Health Information Organization
The Infertility Cure
By Randine Lewis
Fertility & Conception
By Zita West
IVF the A.R.T. of making babies
By Sher, Marriage Davis, Stoess
The Basic Recipe - 4 steps
1. Preparation for Treatment
2. Induction of ovulation
3. Egg Retrieval
4. Embryo Transfer
Each of the steps above are necessary to go through to complete an IVF cycle.
Egg Retrieval
Pre-retrieval Consultation
At this time the doctor will describe the procedure in detail, how the woman will feel afterwards, and the risks involved.The corpus luteum may be deficient at this time so most clinics will administer progesterone is either injections or vaginal suppositories.
At this time the anesthesiologist may also want to talk to the couple to describe what will happen and to check medical history to avoid complications.
This is also when the couple decides how many embryos to transfer, and what to do with the extras, all of course in relation to the amount retrieved.
Ultrasound Guided Retrieval
This is said to be superior to laparoscopy retrieval. The ultrasound is used to guide the doctor while performing needle-aspirated egg retrieval. This is usually done while sedated and/or with the use of paracervical block for pain relief (this is a local anesthetic injection).The retrieval is performed by introducing a long, sterile ultrasound probe into the vagina. This gives the image needed to see the ovaries. This same probe has another tube which contains a needle that inserts into the follicles and aspirates the eggs inside.
After the retrieval the couple is told the number and quality of the eggs retrieved.
The procedure takes 20-30 minutes, and there is about 1 hour of post operation care.
Semen Specimen to Fertilize the Eggs
Insemination usually happens 4-6 hours after retrieval. Sometimes it may be more desirable to have the semen specimen retrieved a few days before and then frozen, this is because it can be collected when the couple is together so as to recreate the feelings that would be there if it were to be collected in a natural sexual environment. Quite often though, it is collected fresh on retrieval day. There are also special condoms which are designed to collect the semen during sex.Most clinics would prefer fresh semen, although frozen is said to have just as high a fertilization rate.
Taking Care of the Embryos
The 3-5 days between retrieval and transfer
Once the egg(s) has reached optimal maturity it is placed in a liquid insemination medium in a petri dish.This medium nourishes the eggs just as the woman's body fluids would in the reproductive tract.
It contains sodium bicarbonate which maintains the ph at the same level as the woman's body. It also helps neutralize the acidic waste created by the living breathing eating and excreting cells which may endanger the wellbeing of the embryos.
The petri dishes are kept in an air controlled incubator which regulates the amount of carbon dioxide present to ensure the proper functioning of the sodium bicarbonate.
Sperm 'Washing' and Capacitation
The sperm that has been collected cannot directly fertilize the eggs that have been retrieved. Normally, fluids in the woman's reproductive tract (cervical mucus) remove a layer from the head of the sperm which allows it to release its enzymes it uses to burrow through the wall of the egg. This process is called Capacitation. This process must be done in the lab. This is done by washing the sperm in an incubator for about an hour.Caffeine-like substances are sometimes added to increase motility of the sperm!
Insemination
The 50,000 (+/-), or 2 drops of capacitated sperm are then added to the petri dish containing the eggs. It is then incubated again until the next day. Fertilization should occur in the first few hours.This is a crucial point. The number of eggs fertilized (if any) plays a major role in the following decisions that are to be made.
Fertilized Eggs
16-20 hours after insemination, the eggs are transferred to a new medium to nourish cell division and growth.The eggs are checked under microscope to ensure that a nucleus is developing so as to have a very accurate number of viable embryos.
The surrounding corona of the egg, which is naturally peeled off the embryo in the reproductive tract, is then taken off through a delicate process. This makes it easier for the lab to see how well things are going inside.
If the egg has been fertilized by more than one sperm, this is when it will be seen and discarded because it will not grow into a viable embryo.
The fertilized egg, or 'zygote' undergoes what is called 'cleavage' (cell division) for about 48 hours and is now referred to as an embryo. At this time it is inspected again. It will now be a translucent amber coloured mass of 4-8 cells, an exciting time!
Once the healthiest embryos has divided into 4-8 cells the transfer should take place. This is usually 3-5 days after retrieval.
The next and final step is Embryo Transfer
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Infertility - Men's Health
 Spence Pentland, R.TCMP., DTCM Spence Pentland is a registered Acupuncturist and Chinese medicine practitioner with the College of Traditional Chinese Medicine practitioners and Acupuncturists of BC He practices at Acubalance Wellness Centre Ltd. on West 8th Ave. in Vancouver BC Canada. He is committed to Andrology, treating almost exclusively Men's and Women's infertility. |
Infertility - Gynecology
 Lorne Brown, Dr. TCM Lorne Brown is a Doctor of Chinese Medicine with the College of Traditional Chinese Medicine practitioners and Acupuncturists of BC He practices at Acubalance Wellness Centre Ltd. on West 8th Ave. in Vancouver BC Canada. Treating Exclusively Women's infertility & gynecology. |
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