In Vitro Fertilization

1. In Vitro Fertilization “In Glass” Fertilization

2. Infertility • Habitual abortion patients • Specific family history for genetic disorders such as sickle cell anemia, tay-sachs disease, or cystic fibrosis Reasons for procedure

3. The patient is given HCG prior to surgery in order to mature the oocytes. • Eggs are retrieved using a hollow needle through the pelvic cavity with the aid of ultrasound. (follicular aspiration) • The surgeon tries to take only mature oocytes • There may be many vials of fluid retrieved which will be passed off to the embryologist • Patient is usually under local anesthesia and is ambulatory the day of the procedure, however some facilities have obtained a greater retrieval rate using general anesthesia. Follicular Aspiration

4. Usually many eggs are retrieved in order to get the best results and in case some oocytes don’t allow fertilization • The sperm is collected before the procedure and the insemination is done in the laboratory • The oocytes and sperm can be placed in an incubator to allow insemination to happen then or sometimes the ICSI process is used and the sperm are injected into each oocyte • The individual embryos are run through a variety of tests to pick the best embryo Incubator fertilization ICSI insemination

5. The embryos are transferred back into the uterus one to six days later • The embryo is usually two to four cells when transferred • This transfer requires a vaginal speculum • The surgeon will place a catheter with the determined amount of embryos inside the uterus, (this may be guided by ultrasound) and then insert them • It takes about five days for the inserted embryos to implant on the endometrium as blastocysts • Blood tests are later run to determine the implantation has taken place. • The rough road of pregnancy is now underway • The procedure is usually quite painless