Ovulation is when a woman’s body releases an egg. This typically happens monthly and entails an egg being released from the ovary. When she is about to undergo an in vitro fertilization (IVF) cycle, they want to make every effort to increase their chances of success. They induce IVF stimulation to produce more than one egg to improve her and her partner’s chances of having embryo(s) to transfer.

The IVF process can be overwhelming, especially if you’ve never been through it before. In this blog, we’ll explain the process, what IVF stimulation entails, how your doctor can help educate and support you on all your reproductive options, and what can give you the best chance at a successful IVF outcome.

An Overview of IVF and IVF Stimulation

When undergoing IVF, women are prescribed fertility medications to fit their diagnosis or circumstances best. These hormones increase the number of follicles that will develop over a single cycle. During the IVF Cycle timeline, women have several appointments to monitor her follicles’ size (each follicle contains an egg).

When the follicles indicate that the eggs are mature, they are retrieved using laparoscopic techniques. Follicles are viewed using ultrasound, and then a small needle is inserted into the follicle to retrieve the egg. Based on how well the woman responded to the IVF stimulation process, the amount of eggs retrieved can vary.

Any eggs retrieved that are mature would then be fertilized with the partner’s (or a donor‘s) sperm.

A fertility doctor may recommend undergoing IVF if any of the following describes you:

• You’ve been diagnosed with medical issues such as polycystic ovarian syndrome (PCOS), endometriosis, blocked fallopian tubes, diminished ovarian reserve, or in men’s case, a concern with their sperm (low sperm count, etc.)
• Couples in a same-sex relationship and are working with a surrogate.
• Women who are under 35 years old and have been trying to conceive for over a year
• Women that are over 35 years old and have been trying to conceive for more than six months
• Women that are 40 years old or older who would like to conceive. It’s important to note that egg quantity and quality diminish as a woman ages. Donor eggs may be recommended in this case
• If you have a history of recurrent pregnancy loss and genetic testing is recommended
• You or your family has a known hereditary issue that you may want to test for when pursuing IVF

Where IVF Stimulation Fits into the Entire IVF Process

Every IVF protocol and timeline are different but below are the overall primary stages that each cycle has in common, including where the IVF stimulation process falls. They are:

Stage One – Fertility Consultation: Before you begin any fertility treatment, you’ll meet with a reproductive endocrinologist. They will review your medical history, any previous treatment you’ve done, and overall health. Depending on the IVF clinic, some initial consultations are just a conversation, while others will also include blood work and an ultrasound.

Stage Two – IVF Preparation: This will include blood work, fertility testing, ultrasound, and, depending on the protocol, potentially regulating the woman’s menstrual cycle.

Stage Three – IVF Stimulation and Monitoring: Most IVF cycles are done with injectable hormones that stimulate follicular growth. Again, the objective is to produce more eggs in a single cycle to be retrieved and fertilized to create embryos. You will be monitored during the IVF stimulation process.

Stage Four – The Trigger Shot, Egg Retrieval, and Fertilization: Based on your monitoring, once it’s time for retrieval, you will take the trigger shot. Your clinic will then schedule your egg retrieval for 36 hours later.

Using Reproductive Technology to Improve Your Chances

An option to discuss with your doctor before the IVF stimulation stage is whether Pre-implantation Genetic Testing for Monogenic Diseases (PGT-M) or Pre-implantation Genetic Testing for Aneuploidy (PGT-A) would help the outcome of your IVF. These genetic tests would be performed on any embryos created. Genetically tested embryos have a higher implantation rate and a lower chance of miscarriage, which can help your IVF outcome.

Another possibility is a genetic test known as Endometrial Receptivity Analysis. This can help establish the best day for embryo transfer. This would entail an endometrial biopsy being taken by your doctor in a mock embryo transfer cycle. This sample would then be carefully analyzed to find when your specific window of implantation would be. Some believe this information can provide the best time to transfer the embryo to the hopes that the uterine environment would be ideal for it to implant.

These tests are not necessarily appropriate for everyone, so it’s best to ask your doctor to tell you more about each’s risks and potential benefits.

Ideally, your IVF protocol is as unique as you and tailored to your health history and fertility goals. However, we encourage you to ask questions not just about the IVF stimulation process and inquire about all the options you have available to maximize your chances of a successful and happy pregnancy.

As always, GoStork can provide you resources and tools to help you make the choices that are right for you!

Read more from this series: 

Maximizing Your Chances of IVF Success (Part 2): Genetic Testing