In Vitro Fertilization
In Vitro Fertilization

In Vitro Fertilization (IVF) is a highly successful form of Assistive Reproductive Technology (ART) many people use today to achieve a pregnancy. Since 1986 over one million US babies have been conceived with the use of IVF. Throughout his many years of dedicating his practice to expanding the families of his patients, Dr. Russell has not only helped thousand of couples conceive IVF babies over the past 30 years, but has also been an innovator in the development of the methods we use today for our IVF procedures.

Our team of experts are constantly on the cutting-edge of reproductive technology; from the first IVF pregnancy in Delaware, the first ICSI pregnancy in the region, and the first immature egg pregnancy in the United States.

If you have been trying to conceive without success and have one or more of these problems, we may be able to help. Please contact our dedicated team of experts today.

IVF was originally performed on women with blocked or damaged fallopian tubes who could not conceive naturally. Today, IVF is the treatment of choice for women with all types of infertility diagnoses who have not had success with less invasive treatments.

Good candidates for IVF:

In a normal menstrual cycle, just one egg (oocyte) develops and matures within the ovary. The egg is housed in a fluid filled structure in the ovary, called a follicle, which can be seen on ultrasound. In an IVF cycle, self-administered fertility medications are used to stimulate the ovaries to produce multiple follicles containing eggs.

The IVF team will educate you on when you will start your stimulation medications, and how to use them. You will use the self-administered fertility medications for approximately 9-11 days, depending on how your ovaries respond. You will visit the office frequently during your stimulation to monitor your blood hormone levels and follicular development with ultrasound.

Once the majority of the follicles have reached a mature size, another medication, called a trigger shot, will be given by injection. You will be given explicit instructions on when and how to take the medication. The shot must be given at the appropriate time of follicle development to prepare the egg for removal from the body, also called the egg retrieval.

Once the eggs are mature and ready for insemination, a procedure called egg retrieval will be performed. This procedure is performed in our AAAASF accredited surgical center with the use of ultrasound guidance and in most cases under a light sedation. The procedure itself takes roughly 10-15 minutes. However, you can expect to remain in the office for at least 1 hour following the retrieval for monitoring. You will be informed of the number of eggs retrieved and medication instructions, prior to leaving the office.

IntraCytoplasmic Sperm Injection (ICSI) is a procedure that manually causes fertilization to occur by injecting a single selected sperm into the egg. This is typically used for all IVF inseminations, and done the day of retrieval. If using your partner, or known donor, the sperm will be collected on the day of retrieval.

Assisted hatching (AHA) is a procedure in which the zona pellucida (outer covering) of the embryo is partially opened, usually by application of an acid or laser, to facilitate embryo implantation and pregnancy.

Preimplantation Genetic Testing (PGT) helps identify embryos that have recognizable chromosomal abnormalities prior to transfer to the uterus. PGT can be used for patients of all ages who have unexplained fertility, severe male factor, advanced maternal age and several failed IVF cycles with poor quality embryos. This procedure benefits families who have a known history of certain genetic abnormalities.

On the fifth day of embryo development, a single cell is taken from an embryo through an opening made in the shell of the embryo through assisted hatching. The DNA from that single cell is then analyzed for any chromosomal abnormalities. The analysis usually takes 48-72 hours to complete. The embryologist will determine which embryos are to be transferred based upon the results of the analysis.

The embryo transfer process is similar to the IUI or a routine pelvic exam and pap test. A speculum is placed in the vagina, the cervix is cleaned with sterile culture media and the embryo is inserted through the cervix with the assistance of ultrasound guidance to place the embryo at the top of the uterine cavity. The number of embryos to transfer will depend on embryo quality. Due to the high success rate with Pre-Implantation Genetic Testing (PGT), we strongly encourage consideration of a single embryo transfer (eSET).

After completion of embryo transfer, you will require additional hormone replacement to ensure the environment in the uterus is appropriate for implantation. You will be given a protocol of estrogen and progesterone, along with other medications and return for hormone testing 4 days after the embryo transfer procedure. If any changes need to be made to your medication regimen, they can be done so at this time. Your pregnancy test is performed roughly 10 days following your embryo transfer.

Once we have confirmed your pregnancy with a blood test, we will have you follow up with a repeat pregnancy test and ultrasound to continue to monitor the development of the pregnancy. In most cases, DIRM will work with your OB/GYN to provide your initial obstetrical care for the first 12 weeks of your pregnancy. After your first trimester, you will continue your obstetrical care with your OB/GYN, or, if you do not have one, we can provide the names of excellent obstetrician/gynecologists in your area.

Unfortunately, not all IVF cycles result in pregnancy. You are encouraged to schedule a follow-up consultation with Dr. Russell should your cycle not result in a pregnancy. The purpose of this visit would be to summarize your cycle, answer questions, and discuss future plans, such as future IVF cycles, other infertility options or non-medical family building options.