- Overview (jump to topic): In vitro fertilization (IVF) involves retrieving the woman’s egg and the man’s sperm, which are combined together in a lab to achieve fertilization. The resulting embryo is then transferred into the woman’s uterus for pregnancy.
- Who is a candidate for IVF? Women with various forms of infertility; men with infertility from low sperm counts, couples who have failed conventional infertility treatments, and LGBTQ+ individuals and couples needing reproductive services for other reasons.
- Benefits of IVF: Because IVF enhances fertilization and implantation chances through lab analysis and monitoring, this is the most effective infertility treatment for many couples and individuals.
- What is the IVF process? Stimulating the woman’s ovaries to produce eggs, retrieving them and fertilizing them by introducing the eggs to sperm in a lab dish, monitoring the embryo(s) that develops, then transferring one embryo (typically) into the woman’s uterus where it can implant to create a pregnancy.
- IVF considerations: Include elective single embryo transfer, what to do with extra embryos, and preimplantation genetic testing (PGT), as well as counseling for emotional, physical and financial impacts of IVF.
- IVF risks: Those that are associated with any surgical procedure, such as infection and pain. Medications used specifically to develop and mature multiple eggs can lead to side effects, such as hyperstimulation syndrome. If transferring more than one embryo, a multiple pregnancy (twins or more) can occur, carrying risks for the mother and child. Our doctors discuss all risks and other considerations with each patient.
What is IVF?
In vitro fertilization is a method of assisted reproduction that essentially controls the fertilization and embryo implantation process by taking these important steps out of the bodies of infertile couples or individuals and conducting much of it in an IVF lab.
“In vitro” is Latin for “in glass,” referring to the laboratory Petri dish in which sperm and the egg are combined to create an embryo. Lab-based IVF is able to work around most conditions that cause infertility in women and men, leading to high success rates.
IVF is not one treatment but a series of procedures that can sometimes take from 6-8 weeks from start to finish. The first step is for the woman to take medication to induce development of more than the normal single egg in a menstrual cycle. The eggs and the man’s sperm are collected and combined in a lab culture, and the resulting embryos are then evaluated and the most highly graded embryo is transferred into the mother’s uterus for pregnancy.
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Fresh & frozen IVF cycles
The entire IVF process is referred to as a “cycle,” as it coincides with the woman’s ovulation cycle. When the woman’s eggs are retrieved and then the embryo is transferred in her uterus during the same cycle, it is called a fresh IVF cycle. Embryo transfer in a fresh cycle takes place three to five days after the egg retrieval is completed.
A frozen embryo transfer cycle is when the embryos have developed and then are frozen and stored, cryopreserving them for future use. Even when the couple or woman is ready to become pregnant as soon as possible, the fertility specialist may recommend a frozen embryo transfer cycle in which the embryo transfer is performed during a future menstrual or hormonally programmed cycle so that her uterus is better prepared for implantation and pregnancy.
A fresh IVF cycle can result in the transfer of one fresh embryo and cryopreservation of any additional embryos created during the fresh cycle for a future frozen embryo transfer cycle.
Fertility preservation with egg & embryo freezing
A woman or couple may opt to use the first part of IVF treatment to retrieve the eggs, at which point the eggs can be frozen (cryopreserved) for future fertility plans. Similarly, once the eggs are fertilized and develop into embryos, the woman or couple can choose to freeze the embryos for fertility preservation and future embryo transfer.
Our IVF history and approach to IVF
The Fertility Institute performed the first successful IVF procedure in Louisiana in 1983, resulting in the state’s first IVF baby, born in 1984.
Since 1983, when we performed the first successful IVF procedure in the state, we have helped parents-to-be from around the country build their families through IVF and other assisted reproductive technology (ART) procedures.
The pioneering specialists at The Fertility Institute continue to be fertility leaders and understand that every family’s fertility journey is unique. While IVF offers the highest success rates compared to other fertility treatments, our doctors don’t immediately turn to this procedure for every couple.
Our doctors talk with each patient to determine the most appropriate course of fertility treatment. They work together with families to make whole-body decisions based on biology, emotions, finances and even spirituality. If less expensive and less invasive treatment options are available, such as controlled ovarian stimulation combined with intrauterine insemination (IUI), our doctors will recommend those options first.
Why choose FINO for IVF?
- FINO is Louisiana’s first fertility clinic, building families through assisted reproductive technologies since 1973 and providing successful IVF since 1983.
- A state-of-the-art IVF lab at both our New Orleans and Baton Rouge clinics.
- Free instructional videos for IVF medication administration.
- Discounts on additional IVF cycles if the first does not succeed.
- Two embryo transfers included in the price of one egg retrieval.
Benefits of IVF
IVF is the most effective form of assisted reproductive technology because every step of the process is prescribed and monitored by fertility specialists. Every egg, sperm sample and embryo are analyzed for health and viability.
The risks for genetic defects, which can negatively impact the health of the pregnancy or the baby, can be tested in advance of the procedure. This is especially beneficial for couples and individuals with a known risk of carrying genetic conditions that can cause birth defects in a child. Embryos created through IVF can be tested for these specific genetic defects and the unaffected or healthy embryos can be transferred or cryopreserved for future use.
Use of donor eggs or sperm
IVF also enables a woman or couple to use donor eggs, donor sperm or donor embryos to achieve a pregnancy. The use of donor egg or donor embryo might be required in women of advanced age or with decreased ovarian reserve. The use of donor sperm would be required in men with no sperm production or in third party reproduction for LGBTQ+ patients.
The Fertility Institute has strong relationships with donor egg banks across the country that can ship eggs from out of state if egg donation is needed. Additionally, The Fertility Institute can facilitate the IVF cycle when the recipient brings her donor to the program (directed egg donation).
This is also significant for LGBTQ+ couples who need donor sperm and/or eggs to create a pregnancy.
Who is a good candidate for IVF?
What is the IVF process?
Step 1: Ovarian stimulation and monitoring
To increase the chances of creating a number of healthy, viable embryos, the first step in IVF is prescribing medication to stimulate a woman’s egg production. This process is called controlled ovarian stimulation, and it maximizes the number of mature follicles in a woman’s ovaries in order to produce multiple healthy eggs during the female ovulation cycle (compared to the typical single egg in a natural ovulation cycle).
There are multiple treatment protocols and our healthcare team will decide which one will optimize the individual’s or couple’s success based on the information gathered in the initial evaluation. In general, follicle-stimulating hormone (FSH), luteinizing hormone (LH) or a combination of both are used to stimulate the development of multiple egg-containing follicles.
The patient will administer these hormones via self-injection. The number of days and the doses will vary depending on follicle development, which is monitored by our fertility clinic specialists through regular vaginal ultrasound tests and blood tests to measure hormone levels.
Additional medications may be administered to prevent premature ovulation or to prepare the lining of the uterus to accept the future embryo.
When the follicles are fully developed, usually after 8 to 10 days of medication, the patient will administer another injection called a “trigger shot,” which will initiate the final maturation of the developing eggs.
Step 2: Egg retrieval
As the eggs mature and release, the woman will undergo a short outpatient procedure in which our fertility specialist retrieves the eggs through a minimally invasive surgical procedure. While the patient is sedated and given pain medication, the physician uses vaginal ultrasound to guide a needle into each follicle to draw out its contents, including the mature egg and its surrounding fluid, in a process called aspiration.
The fluid from each follicle is immediately examined under a microscope by our embryologists for health and viability, then the egg is either frozen or fertilized.
Step 3: Sperm collection
Usually on the same day as egg retrieval, the male partner will collect a semen sample through masturbation at the clinic. However, if there are certain structural infertility factors involved, sperm may need to be surgically removed directly from the testicles prior to the day of egg retrieval. The doctor and patient will develop a plan for sperm retrieval after an initial round of diagnostic male infertility tests, including a semen analysis.
The clinic lab will then separate the sperm cells from the semen fluid and examine the specimens to find the strongest, most active sperm.
Step 4: Fertilization
The healthy eggs and prepared sperm are placed in a laboratory dish for fertilization over the course of three to five days. It’s important to know that not all the eggs will fertilize, and not all fertilized eggs will continue to grow into embryos.
In some situations a procedure called intracytoplasmic sperm injection (ICSI) may be utilized to improve the chances of egg fertilization. ICSI involves the injection of one healthy sperm directly into the cytoplasm of the mature egg.
Step 5: Embryo monitoring, testing and transfer
Our IVF lab diligently monitors the embryos as they develop to ensure the best conditions for each stage of development. Once a number of healthy embryos develop, one (typically) or more (if deemed necessary according to a plan previously determined by the family and the fertility specialist) will be transferred into the uterus for pregnancy.
As needed, the IVF lab team can perform preimplantation genetic testing (PGT) on selected embryos to confirm the embryo is healthy and clear of genetic conditions that could cause health issues in the pregnancy or the baby.
Embryos ready to be transferred are placed in the uterus using a catheter under ultrasound guidance. The patient is awake for the procedure.
Considerations prior to embryo transfer
- Is the couple a candidate for eSET?
If more than one embryo is transferred, then the procedure can result in more than one baby, which poses risks for the mother and the babies (see IVF risks below). To greatly reduce the risk of multiple babies, The Fertility Institute follows ASRM guidelines and encourages patients, when appropriate, to transfer only one embryo, which is called elective single embryo transfer (eSET), which reduces the chance of multiples.
- What is the plan for extra embryos?
Extra embryos can be frozen and stored for future use, making future treatment cycles less expensive and invasive. Embryos can also be donated or discarded. A plan needs to be in place prior to the procedure.
- Will genetic testing be performed?
If parents want to screen for chromosomal abnormalities, then the lab can perform PGT on the embryos after five to seven days of development or when the embryo reaches the blastocyst stage. Genetic abnormalities in the embryo can be a major cause of implantation and pregnancy failure, as well as birth defects in a child.
Considerations, IVF side effects & risks
As with most medical procedures, there are potential side effects and risks associated with IVF, as well as other concerns.
Things to consider during IVF treatment
The Fertility Institute of New Orleans offers special IVF consultation and counseling to help patients feel prepared for treatment.
From the beginning of discussions about IVF, our physicians counsel families about the physical demands, as well as the emotional, financial and time investment in this treatment option. These may result in psychological stress, and we help patients mediate these stressors, including effective preparation, relaxation techniques and stress management. We also can help people get expert infertility counseling if desired.
The Fertility Institute provides third-party financing options and offers discounts to help ease the financial portion of starting a family through assisted reproductive technology. The Fertility Institute offers special IVF counseling and financial consultations to make sure you’re informed for your next step.
We offer several discounts including multiple cycle IVF and embryo transfer discounts.
IVF side effects
Fertility medications can have some noted side effects for the women who take them, including headaches, mood swings and irritability, hot flashes, abdominal pain and bloating. One rare side effect is ovarian hyperstimulation syndrome, which can occur when the medication results in too many eggs to develop in the ovaries, causing them to become painful. However, our fertility specialists monitor for hyperstimulation and can act quickly if ovarian hyperstimulation syndrome occurs.
The egg retrieval and embryo transfer procedures can cause side effects such as mild cramping and bloating, constipation, breast tenderness or passing small amounts of fluid from the vagina.
We follow up with patients after the procedures, and we encourage patients to always contact us if any side effects occur.
Risks of IVF
One of the significant historical risks of IVF is birthing multiples (twins or more), which our providers address when the patient is first considering the procedure. Carrying multiples runs the risks of miscarriage, gestational diabetes, failure to thrive, anemia and delivery via C-section. Multiple babies are more likely to be born prematurely, have low birth weight and run a potentially increased risk of long-term disabilities.
Our physician will speak with IVF candidates about these issues ahead of time, and frequently recommend elective single embryo transfer during IVF to avoid multiples.
As with all minimally invasive surgical procedures, there are minor risks associated with some of the IVF steps. During egg retrieval, there are potential risks with the anesthesia and possibly internal bleeding, infection or damage to nearby organs or blood vessels. The catheter used during embryo transfer may cause spotting, bleeding or cramping after the procedure.