In some cases, there may be recommended preparation to complete 30, 60, or 90 days prior to treatment. Your nursing team will review these specifics should they apply to you. For IVF only, the tentative timeline is as follows:
Day 1 of cycle:
Reach out to your nursing team via the patient portal or call our office to schedule your first appointment. If your period falls outside of office hours, please await a portal response once the office is open or call during regular office hours. If you do not get periods, please reach out when you have medications and are ready to begin. We will schedule an appointment to see where you are at in your cycle and create a plan from there.
Day 2-4
Your first appointment will be scheduled during this time frame. We call this your baseline appointment. Once results are received from this appointment, you will be provided with your medication protocol. If any testing comes back abnormal, we will inform you and update your plan accordingly.
Day 3-10
Follicular, Egg, and Lining Development
The first phase of an IVF cycle is follicle development. During this time, you will have multiple appointments for blood and transvaginal ultrasound to most accurately track growth and development of your follicles. We will also evaluate your uterine lining, especially if preparing for a fresh embryo transfer. Frequent monitoring allows us to track anticipated procedure timing, adjust medications as needed, and accurately determine the day that you administer your trigger shot. Your egg retrieval will take place 35 hours from the administration of your trigger shot. While most clients stimulate for 10 days, you may stimulate shorter or longer than this based on your body’s response to the medications.
Day 12(ish)
Retrieval takes place!
Sperm Preparation
If the sperm is being provided by a male partner, it is most often collected through ejaculation into a sterile cup the morning of the egg retrieval. This can be collected in our office, or at home. If necessary, sperm can be collected using more advanced sperm retrieval procedures like PESA, TESA, or TESE. Sperm can also be collected ahead of time, frozen, and then thawed the morning of the retrieval – this is particularly useful if the male partner will not be able to present at the office the day of the procedure. Sperm may also be provided by a donor.
Once the andrology lab receives the semen, the andrology team will clean and concentrate the sperm from the larger sample of semen. After this first step of isolation, the sperm is washed and suspended in a solution that mimics the environment of the Fallopian tubes in the female reproductive tract.
Once this process is complete, the concentrated motile sperm will be transferred to the embryology lab where fertilization will take place.
The Retrieval
The Egg Retrieval Procedure is a minor outpatient procedure done to collect the developed eggs from the woman’s ovaries so that they can be fertilized in the laboratory. It is performed 35 hours after the “trigger,” at one of our offices under light anesthesia for comfort and lasts approximately 5-10 minutes.
During the procedure, a tiny hollow needle with suction capabilities to pierce through the vaginal wall and drain the fluid from the follicles which contain the developed eggs. The follicular fluid containing the eggs is immediately transported about 20 steps to our IVF laboratory and sorted through by one of our embryologists who will find, isolate, and nurture your eggs in media as they await fertilization. The number of eggs retrieved will depend on your age, history, fertility diagnosis, medication protocol and response to medications.
Fertilization of Eggs in the Lab
The most used (and most efficient) was to fertilize eggs is through a process called ICSI (Intracytoplasmic Sperm Injection). This is a special fertilization technique whereby sperm are loaded into a micro needle and injected directly into the egg. Only mature eggs can be injected. ICSI holds a 70-80% fertilization rate, where conventional IVF falls around 50% or less.
Final Steps
The final step in your IVF process is either a fresh embryo transfer back to the carrying uterus 3-5 days after egg retrieval, or to freeze the embryos on day 3, or day 5, 6, 7 pending protocol.
For more information on treatment timeline, watch our YouTube video: What is the timeline for treatment? When do I need to be at a CNY fertility clinic?
