facing some kind of reproductive issue, such as polycystic ovarian syndrome (PCOS) or male factor infertility. It is also commonly used by aspiring single parents and LGBTQ+ same-sex couples. In each of these scenarios, IVF makes it possible for people to become parents when they are unable to conceive on their own.

  • Why Choose IVF?

    Aside from increasing the odds of getting pregnant, there are many reasons why patients decide to pursue IVF. Some of these include:

    • IVF makes it possible for you to freeze your eggs or embryos so that you can have more control over when you have a baby
    • IVF, in combination with preimplantation genetic testing (PGT), allows patients to have their embryos tested for genetic abnormalities before implantation
    • IVF makes it possible for you to become a parent when using donated eggs and/or sperm

    Couple on Couch
  • What Is IVF?

    “In vitro” is a Latin phrase that means “in glass,” and in medical science, it refers to the process of working with cells that are separated outside of their original organism. In vitro fertilization is the process of taking an egg from the ovaries and fertilizing it with sperm outside of the body in a laboratory. 

    Once the egg has been fertilized and has successfully developed into an embryo, it can either be transferred into the recipient’s uterus or frozen for later use. Once transferred into the uterus (whether through a fresh or frozen embryo transfer), the embryo will hopefully attach itself to the uterine lining where it will ultimately develop into a baby. Patients with extra frozen embryos also have the option of offering their embryos for adoption.

    Doctor and Patient Looking at Sonogram

The IVF Process: A Step-by-Step Overview

To give the best chances of having a successful conception and pregnancy, IVF treatment requires a lot of coordination and timing, especially in comparison to some other forms of fertility care. From start to finish, the IVF process can take several months to complete a single cycle. Some patients have to undergo multiple cycles of IVF before achieving a successful pregnancy. While every IVF journey is different, a typical IVF cycle consists of seven basic stages:

  • 1

    Ovarian Stimulation

    In traditional IVF using the patient’s own fresh eggs, patients typically begin the process by taking prescribed fertility medications. These medications alter your hormone levels and signal to the body to start producing more eggs than usual. For the average female patient, she produces only one mature egg per menstrual cycle. The medications stimulate the ovaries into producing multiple mature eggs at once, ultimately giving the patient more chances to have a successful outcome. Ovarian stimulation is also used in egg freezing and egg donation.

  • 2

    Retrieve Mature Eggs

    Once multiple mature eggs have reached the optimal level of development, the doctor performs a minimally invasive surgical procedure to retrieve them. Known as egg retrieval, the procedure involves a small aspirating needle being inserted into the ovary. The doctor uses an ultrasonic probe inserted into the vagina to help them navigate the needle so that it can collect the mature eggs from the ovary. The procedure typically takes up to half an hour to complete. Because it is minimally invasive, it is generally performed on an outpatient basis. Before starting the egg retrieval procedure, patients are given light sedation, which helps to minimize pain and discomfort. After the mature eggs have been extracted, they are identified under a microscope and treated with nutrients in a petri dish.

  • 3

    Prepare Sperm for Fertilization

    To obtain sperm for IVF, the male patient or a sperm donor must provide a semen sample. In most cases, the semen sample is produced through masturbation, although some patients may need to undergo a process called microsurgical sperm aspiration, depending on the situation. Once produced, the semen sample is then washed, which is a process that involves separating the sperm from the seminal fluid, resulting in a concentrated sample of healthy sperm. This helps to increase the odds of fertilization. 

    This process is also performed when cryopreserving a patient’s sperm or freezing a donor’s sperm sample. Frozen sperm samples are stored in liquid nitrogen storage containers. When ready for use, they are thawed out and checked to ensure viability. Once thawed, the sperm are ready to be used for fertilization.

  • 4

    Fertilization and Embryonic Development

    Fertilization is often accomplished by simply mixing an egg with sperm in a petri dish to allow for insemination. In some cases, your doctor may recommend a procedure known as intracytoplasmic sperm injection (ICSI), in which a single sperm is injected directly into the center of the egg using a micropipette. 

    The sample is then left to culture for approximately 12 to 16 hours, after which it is examined to see if fertilization has been successful. The embryos are developed for three to five days so that they can reach the blastocyst stage of embryonic development. At this point, the embryo is a ball of rapidly dividing cells. The blastocyst embryo consists of an inner mass of cells that will eventually develop into the actual embryo and an outer wall of cells that will protect the inner mass and eventually develop into the placenta. 

    The blastocyst stage is a pivotal moment in embryonic and fetal development, as it is the stage in which the embryo implants in the uterine lining. Once the embryo has reached the blastocyst stage, patients have the option of transferring it into the recipient’s uterus or freezing it for future implantation.

  • 5

    Embryo Transfer

    The final step of the IVF procedure is the embryo transfer. At the Indiana Fertility Institute, we typically only transfer one to two embryos in a single cycle, which is what is recommended by the American Society for Reproductive Medicine (ASRM). Transferring a smaller number of embryos at once helps to reduce health and safety risks for both carriers and babies. 

    Embryo transfer is performed using ultrasound and a catheter to deliver the embryo directly into the uterus. The process feels similar to a routine pap smear.

  • 6

    Blood Tests and Pregnancy

    Following embryo transfer, the patient will wait about two weeks before visiting the fertility clinic to take a blood test. The blood test measures whether the human chorionic gonadotropin (hCG) hormone is present in the bloodstream, which will signify that embryo implantation has been successful. HCG is a hormone that is produced by the placenta during pregnancy, so if the blood test detects elevated levels of hCG, it can indicate that conception has been successful. 

    Before the blood test, it’s recommended that patients do not take at-home pregnancy tests. Because the traditional IVF process requires medications that alter your body’s reproductive hormones, over-the-counter pregnancy tests are not able to deliver reliable results, often showing false positives or false negatives.

    If the initial blood test shows that hCG is present, you will come into the clinic for repeated blood tests to monitor the fluctuations of hCG, which will increase as the pregnancy progresses. About a month after embryo transfer, an ultrasound is scheduled to confirm the pregnancy.

  • 7

    Freeze the Remaining Embryos

    Because IVF involves the retrieval and fertilization of multiple mature eggs at once, patients sometimes end up with several viable embryos that they are not ready to use. In these scenarios, patients have the option of freezing their viable embryos to be used in a future IVF cycle. They also have the option of making their frozen embryos available for adoption. 

    Embryos are frozen using the same cryopreservation technology that is used in egg freezing, which is a technique known as vitrification. Vitrification is a fast-freezing method that prevents ice crystals from forming in the embryo as it transforms into a frozen, glass-like state. This helps to protect the embryo from any damage during the freezing and thawing processes.

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