- Preparation for the Procedure
- The Day of Your Oocyte Retrieval
- Days 1–4 of Embryo Growth
- Day 3 Embryo Transfer
- Day 5 Embryo Transfer
- What Happens to the Remaining Embryos?
From the time you begin ovarian stimulation to the day of your egg retrieval, our laboratory technicians and embryologists are involved in many diagnostic and preparatory procedures. In particular, we will be drawing your blood to determine the concentration of estradiol (an indicator of oocyte maturation). As a precautionary measure, we will also have the partner schedule an appointment (approximately one to two months prior to your procedure) to leave a semen sample, which will be frozen and serve as a backup sample in case of an emergency.
The day of the retrieval your physician will aspirate your ovarian follicular fluid containing the oocytes. One of our technicians will be at the side of your physician assisting during the procedure. During this time the follicular fluid will be collected in a test-tube, which is then transferred into the embryo lab where one of our embryologists will transfer the oocytes into a dish with specialized media. The oocytes are then incubated at body temperature until fertilization. During this incubation time, the husband will collect a semen sample, which our technicians will prepare for the fertilization process. After the incubation period, your oocytes are fertilized by one of two methods: microdroplet or ICSI (intracytoloplasmic sperm injection). Microdroplet fertilization involves adding sperm to the media containing the oocyte. ICSI is a technique by which a single sperm is injected into the egg. In general, this procedure is used in cases where severe male factor infertility is involved. After either fertilization technique is employed, the oocytes are incubated overnight.
The morning after fertilization, our embryologists will transfer your embryos to a special growth media and assess them for fertilization. The embryos will then be cultured and reevaluated on days 2 and 3. Depending on the quantity and quality of the embryos, a day 3 or a day 5 transfer will be selected. The embryos are left in the incubator on day 4. You will receive a call on day 2 with an update then again on day 4 for a second update as well as a transfer time for day 5.
The third day after fertilization some of your embryos should ideally reach the six- or eight-cell stage. We will provide you and the physician with an assessment of the embryo quality and a picture of the embryos to be transferred. You and the physician will carefully discuss and determine the number of embryos to be transferred (one to three), and the disposition of any remaining embryos. Most couples choose two embryos for transfer. During your embryo transfer, our embryologists will place these embryos in a catheter. The catheter is given to your physician who will then transfer the embryos to your uterus.
On the fifth day after fertilization, some of your embryos should ideally be at the blastocyst stage. We will provide you and the physician an assessment of the embryos’ quality and a picture of the embryos to be transferred. You and the physician will carefully discuss and determine the number of embryos to be transferred as well as the cryopreservation or disposition of the remaining embryos. Most couples choose two embryos for transfer. During your embryo transfer, our embryologists will place the embryos in a catheter. The catheter is then given to your physician who will then transfer the embryos to your uterus.
At the time of transfer, you are given choices concerning the fate of your remaining viable embryos:
- The embryos may be frozen (cryopreserved) for a future IVF embryo transfer.
- An embryo culture may be continued to see if the embryos develop to the blastocyst stage and then cryopreserved.
- The culture of embryos may de discontinued.
At the completion of an embryo transfer, additional embryos may remain unused. Cryopreservation may be used to retain the embryos, alleviating the need to retrieve additional oocytes for future pregnancy attempts. An Embryo Storage Agreement must be signed prior to cryopreservation of embryos.
Payment includes the first year of storage. Thereafter, payment for the current for the current storage period must be paid in advance. A client may terminate a storage agreement at any time by requesting and completing a Consent to Discard Pre-Embryos OR a Consent to Donate Pre-Embryos to IRB Approved Research form (contact the Andrology Lab to obtain the correct form). Please carefully read and complete the entire form. Please note: a UUHSC employee or a notary public must witness your signature. The original written notice must be received and acknowledged by the University before the agreement is terminated.