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IVF: What to Know Before You Begin

Joe Cody

A petri dish with an egg about to be fertilized.

What exactly does IVF (in-vitro fertilization) entail? That’s a question that so many people who embark on an IVF journey wish they understood better before they began. So, to give you a head start, Grain Fertility has laid out the IVF process to help you feel more prepared and more confident in your ability to advocate for yourself as you move through it. 


Preparing for IVF

Infertility is medically defined as the inability to conceive after one year of regular, unprotected intercourse (or six months if the woman is over 35). However, this definition isn’t set in stone. Patients with medical conditions like cancer, sickle cell disease, or those pursuing parenthood through non-traditional means—such as single parents or same-sex couples—may begin their fertility journey earlier. But generally, by the time most people consult a reproductive endocrinologist (RE) and are advised to consider fertility treatment, they’ve already been trying to conceive for months or even years.


The first step at the fertility clinic is a comprehensive evaluation to look for the underlying causes of your fertility problems. Depending on the diagnosis, your treatment options may range from lifestyle modifications and medications to surgical interventions or advanced assisted reproductive technologies (ART), such as intrauterine insemination (IUI), in vitro fertilization (IVF), or third-party reproductive options like donor eggs, or surrogacy. Each treatment plan comes with its unique demands that have an impact on both your emotional well-being and daily life.


Understanding the IVF Process: Key Phases

A standard IVF cycle spans approximately four to six weeks, beginning with ovarian stimulation and ending with a pregnancy test. The journey can be divided into three primary stages:


  1. Stimulation Phase

  2. Egg Retrieval and Fertilization

  3. Embryo Transfer


Here’s a closer look at each phase.


1. Stimulation Phase

During this stage, you will take hormone injections to stimulate your ovaries and encourage multiple eggs to mature simultaneously. The goal is to maximize the number of eggs available for retrieval. The treatment protocol is personalized based on factors such as your age, medical history, anti-mullerian hormone (AMH) levels, and response to prior cycles (if you've had any).


Monitoring is a critical component of this phase, and you'll be required to have frequent blood tests and ultrasounds to assess hormone levels and follicular development. Once the follicles reach an optimal size (typically 18mm or larger), you'll get a "trigger shot" 36 hours before your scheduled egg retrieval to prepare the eggs for collection. Timing is crucial, because even slight deviations can have an impact on the results of the retrieval.


2. Egg Retrieval and Fertilization

Egg retrieval happens 36 hours after the trigger shot. It is a minimally invasive procedure for which you will be sedated. Your mature eggs are collected and taken to the lab where they fertilized with your partner or donor's sperm.


Over the next 5-6 days, embryologists monitor the embryos’ progression as the cells divide and the embryos move toward the blastocyst stage. On average, about 70% of fertilized eggs develop into embryos. From there, only about 50% of fertilized eggs develop into blastocysts, and the success rate can be lower if you have certain medical or age-related factors.


Depending on the next steps you've chosen, your embryos may either be transferred to your uterus immediately, or frozen for future use. Freezing is often recommended if your uterus requires some additional preparation to achieve optimal implantation conditions.


3. Embryo Transfer

Prior to your embryo transfer you'll take additional medications and undergo monitoring to ensure your uterus is primed for implantation. The transfer itself is a brief procedure, that takes around 10 minutes, and then the "Two Week Wait" (TWW) begins. This is a 10-14 day period you will need to wait before a blood test will be able to tell you whether you are pregnant or not. During this time, you will need to continue any medications the doctor has prescribed.


If your IVF cycle results in pregnancy, you will continue to be monitored by your fertility clinic for the first 12 weeks (the first trimester) of your pregnancy. At that point you will “graduate” from your clinic and switch back to your regular Ob-Gyn for the remainder of your pregnancy.


IVF Success Rates

Success rates for IVF vary significantly depending on factors like age, medical history, and the cause of infertility. The Society for Assisted Reproductive Technology (SART) has data from 2022 that looks at the live birth rates of women undergoing their first round of IVF, using their own eggs. Their numbers are as follows:

  • Women under 35 have a live birth rate of approximately 51% per cycle.

  • Women aged 35-37 have a live birth rate of 40%.

  • Women aged 38-40 have a live birth rate of 27%.

  • Women aged 41-42 have a live birth rate of 13.7% 

  • Women over 42, have a live birth rate of 4.6%.


Difficult though it is, it's important to manage your expectations and be prepared for the possibility of multiple cycles. Tools like the CDC’s IVF success estimator and advanced prediction models offered by individual clinics can provide a clearer picture of your possible success rate.


Navigating the Emotional and Physical Challenges Of IVF

There is a lot that comes with the IVF process: frequent appointments, medication side effects (such as bloating, mood swings, and injection site tenderness), and emotional stress. Building a strong support network and maintaining open communication with your care team can make a significant difference.


Additionally, having a good understanding of the IVF process can help you approach your journey with greater confidence and resilience. Remember, every step you take brings you closer to achieving your dream of parenthood!


If you need additional support or have questions about your own fertility journey, Grain Fertility and Lily & Bee Fertility are here to help. Please don't hesitate to reach out and get the help you need. This journey is hard and you shouldn't have to do it alone.


At Grain Fertility we believe patients should own their health data and have access to it when and how they want. We can help you ditch the binder, get organized, and take control of your fertility journey.


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