So one of the first questions I get asked is “What is IVF?” and “What does an IVF cycle entail?”  Well, as a recent landlubber myself, unfamiliar with the Sea of Infertility, this has been a “just trying keep my head above water” process that I am just beginning to understand.

IVF stands for In Vitro Fertilization, “in vitro” meaning “outside the body”.  In its simplest form, IVF involves taking as many mature eggs as possible out of my body, my husband’s sperm out of his body, putting them all together in one big happy dish, and hoping sperm enter the eggs and fertilizes them.  Once fertilized (not all of them will), the embryos hang out and grow for either 3 or 5 days (more on that later).  At this point, they bring me back in, sedate me, and put the embryos back into my uterus. Then ya hope like hell that those little suckers implant and BOOM… you’re pregnant. That is IVF.

Now as to the IVF Cycle…that looks somewhat different for each couple, depending on their issues, advantages, and challenges.  The cycle refers to the process surrounding the IVF procedure such as medication, stimulation, and monitoring.  Mine is following a pretty traditional cycle protocol.  My issues are tubal, which is great news when it comes to IVF, because IVF bypasses those pesky tubes altogether.  The eggs come out of the ovaries, fertilize in the dish, and a put back in the uterus.  No tubes needed.  Yeah for me! An IVF cycle generally last 4-6 weeks, depending on a lot of things.  It begins when you start your period on the cycle that you have designated as your IVF cycle.  Then you generally follow the following steps:

1. Call your fertility clinic and tell them you have started your period.  THis is considered DAY 1
2. Day 2:  Come to clinic for a base line ultrasound to make sure your uterus and ovaries are looking good and fancy. Certain hormone levels are tested. We hopefully receive clearance to proceed.
3. Begin taking fertility medications and injections after your visit on DAY 2. WAIT Till YOU SEE HOW MUCH!  I am doing an antagonist medication protocol (more on the different protocols later).  So I start off with multiple injections that cause more than the normal 1 egg to grow (we are shooting for 12-20 eggs!).  So 2 shots a day of Folistim and Menapur for at least 9 days
4. Day 5.  Return for ultrasound and blood tests for estradiol levels.  See how many follicles are growing.  Follicles are sacs surrounding the eggs in the ovaries that are being primed for this cycle. The estradiol levels indicate if you are responding well to the ovarian stimulation and if the lining of your uterus is growing nicely.  The lining is what that little sucker is going to stick too when it is put back in.   Medication is adjusted accordingly.
5. Day 7:  Another ultrasound to monitor the follicle growth.  At this point, you can see how many potential “good follicles” you have coming along.  Now the concern becomes that you will ovulate too early and have to cancel the cycle (once the eggs bust out of the follicle..they are useless for IVF).  And so enters the 3rd injection in the rotation, Ganirelix, which prevents the body from ovulating prematurely.
6. Day 8-12?  Ultrasounds and injections continue each day until and adequate group of egsg reaches maturity (Generally when they become > or equal to 18 mm.  Enter the 4th injection, and hCG Ovidrel, which tells the body to complete the egg maturation process and prepare for ovulation.  All other injections cease.
7. Next Step:  Egg Retrieval (ER).  This happens around 36 hours after the hCG shot.  I go to the clinic, undergo sedation, and have a needle inserted into each ovary to aspirate the follicles and take the eggs out.  They let us know how many eggs were retrieved. Fingers crossed!
8. Next Step:  Petri Dish Fertilization…Is there any other kind?  My husband gives a semen sample and it is placed with the eggs. Magic ensues.
9. Over the next few days, the clinic will keep us updated on how many embryos were fertilized and how many of them are growing.  Each embryo is graded for quality.  It is possible to lose some along the way.  The center will then make the decision on whether or not to do the Embryo Transfer (ET) back into my uterus 3 days or 5 days after the retrieval (More on the Pros and Cons of 3 day versus 5 day ETs later).  Progesterone shots begin.  Progesterone supplements makes sure the potential pregnancy doesn’t end early due to low progesterone levels.  These people cover ALL their bases.
10. I am sedated either 3 or 5 days after the retrieval and the embryos are placed back into my uterus, where they will hopefully implant over the next couple of days. We select how many embryos to be placed back in.  If there are any left, they are frozen to be used in the next cycle if this the cycle does not result in a pregnancy.  We are shooting to transfer two, with the hopes that one sticks.  I wouldn’t mind if we had twins.  What do you think?
11. 9-11 days later-after being on 5 days of bed rest, we pee on a stick and  find out if I am pregnant!!!!Or have a blood test at the clinic…whatever floats your boat!

So there you go…IVF and the IVF cycle in a nutshell.  If you have any questions, please feel free to ask!

Here is a link to a great animation of the process.  On a side note, in the beginning when you see the egg released from the ovary and picked up by those finger-like fern objects-thats was was clubbed and blocked on my tube.