Surrogacy may be the only option for some women to safely create a genetically related child. A gestational surrogate is a woman who carries the infertile patient’s child through pregnancy and delivery. Many women become surrogates for altruistic reasons. Most are compensated for their time and efforts. Surrogates may be known, such as a sister, friend, or other relative, or they may be selected from a referral agency.
Embryo transfer is a relatively simple procedure and the final step of the in vitro fertilization (IVF) process, helping to facilitate conception. Embryos are usually transferred 3-5 days after egg retrieval.
During embryo transfer, anesthesia is rarely necessary, although a sedative such as Valium may be used if the patient desires. An ultrasound is used to help the physician guide the catheter into the uterine cavity. A full bladder assists in having optimal ultrasound visualization. Usually a single embryo is loaded into a fine transfer catheter that passes through the vagina and cervix, into the uterus where the embryo is deposited.
Following transfer, the patient is allowed to empty their bladder and then return to normal activity. We usually recommend no strenuous activity for 3-4 days while implantation is occurring. Bedrest after embryo transfer has not been shown to improve pregnancy rates and is no longer routinely recommended.
Egg freezing is an exciting and potentially “life changing” procedure offered at Reproductive Care Center’s Utah Infertility clinic. Patients and reproductive biologists have long had tremendous interest in egg freezing and technological advances now make it possible.
A healthy woman can support a pregnancy into her late forties or early fifties, however, egg quality declines with aging. Some women choose to delay childbearing and egg freezing allows them preserve fertile eggs for future use in an IVF cycle.
Increasing female age is perhaps the greatest enemy of fertility. “Reproductive life” begins with the first menstruation and culminates in the menopause where few, if any, viable eggs remain. Many women delay childbearing until they are older and have established their careers. The age at which females are marrying has also increased. Unfortunately, the societal clock and biological clock are not always in “sync”. These delays in childbearing are partially responsible for the increased incidence of infertility related to age.
Assisted hatching is a procedure designed to improve embryonic implantation rates. It is performed in conjunction with an in vitro fertilization cycle (IVF), where an embryo is created as a result of FSH stimulation, egg retrieval, and fertilization.
In an IVF cycle, embryos are cultured until mature and ready for transfer, which is usually from three to six days. As the embryos develop, they pass through several developmental stages including blastocyst formation. (We typically refer to day 5 embryos as blastocysts, however, embryos may form blastocysts before or after 5 days.)
The introduction of ICSI revolutionized the treatment of male infertility allowing men with as few as one sperm to father genetically related children. Prior to ICSI, the only option for patients with moderate to severe male infertility was to use a sperm donor, donor embryos or adoption.
ICSI is conducted in conjunction with an IVF cycle. Once the follicles mature, the eggs are retrieved transvaginally using ultrasound guidance. Once retrieved they are transferred to the embryology laboratory where the eggs are separated from the follicular fluid.