Plan Your Family

What is the IVF process?

Our fertility specialists guide you through the following IVF steps:

 

 

PART A
Consultation, Diagnostic Tests and Orientation: The IVF process begins with a consultation to discuss your goals and help you understand what to expect. This is then followed by diagnostic tests and orientation.

 

 

PART B 
Stimulation: During ovarian stimulation, injectable medications are used to recruit follicles/eggs. Your progress is monitored by blood tests and ultrasounds every 2-3 days. When the follicles appear ready a trigger medication is used to mature the eggs for egg retrieval 2 days later.

Egg Retrieval: Using ultrasound guidance, egg retrieval is a brief surgical procedure where a needle is inserted through the vagina to access the ovaries.

Fertilization: This step can happen in two ways:

a. Standard Insemination: Insemination through IVF refers to incubation of washed sperm with the harvested eggs in a petri dish to allow fertilization. Around 30,000 sperm are incubated per egg and fertilization is allowed to occur ’naturally‘ in the dish.

b. Intracytoplasmic Sperm Injection (ICSI): A procedure where a single sperm is injected into a single egg. The rate of fertilization of mature eggs is typically 60-70% (i.e. 7/10 mature eggs fertilize).

 

 

 

ICSI Indications:

• Sperm parameters in a semen analysis are low
• Previous failed fertilization with standard insemination IVF
• Embryo biopsy required for genetic testing
• Long duration of unexplained infertility (> 3 years)
• Sperm is surgically extracted directly from the epididymis or testicle
• In the case of low egg numbers

Embryo Culture: Fertilized eggs are cultured in the IVF laboratory until transfer, biopsy or freezing. An intricate balance of gases and culture media choices optimizes outcomes.

Embryo Transfer or Embryo Freeze:

• Embryo Selection: Methods for embryo selection include: Traditional Morphology, Eeva and Comprehensive Chromosomal Screening (CCS) and Preimplantation Genetic Screening (PGS). Read more about the pros, cons and costs of each embryo selection method.
• Embryo Freeze: If you’re not planning to have a baby right away, embryo freezing is an excellent option. Read more about embryo freezing here.

IVF Indications:

• Tubal disease
• Severe male factor
• Diminished ovarian reserve or advanced egg age
• Long duration of unexplained infertility
• Pre-implantation genetic diagnoses or pre-implantation genetic screening/comprehensive chromosomal screening
• Previous failed treatments such as insemination, tubal surgery

What is Eeva™?

Eeva™ is an additional technique to non-invasively aid embryo selection. It supplements traditional morphology assessment.

A time-lapse video is created of the embryos as they grow in the incubator with observations made every 5 minutes.

This video is interpreted by an intelligent computerized algorithm which is based on a Stanford University patent where the ‘normal development’ of thousands of embryos was modeled. This algorithm is the key advantage of Eeva™. It allows us to know if the embryo reached its developmental milestones as expected or if it has deviated from the expected journey. Both paths may lead to morphologically normal embryos but the former may be more likely to succeed.

Eeva™ is the only time-lapse embryo system which is FDA approved as a diagnostic device. It has been shown to improve ’embryo selection’ and prediction of blastocyst development and implantation rates.

What is IUI (Intrauterine Insemination)?

IUI is the process of inserting a sperm specimen that has been washed and processed in the andrology laboratory directly into the patient’s uterus near the time of ovulation.

The IUI procedure can be accomplished using fresh or frozen or frozen sperm from a donor or partner.

 

 

What is ICSI (Intracytoplasmic Sperm Injection)?

Intracytoplasmic Sperm Injection (ICSI) is when a single sperm is injected into a single egg.

ICSI Indications:

• Sperm parameters in a semen analysis are low
• Previous failed fertilization with standard insemination IVF
• Embryo biopsy required for genetic testing
• Long duration of unexplained infertility (> 3 years)
• Sperm is surgically extracted directly from the epididymis or testicle
• In the case of low egg numbers

 

A donor egg refers to using the eggs of another woman to become pregnant.

Egg donors must meet certain medical and ovarian criteria, be screened for medical, infectious, and psychological disorders, and should be under age 35. To retrieve an egg, donors go through the same in vitro fertilization process up to the egg retrieval part.

Sources for egg donors include:

1. Known donor in Canada: In Canada, it is not legal to pay or compensate egg donors, so the egg donor must be a person who donates for altruistic reasons. The egg donor is often a friend or relative of the intended mother. The egg donor must still be screened in accordance with Health Canada guidelines and also for medical, psychological, genetic or ovarian reserve issues.
2. Anonymous or known egg donor from outside Canada: In the US it is legal to pay egg donors who may be known or anonymous. All egg donors are mandatorily screened according to US Food and Drug Administration regulations. There are 3 legal ways to use egg donors from outside Canada:
   • Fresh donor egg: The intended parents travel to the country where the identified egg donor is and go through a fresh IVF cycle with her. The embryo(s) are transferred into the recipient (intended mother).
   • Frozen donor egg: The frozen eggs are stored in an Egg Bank for purchase and legally shipped to Canada.
   • Frozen embryos using donor egg: Embryos are created, frozen, and shipped to Canada from donor eggs and intended father/donor sperm at the clinic in the US.

Donor egg success rates are generally high but depend upon many factors including: the age and history of the egg donor, success rates of the Egg Bank, and receiving clinic if applicable.

Genesis Fertility staff are extremely careful with the safe handling and storage of donor eggs. If you have any questions about the egg donation process or costs involved, Call 604 879 3032 to book a visit with our fertility doctors.

Indications:

• Poor egg quality in the intended parent
• Lack of eggs (ovarian insufficiency) in the intended parent
• Premature ovarian failure, early menopause, or primary ovarian insufficiency

You may find the following articles helpful:

• Would You Donate Your Eggs to a Couple Who Couldn’t Conceive?