IVF is a method of assisted reproduction in which a man’s sperm and a woman’s eggs are combined outside the body in a laboratory dish. If the egg fertilizes and begins cell division, the resulting embryo is transferred into the woman’s uterus where it will hopefully implant in the uterus and further develop. IVF is used to treat infertility caused by damaged or absent fallopian tubes, abnormal ovulation, unexplained infertility, inadequate sperm number or function, and age-related infertility.
Embryo freezing involves storing the embryos that are not being used at sub-zero temperatures to preserve them. Embryo freezing is useful for extra embryos remaining after a cycle of IVF, as it allows patients another opportunity to attempt pregnancy if they don’t conceive with the fresh embryo transfer, or to conceive again if pregnancy occurred.
The basic steps in an IVF treatment cycle are ovarian stimulation, egg retrieval, fertilization, embryo culture, and embryo transfer.
ICSI is a procedure used in conjunction with IVF in which a single sperm is injected directly into an egg to attempt fertilization. It is most commonly used with male factor infertility or couples with prior IVF fertilization failure, however ICSI could be used under other circumstances which your physician would discuss with you if required.
The fertilized egg is called an embryo. On the day after the IVF procedure is performed, the embryo consists of only one cell. The embryos are checked in the lab on day 3 following egg retrieval, at which time most embryos have 6-8 cells. At this stage, they are called ‘cleavage stage’ embryos. In some couples, the embryos are transferred into the womb on day 3.
A blastocyst is an embryo that has developed for 5-6 days after fertilization. Some couples are offered blastocyst culture and transfer on day 5, especially those opting for single embryo transfer, since usually the strongest embryos develop to this stage.
Women with multiple embryos following IVF may be encouraged to have a single embryo transferred to the uterus even when many embryos are available. The goal of this treatment option is to reduce the chance of a multiple pregnancy, since multiple pregnancy can be risky for both mother and babies.
Medications can be used to treat women who are not able to produce fully matured eggs or whose eggs fail to ovulate. These medications temporarily correct ovulatory problems and could increase a woman’s chance for pregnancy. These medications include oral medications such as clomiphene and letrozole, or injection medications such as gonadotropins.
IUI is an office procedure in which motile sperm is prepared and placed directly into a woman’s cervix or uterus to increase the chance of pregnancy. Usually IUI is combined with medications to produce multiple oocytes (or eggs). This is also called ovarian stimulation.
The following are common medications used in conjunction with IUI:
Clomiphene is an oral fertility medication that is used to increase the number of eggs that are released at the time of ovulation. This medication is taken for 5 days, usually from day 5-9 of the menstrual cycle. An ultrasound is often performed around the tenth day of the menstrual cycle to predict the timing of ovulation and IUI.
Gonadotropins are injection medications taken daily to increase egg production by the ovaries. An IUI treatment cycle in which gonadotropins are used is also called “superovulation.” Gonadotropins contain follicle-stimulating hormone (FSH), which is produced naturally by the body to cause egg development and release. Because each woman reacts differently to these medications, close monitoring is required during superovulation. This includes vaginal ultrasounds and blood tests every 1-2 days.
Donor insemination (DI) is the process of placing frozen/thawed sperm from a donor into a woman’s uterus at the time of ovulation. Donor insemination is an option for women who wish to become pregnant but are single or part of a same-sex couple, have a partner with male factor infertility that cannot be treated, or have a partner who is a carrier of a serious hereditary disease.
Egg donation involves using an egg donated from one woman to another to be used in IVF. This may be recommended to women who have premature ovarian failure, a poor response to ovarian stimulation medications, several previous IVF treatments without achieving pregnancy, or infertility due to advanced maternal age (over 43 years of age). In Canada, this treatment is permitted only if the egg donor is known to the recipient and is not being compensated.
Gestational carrier is a fertility option which allows the intended parents to achieve a pregnancy by first creating embryos through IVF with their own eggs and sperm and then transferring these embryos to another woman, called the gestational carrier. If a pregnancy results, the gestational carrier then carries this pregnancy to term. Gestational carrier is indicated for women without a uterus or without a functional uterus and in women with underlying medical problems which could cause risks to mother or baby in pregnancy. In Canada, this treatment is only permitted if the gestational carrier is known to the recipient and not being compensated.
These treatments are used to collect sperm from men who have azospermia, or absent sperm in the ejaculate because of a blockage or abnormal sperm production. PESA involves removing sperm from the epididymis (a duct in the male reproductive tract) using a needle. With TESE, testicular tissue is removed in an attempt to collect living sperm. The sperm collected can only be used in conjunction with IVF/ICSI since it is not fully mature and able to fertilize an egg naturally. These treatments are also options for men who have had a vasectomy.
Aurora collaborates with Dr. Jennifer Hilton in Regina to provide treatment monitoring. Please ask us for more information on how this may benefit you.
Aurora coordinates ultrasound and other testing for patients who require treatment outside of Saskatoon. Please consult our Fee Schedule for treatments offered and costs.
You will require a referral from your family physician or specialist (OB/GYN, urologist, oncologist, etc.), to be seen in our clinic.
Make an appointment with your family physician or specialist to discuss your fertility issues.
When speaking with your family physician or specialist, discuss a referral to Aurora Reproductive Care and give your family physician or specialist our referral form to complete. The physician will fax the form to our clinic. Once we have received the form in our office, we will contact you with an approximate wait time for an appointment.