In Vitro Fertilization (IVF)
Since 1990, the Baystate Health in vitro fertilization (IVF) program has been working with men and women throughout western Massachusetts and Connecticut to help them realize their dreams of becoming parents. We perform approximately 500 IVF and 900 IUI cycles per year.
As a Society for Assisted Reproductive Technology (SART) member clinic, we maintain an experienced team of doctors and the highest standards for quality and safety. We also report patient outcomes and IVF success rates to SART. View the SART clinical report summary for Baystate Reproductive Medicine.
The caring team at Baystate Reproductive Medicine is here to help you through the steps of IVF. We provide patient-focused and compassionate care that’s conveniently located in either Springfield or Northampton.
WHEN IS IVF CONSIDERED?
IVF is the most effective and common type of assisted reproductive technology (ART). Most of our patients become pregnant without requiring IVF. However, there are instances where IVF is considered to offer the best chance for success:
- Tubal blockage or after tubal ligation (tied tubes)
- Severe endometriosis
- Moderate to severe male factor infertility
- After failed therapies such as stimulated IUI, especially if the cause of infertility is unknown
- Female age-related infertility caused by poor quality or too few eggs
- When eggs have been frozen prior to chemotherapy or radiation
WHAT IS THE PROCESS FOR IVF?
IVF is a complex process with several steps. A complete cycle of IVF typically takes about three weeks. IVF patients require ongoing screenings and monitoring throughout the cycle and there are typically frequent visits to our clinic.
A typical IVF cycle includes the following steps:
If you’re using your own eggs, we’ll begin by stimulating your ovaries to create multiple eggs. We typically use fertility hormones to do this.
Women undergoing IVF ovulation induction with injectable fertility drugs must be carefully monitored using ultrasound, estradiol measurements, and physical exams. This monitoring helps ensure the safety of ovulation induction, provides information used for FSH dosage adjustments throughout the IVF cycle, and ensures egg development is progressing. Woman can expect to visit our office for monitoring four to five times over 10 to 12 days.
In an IVF cycle, the eggs are retrieved from the follicles using transvaginal- guided ultrasound while the patient is under light general anesthesia. A small needle is guided through the back of the vagina into the follicle and eggs are withdrawn. Multiple eggs can be removed in about 20 minutes.
The withdrawn follicular fluid is passed to the reproductive biologists in our lab who locate the eggs. Mature eggs are placed in a nutritive liquid (culture medium) and incubated. If sperm is not available at the time of egg retrieval, we may freeze the eggs to use later.
Baystate’s donor egg program is an option if a woman’s eggs are poor quality or if there are too few eggs.
If you’re using your partner’s sperm, he’ll provide a sperm sample the same day as egg retrieval. If needed, sperm may be extracted surgically. Donor sperm can also be used.
Sperm are separated from the semen fluid in our reproductive biology lab.
We can also freeze sperm in advance if men anticipate being away at the time of egg retrieval or if they are concerned about difficulty collecting sperm on the day of retrieval.
Sperm are mixed with the eggs in a petri dish and fertilization occurs. Not all eggs may be successfully fertilized.
When a man’s semen quality or number is severely low, intracytoplasmic sperm injection (ICSI) may be an alternative to conventional IVF. In ICSI, a single healthy sperm is injected directly into each mature egg. This greatly increases the chances of fertilization.
Once fertilized, the pre-embryos are placed in an IVF incubator, which is strictly controlled for environmental variables such a temperature and gases in the air. The pre-embryos remain in the incubator until mature, usually three to five days.
Embryos that have differentiated into two distinct cell types (usually after incubating for five or more days) are known as blastocysts. Blastocysts are heartier than day three embryos and have a higher implantation rate—meaning fewer have to be transferred to the uterus and there’s a lower chance for multiple births. Blastocysts are transferred when possible, but not all couples will have enough embryos for culturing to the blastocyst stage.
The IVF patient usually comes to our office three to five days after egg retrieval, depending on the number and quality of embryos on day three. The embryos are transferred into the uterus in a procedure that usually takes less than 15 minutes. The transfer of embryos to the uterus is done using ultrasound guidance, which allows the doctor to carefully place the embryos in an optimal area of the uterus.
If it is not possible for a woman to carry a pregnancy due to problems in her uterus or a serious medical condition, couples may choose to work with a gestational carrier.
Support of the uterine lining with hormones
Starting on the day of the egg retrieval, the IVF patient takes supplemental estrogen and progesterone to support endometrial development. A pregnancy test is performed 14 days after egg retrieval.