What is In Vitro Fertilization (IVF)?
IVF involves mixing egg cells with sperm cells outside the body to form an embryo. An embryo is then transferred to the mother’s uterus through the opening in her cervix, creating a pregnancy that will be carried to term and delivered normally. The IVF process involves four steps:
- Recruitment of multiple eggs from the ovaries using several different medications
- Collection of the eggs from the ovaries
- The mixing of sperm and egg to facilitate fertilization
- The placement of the embryo(s) into the uterus
When is IVF used?
IVF is the most effective therapy for patients diagnosed with infertility. Originally developed for women with blocked or damaged fallopian tubes, IVF is now also employed for:
- Mild to moderate male factor infertility
- Unexplained infertility
- Infertility due to aging
As an added advantage our Boston-based IVF Laboratory can assess the formed embryo, possibly providing insight to the cause of infertility thus helping to guide future treatment.
IVF Services Offered by the Brigham and Women’s Hospital Center for Infertility and Reproductive Surgery:
IVF (In Vitro Fertilization)
Eggs (oocytes) are taken from a women’s ovaries and inseminated with sperm four to six hours later. If fertilization occurs the embryo is grown (cultured) for 72 to 96 hours. An embryo transfer procedure is then performed, transferring selected embryos into the mother’s uterus on the third or fifth day after the original egg retrieval.
Intracytoplasmic sperm injection (ICSI) can be used in cases where the male’s sperm count is extremely low, does not move normally, or if eggs have not fertilized normally in the past. Fertilization is achieved by injecting a single sperm directly into the egg. The resulting embryos are then transferred to the mother’s uterus.
Other IVF-related Procedures and Services:
Preimplantation genetic diagnosis (PGD)
As a full service fertility center, embryologists in our lab can conduct genetic analysis on embryos prior to implantation into the uterus. These tests are done with cells that are removed safely from the embryo during early development. The genetic tests can assess whether the embryo may carry certain genetic diseases or even screen for common chromosomal abnormalities that can cause miscarriage. Your IVF doctor and the genetic counselors will help determine if this is the right therapy for you.
Assisted hatching (AH)
AH may be an appropriate approach for selected patients or those with repeat failed IVF implantations. The embryo is surrounded with a covering called the zona pellucida. A microscopic hole is created in the zona which may enhance the normal “hatching” process for the embryo and help it imbed in the uterus.
Embryo Freezing and Cryo Embryo Transfer Cycles (CET)
Extra embryos (if available) created during the IVF procedure can be frozen and stored if a couple wants to use them in a future embryo transfer cycle. Using frozen embryos in future cycles means patients will not need to undergo a new stimulation and egg retrieval procedure. IVF using frozen embryos is highly successful.
Surgical Sperm Extraction
In cases where a vasectomy cannot be reversed or the male is making but cannot deliver sperm (eg. congenital absence of the vas deferens, the duct that delivers sperm from the testes to the penis), a surgical procedure can be used to recover sperm from the testes. When possible the recovered sperm can be frozen for use in future IVF or ICSI procedures.
Egg Donation / Donor Oocyte
Once considered “incurably infertile”, the availability of donated egg cells (ovum or Oocyte) now provides many couples a chance at pregnancy. Designated (from someone you know) and anonymous egg donation is available. Donors will undergo a standard IVF ovulation stimulation and egg retrieval procedure. Donated eggs are mixed with the recipient partner’s sperm and embryos are transferred into the mother’s uterus as per standard IVF practice. Donated eggs are also available from cryo-egg banks and can be used as an alternative to a fresh cycle with a donor.
Gestational Carriers (Surrogacy)
A form of surrogacy, gestational carriers will receive an embryo and carry it to term on behalf of the intended parents. This is an option for women that produce viable eggs but may have any number of physical disorders that prevent them from becoming pregnant. Individual patients and couples may bring their own carrier, however our infertility clinics can also provide a matching service.
Elective Egg Freezing
Advances in IVF technology have now allowed us to freeze unfertilized eggs successfully. For many women, fertility preservation is of paramount importance. Some women may choose to freeze their eggs before facing medical treatment that could negatively impact or delay their fertility. Certain types of chemotherapy, for example, negatively impact a woman’s future fertility and freezing eggs will help ensure that she will have a chance to conceive upon completion of her treatment. Another option many women choose is to freeze eggs for fertility preservation for social reasons. This option may help women have more flexibility in their family planning.