• Tubal issues: damaged, blocked, or absent fallopian tubes
• Severe male fertility factor: very low sperm concentration, motility, morphology
• Endometriosis
• Low ovarian reserve
• Sperm antibodies
• Anovulation: often from polycystic ovarian disease
• Hypogonadotropic hypogonadism: reduced or absent release of appropriate pituitary hormones to develop follicles so eggs can be released and from other such causes
• Other unexplained causes

IVF Treatment and embryo transfer involves the stimulation of the ovaries to develop several follicles and eggs thru the use of oral or injectable medications. Normally the female only develops one or two follicles and eggs on her own each cycle. The ovaries are carefully monitored throughout the first half of the menstrual cycle with vaginal ultrasounds and blood tests. This helps insure high quality follicle and egg development and helps with patient safety. Once the follicles are appropriately matured, an artificial ovulation surge is created using LH or HCG and thru appropriate timing, the mature oocytes (eggs) are retrieved (harvested). The egg retrieval is an outpatient procedure which is made comfortable with intravenous anesthesia provided by a caring and friendly anesthesia team.

The eggs are retrieved through the use of a vaginal probe ultrasound and needle biopsy guide. The follicles are visualized and a egg retrieval needle is inserted into the needle guide through the vaginal wall and directed into each individual follicle. Suction is used to aspirate the follicular fluid and the egg into a test tube which is handed immediately to the embryologist for identification under the microscope and separated out into incubation. The husband’s or donors sperm is then washed and placed around each egg or the best of the sperm are injected into each egg to assist fertilization if necessary. After 2-6 days in the proper temperature, pressure, and medias to assist with proper fertilization, the best 2-3 embryos are transferred into the woman’s uterus under ultrasound guidance and remaining embryos are either immediately frozen if desired, or left to incubate to see if they reach the blastocyst stage. If they reach the blastocyst stage, they are the best, and the most hearty embryos and worth while to freeze for future cycles.

A blood test is then performed 10-12 days later to confirm pregnancy and 2 ½ weeks after the blood test, an ultrasound is performed to evaluate the developing fetus.