IVF Explained

 Posted by on March 12, 2009  Add comments  Tagged with: ,
Mar 122009

In the last week, some of you have asked me questions about the IVF process. I understand that it can be very confusing. The marvels of reproductive science really boggle the mind, and even though we’ve been through 3 (soon to be 4) IVF cycles, it’s still confusing to us sometimes too.

If you’ve read my IVF story, you know how my children came to be, but I’ve never actually explained how IVF works. I’m certainly not an expert, but I’ll do my best to explain the basics.

You’ve often heard me wax poetic about the intense and passionate connection between my husband and me (probably it makes you want to gag), but we really did fall in love on our first date, and we immediately knew that we wanted to have children together. However, we also knew that the odds were against us, for two reasons. First, my husband had been married before, and he has two grown sons. When he and his first wife decided that they didn’t want any more children, he took a very permanent step – he had a vasectomy. Vasectomies can sometimes be reversed, but it had been almost 10 years since my husband had his, and the doctors felt that the likelihood of a successful reversal was slim.

To make matters more difficult, I have PCOS (polycystic ovarian syndrome), which, in a nutshell, means that my ovaries make a crazy number of eggs, but I never actually ovulate. I haven’t had a menstrual cycle, without the help of drugs, since I was 23. In light of these circumstances, the doctors felt that IVF was the best possible solution to our fertility problem.

My husband, who clearly loves me very, very much, went through surgery in a very, erm…delicate area, so that the doctor could retrieve and freeze his sperm. I then took ovarian stimulating hormones to get my ovaries to make a whole bunch of eggs, which my doctor removed with a catheter, using ultrasound guidance. This is the report we received after the procedure:

33 eggs were retrieved. The average number of eggs retrieved is 10-12, so in this case, my PCOS problem was actually a blessing. As I said in my previous post, my ovaries make eggs like gangbusters.

My eggs were fertilized with my husband’s sperm, using a procedure called ICSI (Intra Cytoplasmic Sperm Injection).

Image courtesy of the Infertility Center of St. Louis

During ICSI, a single sperm is directly injected into each egg. Of our 33 eggs, 12 fertilized normally and became embryos. 4 of the embryos were frozen at the 2PN stage (single-cell, 2 pro-nuclei visible). The rest were cultured for three days, to the blastocyst (8-cell) stage. The largest, best quality embryo was chosen to be transferred into my uterus, and 9 months later, I gave birth to Bee.

Bee is the largest embryo in this picture (top row, second from left).


Bee, 2 weeks old.

The 7 remaining embryos were cultured for two more days. During this time, 3 of them stopped dividing, so only 4 qualified for freezing (cryopreservation). During cryopreservation, the embryos are frozen in “straws” in a special, controlled-rate embryo freezer like this one:

Image courtesy of the Advanced Fertility Center of Chicago

They are then immersed in a liquid nitrogen cryotank for long-term storage.

Image courtesy of the Advanced Fertility Center of Chicago

In April, 2005, 3 of our frozen, blastocyst embryos were defrosted and transferred, but I did not become pregnant. This is the heartbreak of IVF – you suffer through so much, physically and emotionally, but there are no guarantees. Thankfully, in March, 2006, our 4 2PN embryos were thawed, and 3 were viable:

One of the embryos in this picture became our little Cakes, but there is no way to know which one.

Cakes, 2 weeks old

For those of you who are curious about the cost of IVF, I can tell you that my husband’s surgery was an outpatient procedure, and it cost about $6000. It was not covered by insurance, so we set up a monthly payment plan with the hospital, and made payments until it was all paid off. Our original IVF cycle cost approximately $10,000, and it was 80% covered by insurance – we made payments on the balance.

The rest of our IVF cycles have been frozen embryo transfers (FETs), which cost about $2500 each. These cycles have not been covered by insurance, so we just plan ahead. We figure out when we want to undergo a cycle, and then save enough money each month to pay cash for the procedure.

We have 1 remaining frozen embryo, and our upcoming cycle is our last. If we get pregnant, using only 1 frozen embryo, it will be nothing short of a miracle. If we don’t, we are still very thankful to the Lord for blessing us with 2 beautiful children. Many couples endure 5, 7, even 10 cycles of IVF with no success. My heart goes out to them, and I realize how truly blessed we are.

We already have the privilege of raising 2 little miracles. What more could we ask for?


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