Stages of IVF

The Fertility Institute of New Orleans (FINO) performed the first successful in vitro fertilization (IVF) in the Gulf South, in New Orleans in 1983.  Since 1983, FINO has performed more than 5000 IVF and other advanced reproductive technology (ART) procedures, [Gamete Intrafallopian Transfer (GIFT), Intracytoplasmic Sperm Injection (GIFT)].

In 2005 after Katrina the FINO administrative office was moved to Mandeville.  FINO fertility clinics are located in Uptown New Orleans, Metairie, Mandeville and Baton Rouge. FINO IVF laboratories are in Metairie and Baton Rouge.

In addition to evaluation of female and male infertility, and IVF, FINO offers ICSI (intra cytoplasmic sperm injection), PGD (preimplantation genetic diagnosis), Ovulation Induction, Artificial Insemination, Egg donation, and Egg freezing  at most locations.

Success Rates

During in vitro fertilization one embryo (SET) or two embryos (DET) can be transferred.  Women using their own eggs who are good candidates for single embryo transfer have the same chance of having a baby with single embryo transfer as women with double embryo transfer if they also have a single frozen embryo transferred and they have a significantly lower chance of twins.  Twin pregnancies are a risk factor for both baby and mother.

[Good Candidate for single embryo transfer (SET): Having first IVF, are younger than age 38, and have at least one extra embryo for freezing, or are any age and have embryos created using donor eggs] Society for Assisted Reproductive Technology and U.S. Department of Health and Human Services Centers for Disease Control and Prevention.  2016    257124

Embryo Transfer Options

Embryo Stage

(Day of Transfer)

1 SET (fresh) 1 SET (fresh) + 1 SET 1 DET (fresh)

Cleavage

(2-3 days)

At least 1 baby: 38%

Twins: Less than 1%

At least 1 baby: 55%

Twins: Less than 1%

At least 1 baby: 49%

Twins: 16%

Blastocyst

(5-6 days)

At least 1 baby: 51%

Twins: Less than 1%

At least 1 baby: 66%

Twins: 1%

At least 1 baby: 60%

Twins: 27%

Source: Centers for Disease Control and Prevention, National Assisted Reproductive Technology Surveillance System (NASS), 2010-2012.

For the most recent IVF results for the Fertility Institute of New Orleans from CDC/SART click:

(https://www.sartcorsonline.com/rptCSR_PublicMultYear.aspx?ClinicPKID=2051).

IN VITRO FERTILIZATION (IVF)

Interior-IVFIVF was initially developed to treat infertility caused by blocked or damaged fallopian tubes. It is now used to treat infertility caused by a multitude of conditions include sever male factor (see ICSI below). The cost of IVF can vary dramatically depending on each individual's medical and insurance situation. Patients of The Fertility Institute have access to a variety of payment options. 

IVF requires the stimulation of multiple follicles followed by retrieval of the eggs. The eggs are placed with sperm in a laboratory dish to fertilize outside the body (in vitro). The fertilized eggs form embryos which can be placed into the uterus where implantation and embryo development can occur just as in natural pregnancy.

INTRA CYTOPLASMIC SPERM INJECTION (ICSI)

ICSI is similar to conventional IVF except that instead of placing the eggs in a dish with sperm, a single sperm is injected into each egg with a micropipette under a microscope.  ICSI is often indicated for male factor infertility or when frozen eggs are being used.    

In vitro fertilization (IVF) is a four-step procedure:

  1. Ovarian Stimulation and Monitoring
  2. Egg (oocyte) Retrieval
  3. Fertilization
  4. Embryo Transfer 

Step 1: Ovarian Stimulation and Monitoring

Various medications are used to stimulate the ovaries to produce multiple mature follicles (controlled ovarian hyperstimulation or superovulation), rather than the single egg normally developed each month. Follicles are cysts in the ovaries in which eggs grow to maturity.

Follicle-stimulating hormone (FSH) is the hormone used to stimulate the development of multiple eggs containing follicles. FSH is given by daily injection. The number of days and the dose will vary depending on follicle development. The response to FSH is monitored by ultrasound and hormone levels. When the follicles are fully developed, usually after 8 to 10 days, human chorionic gonadotropin (hCG) is given to release the eggs and trigger the final maturation of the eggs

Ultrasound

Ultrasound uses sound waves to make sonar pictures of the body. Through ultrasound, the number and size of follicles can be observed.

Blood Tests

The response to FSH is monitored with frequent blood tests. Developing follicles secrete increasing amounts of the hormone estradiol. Along with ultrasound, estradiol levels are used to determine the optimal timing for the administration of hCG.

Step 2: Egg Retrieval

Eggs are retrieved by ultrasound-directed vaginal aspiration of ovarian follicles performed under narcoleptic analgesia, which is a combination of pain relievers and sedation. A needle is guided into each follicle in order to aspirate its contents. The egg along with the surrounding fluid is removed from the follicle. The fluid is immediately examined under a microscope. The process is repeated until all the mature follicles have been aspirated.

Step 3: Fertilization

A semen sample is obtained from the male partner and processed in our IVF Clinic New Orleans, using laboratory techniques to obtain the strongest, most active sperm.

Prepared sperm are placed with one or more eggs in a laboratory dish for fertilization. After 3 to 5 days, if the eggs have successfully fertilized and are growing normally, they are transferred to the uterus. Not all eggs will be fertilized and not all fertilized eggs will continue to grow. In some cases, the embryos may be transferred as early as 2 days or as late as 6 days after retrieval. Some patients may choose to utilize intracytoplastic sperm injection during this step, a procedure which improves the chances of conception by placing a single sperm directly into a mature egg.

Step 4: Embryo Transfer

Embryo transfer is performed under ultrasound guidance without anesthesia. The embryos are placed in a catheter for transfer into the uterus.