In vitro Fertilization, or IVF, relies heavily on ultrasounds to help people reach their fertility goals. Joseph Letourneau, a University of Utah Health fertility doctor, says a woman might have three or more pelvic ultrasounds during IVF, to:
- Scan the uterus, ovaries, and endometrial lining to prepare for healthy embryo growth
- Monitor follicle development in the ovaries and track stages of growth prior to extraction
- View inside the ovaries to help withdraw follicles/eggs for later implantation
- See inside the uterus during embryo transfer to ensure appropriate placement
- Follow progress of an implanted embryo the first six to eight weeks
Letourneau notes ultrasounds are critical to IVF testing and treatment. "They're actually one of the most important pieces of equipment in our clinic." That clinic is the Utah Center for Reproductive Medicine (UCRM) - in operation for more than 30 years now.
What Does a Fertility Doctor do?
"We strive to help people have safe and healthy pregnancies, taking into account: the time someone has been trying to become pregnant; both partner's medical histories; and their personal plans for building a family - both how many children and when. We try to honor all that in the safest and best way for them," says Letourneau.
Fertility doctors guide you through the IVF process, reading ultrasound data and test results, including sperm count in men, and basing next steps on things like the health of the ovaries, endometrial lining, and uterus. These reproductive endocrinologists utilize ultrasound readings for a multitude of reasons, relying most often on what's called a transvaginal ultrasound. Fertility doctors also often specialize in certain conditions or situations, such as polycystic ovarian syndrome, so if you're wondering, 'What doctor should I see?' look at their specialties and background.
What is a Transvaginal Ultrasound?
Letourneau mentions there are many kinds of ultrasounds, but with IVF, the transvaginal ultrasound is most used due to the level of internal reproductive system detail it can identify. "It usually takes only five to ten minutes, for the small, tampon-shaped probe to be inserted into the vagina to get very clear images." Because this type of ultrasound is acting from inside the body and so near the organs of interest, it is ideal for monitoring IVF progress.
"Ultrasound shows different tissue densities," explains Letourneau. "Though it takes a lot of training to be able to find them, I usually tell people that on ultrasound images, ovaries look a little bit like chocolate chip cookies." Letourneau notes the transvaginal ultrasound is not typically painful and the patient also has the option of inserting the probe herself, rather than the physician or sonographer.
If you're not comfortable having a transvaginal ultrasound, Letourneau offers that other options are available. "We can do abdominal ultrasounds, and ask that you have a full bladder, to push the ovaries away from the vaginal wall where we can see them." The full bladder is necessary with abdominal ultrasounds because ultrasound waves travel best through fluids.
IVF Gives More Chances
"IVF is kind of like a ramped up ovulation cycle," illustrates Letourneau. "One regular menstrual/ovulation cycle usually produces one egg and involves the development of a follicle, which houses and supports the egg within the ovary." Letourneau adds the first half of a menstrual/ovulation cycle is about making an egg mature and releasing it into the fallopian tube.
"Our fertility work seeks to figure out through ultrasounds and hormone assessments how many more (than just one) eggs we could safely get," says Letourneau. "Then, instead of just one month worth of chances, maybe you get 12 eggs, and 12 months' worth of chances." The number of eggs retrieved is very personalized and depends on a patient's egg count and age. Ask your doctor about ways to measure your egg count.
Pregnancy may come sooner with IVF than with the natural method. Letourneau explains, "For reference, for about 50 percent of people trying to conceive with intercourse, it usually takes about four to six months to achieve pregnancy."
In the second part of IVF, Letourneau states the focus moves from getting eggs, to developing embryos. "In the IVF laboratory, we try to develop embryos just like they would in the fallopian tube, where they would grow for five or six days in a dark, warm and nutrient-enriched environment." The final step is the lab-to-uterus transfer of the egg or eggs, with monitoring of their growth.
Egg Myth Debunked
One thing some people fear about IVF is that it uses up all their future eggs, but that's not the case, clarifies Letourneau. "These are eggs that would have died off that month from lack of use. We're not borrowing against the future."