The Ins and Outs of In Vitro Fertilization (IVF)

Stimulating the Ovaries

Ovarian stimulation will typically begin after your menstrual bleeding starts. A number of medications can be used to stimulate follicle development, including:
  • Bravelle®
  • Repronex®
  • Gonal-F®
  • Follistim®.
GnRH agonists and/or GnRH antagonists are typically used as well to help control the cycle.
The last part of the ovarian stimulation will include the final maturation of the eggs and the administration of hCG (Profasi®, Novarel®, Pregnyl®, Ovidrel®). hCG is a drug that stimulates the final maturation of the eggs. The day that your healthcare provider decides to give you hCG is critical, as the injection determines when the egg retrieval will be scheduled. In some cases, women who are using GnRH antagonists can use GnRH agonists to trigger the final maturation of the eggs instead.
Although these are the standard medications, each woman's protocol for ovarian stimulation will be different, as some women have a better response to a certain protocol than others. Although it may be tempting, try to avoid comparing your regimen with other regimens too much, as your doctor choose your regimen for you, based on your unique hormonal profile, clinical studies, and the experience and successes of your IVF center.

Retrieving the Eggs

Approximately 34 to 36 hours after the hCG injection has been given, the eggs will be retrieved. You will be given intravenous medications, including a sedative and pain reliever, to help minimize any discomfort during the procedure. In most cases, women sleep through it.
A transvaginal ultrasound probe is used so your healthcare provider can see the ovaries and the egg-containing follicles. The eggs are collected using a long needle (which can be seen on the ultrasound) and guiding it into each follicle. The material within the follicle, including the follicular fluid, eggs, and egg-supporting cells, are aspirated into a test tube. After the retrieval is done, an embryologist will search the follicular fluid and locate the eggs using a microscope.
Following the retrieval, women recover from the anesthesia and are monitored while the intravenous medications wear off. In many cases, women may experience some vaginal spotting and lower abdominal (stomach) discomfort for several days. Full recovery usually occurs within one to two days.
The number of eggs retrieved will vary for each woman, depending on how many follicles she produced and how accessible they were. Your healthcare provider can make an approximation of the number of eggs based on the ultrasound he or she used during the retrieval. The average number of eggs retrieved in each woman is usually around 8 to 25.
Last reviewed by: Arthur Schoenstadt, MD
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