Rutgers Cancer Institute of New Jersey
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New Brunswick, NJ 08903-2681
In vitro fertilization is a process where a woman’s eggs are fertilized outside her body, then placed back inside her body to help her get pregnant.
A woman’s reproductive system includes the vagina, cervix, uterus, fallopian tubes, and ovaries.
During the monthly menstrual cycle, one of the ovaries releases an egg in a process called ovulation.
After ovulation, the egg enters the fallopian tube.
A woman is most likely to become pregnant if she has sex in the days just before, during, or right after ovulation.
During this time, a sperm cell from a man’s reproductive fluid, called semen, is able to fertilize the egg just inside the fallopian tube.
As it travels along the fallopian tube, the fertilized egg, now called an embryo, loses the outer cells that nourished it in the ovary.
The embryo passes from the fallopian tube into the uterus.
In the uterus, the embryo sheds its protective outer layer, called the zona pellucida, in a process called zona hatching.
Zona hatching is necessary for the embryo to implant in the tissue lining the uterus.
During implantation, a connection between the woman and the embryo begins to grow.
This organ, called the placenta, allows oxygen and nutrients to pass from her to the embryo.
In vitro fertilization may be performed if a woman has been having trouble getting pregnant, a condition known as infertility.
Or, it may be done if a woman wants to have a child without a male partner.
Before in vitro fertilization, a woman will receive fertility medication that causes more than one egg to grow and mature in the ovaries.
A man will provide a semen sample so that the healthiest sperm can be collected for fertilization.
If the male partner is completely infertile, also known as sterile, or the woman doesn’t have a male partner, a donor may be arranged to provide sperm for this process.
In vitro fertilization consists of three main procedures:
and embryo transfer.
During the first procedure, called follicle aspiration, eggs will be harvested from the ovaries.
At the beginning of this procedure, an ultrasound probe will be inserted into the woman’s vagina so that her doctor can view her ovaries.
Inside the ovaries, the doctor will look for follicles. Each follicle is a fluid-filled sac that contains an egg.
Then, the doctor will insert a long thin needle into and through the wall of her vagina, and guide it the ovary.
A suction device connected to the needle will collect several eggs from inside their follicles.
During the second part of in vitro fertilization, called fertilization,
the collected eggs will be taken immediately to a laboratory, where they will be fertilized.
Fertilization may be performed by insemination, where several sperm are mixed with the healthiest eggs.
Or, the eggs may be fertilized with sperm injected directly into them during a process called intracytoplasmic sperm injection.
The fertilized eggs, also called embryos, will be monitored for three to five days as they begin to grow.
At this time, the lab may create a hole in the zona pelludica surrounding some of the embryos.
This process, called assisted hatching, will help these embryos implant in the uterus.
Some of the embryos will be used right away for embryo transfer, and the rest will be frozen and stored for future use, if necessary.
The third part of in vitro fertilization is called embryo transfer, which is done three to five days after fertilization.
During embryo transfer, a tool called a speculum will be inserted into the woman’s vagina so that the doctor can see her cervix.
A syringe will be loaded with fluid containing one or more of the “hatched” embryos.
Then, the syringe will be attached to a long, thin tube, called a catheter.
The doctor will insert the catheter into the vagina, through the cervix, and into the uterus.
Once inside the uterus, the doctor will inject the embryos.
Then, the catheter and speculum will be removed.
The woman may continue lie on her back for about fifteen minutes.