It's possible you've ovulated up to a dozen eggs. Maybe even more. There is danger to both the mother and children if you got pregnant naturally with even half of those eggs. About 34 to 36 hours after you receive the hCG shot, the egg retrieval will take place.
Before the retrieval, an anesthesiologist will give you some medication intravenously to help you feel relaxed and pain-free. Usually, a light sedative is used, which will make you "sleep" through the procedure.
This isn't the same as general anesthesia, which is used during surgery. Side effects and complications are less common. Once the medications take their effect, your doctor will use a transvaginal ultrasound to guide a needle through the back wall of your vagina, up to your ovaries.
She will then use the needle to aspirate the follicle, or gently suck the fluid and oocyte from the follicle into the needle. There is one oocyte per follicle. These oocytes will be transferred to the embryology lab for fertilization.
The number of oocytes retrieved varies but can usually be estimated before retrieval via ultrasound. After the retrieval procedure, you'll be kept for a few hours to make sure all is well. Light spotting is common, as well as lower abdominal cramping, but most feel better in a day or so after the procedure.
While you're at home recovering from the retrieval, the follicles that were aspirated will be searched for oocytes, or eggs. Not every follicle will contain an oocyte.
Once the oocytes are found, they'll be evaluated by the embryologist. If the eggs are overly mature, fertilization may not be successful. If they are not mature enough, the embryology lab may be able to stimulate them to maturity in the lab.
Fertilization of the oocytes must happen with 12 to 24 hours. The stress of the day can make it difficult for some, and so just in case, your partner may provide a semen sample for backup earlier in the cycle, which can be frozen until the day of the retrieval. Once the semen sample is ready, it'll be put through a special washing process, which separates the sperm from the other stuff that is found in semen.
The culture dishes are kept in a special incubator, and after 12 to 24 hours, they are inspected for signs of fertilization. With ICSI, the embryologist will choose a healthy-looking sperm and inseminate the oocyte with the sperm using a special thin needle.
About three to five days after the retrieval, an embryologist will identify the healthiest looking embryos. This is typically done visually with a microscope , but in some cases, genetic screening is performed. Otherwise, a "fresh" transfer takes place. The procedure for embryo transfer is just like IUI treatment.
You won't need anesthesia. During the embryo transfer, a thin tube, or catheter, will be passed through your cervix. You may experience very light cramping but nothing more than that. Through the catheter, they will transfer the embryos, along with a small amount of fluid. The number of embryos transferred will depend on the quality of the embryos and discussion with your doctor. Depending on your age, anywhere from one to five embryos may be transferred.
Transferring two embryos is the most common option. More doctors are suggesting having just one embryo transferred and then freezing the rest. This is known as elective single embryo transfer eSET , and it can reduce your risk of a multiple pregnancy. When you get pregnant with just one healthy baby, you reduce your risks for pregnancy complications. After the transfer, you'll stay lying down for a couple hours bring a book and then head home.
If there are "extra" high-quality embryos left over, you may be able to freeze them. This is called embryo cryopreservation. They can be used later if this cycle isn't successful in a frozen embryo transfer , or they can be donated.
On or after the day of your retrieval, and before the embryo transfer, you'll start giving yourself progesterone supplements. Usually, the progesterone during IVF treatment is given as an intramuscular self-injection as progesterone in oil. More shots! Sometimes, though, progesterone supplementation can be taken as a pill, vaginal gel, or vaginal suppository. Besides the progesterone, there really isn't much going on for the next 2 weeks.
In some ways, the two weeks after the transfer may be more difficult emotionally than the 2 weeks of treatment. During the previous steps, you will have visited your doctor perhaps every other day.
Now, after transfer, there will be a sudden lull in activity. You may have lots of questions about the two-week wait. Can you have sex? What if you have cramps? Of course, your doctor is the number one source for any of your concerns. All you can do is wait the 2 weeks and see if pregnancy takes place. It can help to keep busy with your life during this wait time and avoid sitting and thinking about whether or not treatment will be successful. About 9 to 12 days after the embryo transfer, a pregnancy test is ordered.
The test may be repeated every few days. If the test is positive , you may need to keep taking the progesterone supplementation for another several weeks. Your doctor will also follow up with occasional blood work and ultrasounds to monitor the pregnancy and watch for miscarriages or ectopic pregnancies. Your doctor will also monitor whether or not the treatment led to a multiple pregnancy. IVF has a higher risk of conceiving multiples, and a multiple pregnancy carries risks for both the mother and the babies.
If it's a high-order pregnancy 4 or more , your doctor may discuss the option of reducing the number of fetuses in a procedure called a "multifetal pregnancy reduction. Women who conceive with IVF are more likely to experience spotting in early pregnancy , though it's more likely for their spotting to resolve without harm to the pregnancy. The risk of miscarriage is about the same for women who conceive naturally, with the risk going up with age.
If the pregnancy test is still negative 12 to 14 days post-transfer, your doctor will ask you to stop taking the progesterone. Then, you'll wait for your period to start.
The next step will be decided by you, your partner, and your doctor. If this was your first cycle, another cycle may be recommended. Remember that your best chances for success are after doing several cycles. Having a treatment cycle fail is never easy. It's heartbreaking.
It's important, however, to keep in mind that having one cycle fail doesn't mean you won't be successful if you try again. There are many steps you can take after a treatment cycle fail. Get diet and wellness tips to help your kids stay healthy and happy. Once the embryos have been transferred into the womb, you'll be advised to wait around 2 weeks before having a pregnancy test to see if the treatment has worked. Some clinics may suggest carrying out a normal urine pregnancy test at home and letting them know the result, while others may want you to come into the clinic for a more accurate blood test.
This 2-week wait can be a very difficult period because of the anxiety of not knowing whether the treatment has worked. Some people find it the hardest part of the treatment process. During this period, you may find it useful to speak to a counsellor through the fertility clinic, or to contact other people in a similar situation to you through the HealthUnlocked IVF community.
If you do become pregnant, ultrasound scans will be carried out during the following weeks to check things are progressing as expected. You'll then be offered the normal antenatal care given to all pregnant women. Unfortunately, IVF is unsuccessful in many cases and you should try to prepare yourself for this possibility. You may be able to try again if treatment doesn't work, although you shouldn't rush straight into it.
You may find counselling or fertility support groups helpful during this difficult time. Read more about the support available during IVF. Page last reviewed: 18 October Next review due: 18 October For women Step 1: suppressing the natural menstrual cycle You're given a medicine that will suppress your natural menstrual cycle.
Step 2: helping your ovaries produce more eggs Once your natural cycle is suppressed, you take a fertility hormone called follicle stimulating hormone FSH.
Step 3: checking progress The clinic will keep an eye on you throughout the treatment. Typically, the semen sample is collected through masturbation. Other methods, such as testicular aspiration — the use of a needle or surgical procedure to extract sperm directly from the testicle — are sometimes required. Donor sperm also can be used.
Sperm are separated from the semen fluid in the lab. Typically, transvaginal ultrasound aspiration is used to retrieve eggs. During this procedure, an ultrasound probe is inserted into your vagina to identify follicles, and a needle is guided through the vagina and into the follicles.
The eggs are removed from the follicles through the needle, which is connected to a suction device. In intracytoplasmic sperm injection ICSI , a single healthy sperm is injected directly into each mature egg. ICSI is often used when semen quality or number is a problem or if fertilization attempts during prior in vitro fertilization cycles failed. Three days after fertilization, a normally developing embryo will contain about six to 10 cells. By the fifth or sixth day, the fertilized egg is known as a blastocyst — a rapidly dividing ball of cells.
The inner group of cells will become the embryo. The outer group will become the cells that nourish and protect it. Embryo transfer is done at your doctor's office or a clinic and usually takes place two to five days after egg retrieval. If successful, an embryo will implant in the lining of your uterus about six to 10 days after egg retrieval. After the embryo transfer, you can resume your usual daily activities.
However, your ovaries may still be enlarged. Consider avoiding vigorous activity, which could cause discomfort. If you develop moderate or severe pain after the embryo transfer, contact your doctor.
He or she will evaluate you for complications such as infection, twisting of an ovary ovarian torsion and severe ovarian hyperstimulation syndrome.
About 12 days to two weeks after egg retrieval, your doctor will test a sample of your blood to detect whether you're pregnant. The chances of giving birth to a healthy baby after using IVF depend on various factors, including:. Talk with your doctor about any factors that apply to you and how they may affect your chances of a successful pregnancy. Explore Mayo Clinic studies of tests and procedures to help prevent, detect, treat or manage conditions.
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This content does not have an Arabic version. Overview In vitro fertilization Open pop-up dialog box Close. In vitro fertilization During in vitro fertilization, eggs are removed from mature follicles within an ovary A.
Request an Appointment at Mayo Clinic. Egg-retrieval technique Open pop-up dialog box Close. Egg-retrieval technique Typically, transvaginal ultrasound aspiration is used to retrieve eggs. Blastocyst Open pop-up dialog box Close. The method of fertilisation will be directed by your specialist in discussion with your situation to optimise your fertilisation and pregnancy chances in each cycle.
After the insemination procedure, we place the inseminated egg s into our specialised culture incubators to assess for fertilisation approximately 17 hours later the next day. These pronuclei are the genetic nucleus from the egg and sperm, so we need to see only two pronuclei.
One from the egg and one from the sperm. If the egg does not present with 2 pronuclei, then the egg has not fertilised and will not produce an embryo.
Ideally, after combining a sperm with the egg, approximately17 hours later it will fertilise and begin forming an embryo. Our scientists will culture the developing embryo s in a special incubator, where the conditions for growth and development are optimised to grow the best possible embryos.
We create these perfect growing conditions using a special mix of amino acids, and nutrients similar to the ones your own body would use to nurture the embryo. Our goal is to grow all embryos to the blastocyst stage. We know that transferring more robust and developed embryos into the uterus boosts your chances of a successful pregnancy. Unfortunately, not all eggs will fertilise and reach each embryo stage. In the meantime, if you have any questions—our friendly team are just a phone call away.
The embryo transfer is a very simple process—similar to a pap smear. The procedure itself only takes about five minutes. A scientist prepares your embryo by placing it in a small tube called a catheter. Your nurse will let you know exactly when to have your blood test, as it may vary for some patients.
We understand that the lead-up to this final blood test can be an anxious time. A weekend away or a special lunch can ease stress and give you something to look forward to.
Our expert fertility nurses can answer any questions you may have and offer guidance on next steps.
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