In vitro fertilization (IVF) is a type of fertility treatment where eggs are fertilized by sperm in an embryology laboratory to create embryos. IVF helps people who have difficulty conceiving naturally to become parents.
If you’re considering IVF treatment, it’s important to feel supported in your journey. TRIO is one of Canada’s leading providers of IVF. With over 40 years of experience, our fertility experts are here to help you achieve your dream of parenthood.
How Does In Vitro Fertilization (IVF) Work?
IVF involves many complex procedures that are overseen by expert doctors, nurses, and embryologists. Eggs and sperm are combined outside of the body to create embryos. These embryo(s) are then returned to the uterus where conception will hopefully occur.
Why is In Vitro Fertilization (IVF) done?
There are various circumstances where IVF can be helpful, some of which include (but are not limited to):
- Damaged or Blocked Fallopian Tubes
- Advanced Maternal Age
- Low Sperm Quality/ Quantity
- Problems with Ovulation, Menstruation or PCOS
- Sperm that Cannot Penetrate the Cervical Mucus
- Endometriosis
- Reduced Egg Quality
- 2SLGBTQIA+ Patients
- Genetic Conditions
- Unexplained Causes of Infertility
- Donor Eggs, Donor Sperm, or a Gestational Surrogate
- Fertility Preservation
What is the In Vitro Fertilization (IVF) Treatment Process?
1) Birth Control Before IVF
If you are using your own eggs for IVF, you may be asked to take birth control medication before your cycle begins. This is called “down-regulation”. In essence, this process switches off the ovaries, allowing your medical team to plan your IVF treatment. The length of time you will be on this medication will depend on your treatment plan but is usually approximately 2 weeks.
Note: If you have previously had adverse reactions to birth control medication, please inform your TRIO doctors and they will find an alternative for you.
2) Ovarian Stimulation in IVF
After down-regulation, you will begin the stimulation phase of your IVF cycle. Stimulatory medication is administered through daily injections in the subcutaneous (stomach) area. A very fine needle is used for this injection. Your TRIO nurse will show you exactly how to do it.
These drugs encourage multiple follicles (the sacs in your ovaries that contain eggs) to develop. You will be monitored closely during stimulation to check your follicle growth. Your TRIO doctor may adjust your dosage depending on how your body responds. You’ll likely be in this phase for around 2 weeks.
3) Egg Retrieval in IVF
When your follicles have reached a suitable size, you will attend TRIO for your egg retrieval. During this procedure, you will receive conscious sedation to keep you comfortable whilst your doctor gently aspirates your follicles to collect your eggs. You will be inside the procedure room for about 20min. Egg retrieval itself will typically last for 5 minutes and involves minimal discomfort. However, someone will need to take you home afterwards, since you may feel a bit groggy after the anesthetic. You should feel back to yourself after a day or so of rest.
4) Sperm Collection Process in IVF
If you are using fresh sperm, the patient producing the sample will do so on the day of egg retrieval. The sperm will be processed by an embryologist to ensure optimal numbers and motility.
If you are using donor sperm or your partner has frozen sperm, this will be thawed on the morning of the egg retrieval and processed similarly to a fresh sample.
5) Egg Fertilization
Once the eggs have been collected and the sperm have been processed, they will be combined in a special laboratory. It is this combination that will ideally result in fertilization. Two methods are typically used to combine the eggs and sperm, In Vitro Fertilization (IVF) and Intracytoplasmic Sperm Injection (ICSI).
- IVF: Eggs and sperm are combined in a petri dish and left overnight in an incubator. The sperm must swim to and interact with the egg for fertilization to occur.
- ICSI: A single sperm is injected directly into an egg. This may be recommended in cases of reduced sperm quality or where previous IVF attempts have yielded a low fertilization result.
Whichever fertilization method you opt for, your TRIO embryologist will examine the eggs the following morning and provide you with an update regarding the fertilization result.
6) Embryo Transfer
Your fertilized eggs (embryos) will develop in the IVF laboratory under close observation by our embryology team. You will receive regular updates about their progress.
If you are having a fresh embryo transfer, you will return to TRIO after a few days of embryo development. The embryo(s) will be transferred into your (or your gestational carrier’s) uterus using a fine catheter. Any remaining embryos of suitable quality can be frozen for the future.
If you are having a frozen embryo transfer, all suitable embryos will be vitrified (frozen) by our embryologist after developing for a few days in the lab. These embryos will remain frozen until you are ready to use them.
When you’re ready, the embryo(s) will be thawed and transferred to your (or your gestational carrier’s) uterus using a fine catheter. Any embryos that are still frozen can remain in storage.
Whether you opt for a fresh or frozen embryo transfer will depend on your unique circumstances. Your TRIO medical team will help you determine which transfer option is right for you and guide you at every step.
7) The Two Week Wait After IVF
Following embryo transfer, there is a two-week wait before you (or your gestational surrogate) can take a pregnancy test. This gives the embryo enough time to implant in the uterus and to produce the pregnancy hormone hCG. When these two weeks are up, a blood test will be done to check if pregnancy has occurred. Blood tests are much more accurate than urine tests during early pregnancy.
The two-week wait can be emotionally draining for many patients. There are a lot of questions, queries and concerns that may arise during this sensitive time, and it can sometimes feel like communication from fertility clinics stops abruptly.
At TRIO, we understand the importance of supporting our patients through every step of their journey. We are on hand whenever you need us to discuss any worries or doubts you may have and put your mind at ease. There are additional suggestions from our fertility naturopaths and our counselling team you can apply during the two-week wait time.
Egg Donation in IVF
Egg donation can be used for a variety of reasons. Some circumstances where it may be helpful include:
- Early Menopause
- People Born Without Ovaries
- Poor Egg Quality
- The Ovaries Have Been Removed
- Low Ovarian Reserve
- Previous Unsuccessful IVF Treatment
- Chemotherapy
- Genetic Disorders
Donated eggs will be fertilized with sperm (yours, your partner’s, or a pre-arranged donor’s) in the IVF laboratory to create embryos. You (or your surrogate) will be prepped for the embryo transfer, where the resulting embryo(s) will be inserted into the uterus.
What are the Potential Side Effects of IVF?
If you have IVF treatment, there are some possible — yet temporary — side effects you may experience. These could include:
- Bloating
- Sore Chest
- Headaches
- Restlessness
- Hot Flushes
- Nausea
- Low Mood
- Soreness/ Bruising at Injection Site
- Irritability
- Mild Abdominal Pain
Thankfully, these symptoms are mild in most people and you may experience none, some, or all the symptoms listed above. It all depends on how your body reacts to the stimulation medication. Your medical team will also review these and answer questions.
What are the Risks of IVF?
- Surgical Risks: As with any surgery, there are some risks involved with the egg retrieval procedure. For example, a small number of patients can react to the anesthetic medication — although this is rare. Your doctor will be able to discuss the risks with you before your procedure and discuss it in more detail.
- OHSS (Ovarian Hyperstimulation Syndrome): OHSS is a rare condition that can develop after taking stimulatory drugs, where the ovaries swell and leak fluid into the abdomen. Only 1-3% of patients undergoing IVF have severe symptoms. The experienced team at TRIO can spot and treat OHSS quickly if it ever were to occur.
- Multiple Pregnancy: If you return more than one embryo to your, or your surrogate’s, uterus, there is a risk that they will all implant and result in a multiple pregnancy. Multiple pregnancies carry risks to both the person carrying the pregnancy and the babies. Therefore, it’s important to have a discussion with your fertility team about how many embryos to return at embryo transfer.
What are the Success Rates of IVF?
The success rates of IVF depend on many factors, such as your age, medication, the number of eggs retrieved, and the number of eggs fertilized. Along with your medical history and personal profile, this information will help your TRIO doctor assess your chances of getting pregnant with IVF.
We hope that all our patients will get pregnant after one cycle of IVF. However, for some patients, it does take more than one attempt. Each cycle gives your doctor more information about you and what we can do next time to improve your odds of pregnancy. The data shows that for most people, each cycle of IVF increases your chances — so don’t give up hope if your first attempt is not successful.
How Much Does In Vitro Fertilization (IVF) Cost?
The costs of an IVF cycle can vary tremendously depending on which clinic you attend and the treatments involved. The Ontario Government funds 1 IVF cycle for patients who are under 43 that have a valid Ontario Health Card. This covers aspects of a treatment cycle like monitoring, egg collection, fertilization, assisted hatching and embryo freezing but does not cover stimulation medication or any additional treatments you may require. Read our price list for a fully transparent breakdown of the costs you could expect if you decide to have an IVF cycle with TRIO. You can also find out more about OHIP fertility coverage here.
Are you looking to start IVF treatment, or have some more questions about what is involved? We are happy to answer any queries you may have. Contact TRIO today to find out more.
