Treatment Options
In-Vitro Fertilization
In-Vitro Fertilization (IVF) is the process in which the egg is fertilized outside of the body, cultured to an embryo/blastocyst and then transferred back to the uterus for implantation and continued pregnancy.
The first IVF baby to be born was Louise Brown in 1978. Technology has advanced dramatically since then, with a reduction in multiple gestations, increases in pregnancy success rates per embryo transfers, and an increase in the number of single embryo transfers. As of 2018, more than 8 million babies have been born through IVF worldwide.
The advances have been attributed to improved IVF laboratory techniques, upgraded instruments/equipment, enhanced physician training, advancements in research, frozen embryo transfer, and the availability of pre-implantation genetic testing.
Assisted Laboratory Procedures
When beginning an IVF treatment, the ultimate goal for the RFC team is to work with the patients to create a healthy baby while minimizing the risk of multiples. New advances in laboratory techniques have recently enabled us to maximize success rates while minimizing the incidence of multiples. Assisted Reproductive Technologies, including intracytoplasmic sperm injection, blastocyst culture, assisted hatching, pre-implantation genetic testing and cryopreservation, are laboratory techniques used to work with and care for the eggs, sperm and embryos outside the body.
Intracytoplasmic Sperm Injection (ICSI) involves direct injection of a single sperm into a mature egg. This procedure is selectively used in cases involving significant decreases in sperm counts, motility, or morphology. This procedure may also be used in cases where there is a history of previous failed fertilization despite normal sperm testing.
Assisted Hatching involves making a small hole in the zona pellucida (sugar-protein membrane) that surrounds the pre-embryo at the 6-8-cell stage approximately 1 hour prior to embryo transfer. As the embryo continues to grow, the hole becomes larger, making it easier for the embryo to “hatch” out of its shell, which is necessary for implantation to occur. This procedure is performed in patients with a thickened zona pellucida, as well as in patients over 35, or with other histories.
Intracytoplasmic Sperm Injection
Intracytoplasmic Sperm Injection (ICSI) involves direct injection of a single sperm into a mature egg. This procedure is selectively used in cases involving significant decreases in sperm counts, motility, or morphology. This procedure may also be used in cases where there is a history of previous failed fertilization despite normal sperm testing.
Assisted Hatching
Assisted Hatching involves making a small hole in the zona pellucida (sugar-protein membrane) that surrounds the pre-embryo at the 6-8-cell stage approximately 1 hour prior to embryo transfer. As the embryo continues to grow, the hole becomes larger, making it easier for the embryo to “hatch” out of its shell, which is necessary for implantation to occur. This procedure is performed in patients with a thickened zona pellucida, as well as in patients over 35, or with other histories.
Low Stimulation/Natural Cycle IVF
A low stimulation or natural cycle IVF typically refers to an in-vitro fertilization cycle that uses an oral medication in lieu of an injectable gonadotropin medication. The oral medication provides milder stimulation of the ovaries than the injectable medication. Currently, the advances in reproductive medicine point to the use of genetic testing of embryos as the best option for patients, as the testing provides more information about the embryos, lowers miscarriage rate, and increases pregnancy rate per embryo transfer procedure. Therefore, the downside of a low stimulation/natural cycle IVF is that much less eggs are stimulated hence retrieved, and the patient has a much higher chance of having no “normal” embryo to transfer.