IVF TREATMENT: WHAT TO EXPECT AT OUR LA FERTILITY CLINICS
WHAT IT IS ALL ABOUT?Tree of Life Center provides IVF to Los Angeles and Southern California for over 20 years! Our fertility clinic enabled thousand of parents to utilize cutting-edge IVF technology and to accomplish the reproductive goals of many LA families. We know that Los Angeles is crowded, but we want to see our families grow, and more parents enjoy little Angelinos.We strive to make IVF treatment simple and affordable to all! We can guide you step by step through the IVF process and help you achieve a successful fertility journey. While you have many choices for an IVF clinic, our IVF treatments are unique and we have three locations in the Los Angeles metro region to serve your fertility needs.Our embryology laboratory director Dr. Man Li and medical director Dr. Vuk Jovanovic ensure that we provide you with excellent fertility care during your IVF.
WHAT IS IVF?The term In vitro fertilization originates from Latin "in the glass" fertilization. It describes a process performed in a test-tube. Thus, In vitro fertilization (IVF) means fertilizing the egg with sperm in a glass dish. The process would naturally take place in the fallopian tube. In modern fertility clinics, the glass has been replaced with single-use plastic dishes, but the principle remains the same!IVF treatment is a potent fertility treatment option that can overcome severe infertility. Some couples will never be able to restore their fertility naturally and depend on reproductive technology to overcome their infertility. This might be the case with blocked fallopian tubes or poor sperm function.Utilizing state-of-the-art reproductive technology results in IVF costs being significantly higher compared to simpler fertility treatments. We are selective about who to recommend this fertility treatment. We try to find alternatives to IVF, like intrauterine insemination (IUI), whenever possible. We also have new options in the form of the Invocell treatment option - this option is less expensive than conventional IVF and might be an excellent alternative to a selected group of infertility patients.The optimal treatment plan will be created during the initial fertility evaluation. Many patients do not know how IVF can restore their fertility and do not have extensive knowledge of reproductive medicine.
LET'S EXPLAIN THE IVF PROCESS STEP-BY-STEP:
- Ovarian stimulation with fertility medication (absent in natural cycle IVF)
- Egg (oocyte) retrieval (also known as Oocyte aspiration, ovum pickup or just simply "retrieval")
- Insemination of the egg using natural fertilization or ICSI procedure (not done in egg freezing)
- Laboratory culture and development (typically until blastocyst development and up to day 7)
- Embryo transfer into the uterus (fresh transfer) or
- CryopreservationPreimplantation Genetic Testing (PGD or PGS) - optional but improves success rates.
- Support for implantation and pregnancy testing
OVARIAN STIMULATIONOne common misconception is that ovarian stimulation is a mandatory step of IVF. Every woman with a regular menstrual cycle will spontaneously mature one egg each month - without expensive medication! The sole purpose of administering injectable fertility medication is to increase the number of mature eggs and prevent premature ovulation. Our reproductive endocrinologists are able to extract an egg during a natural cycle in over 90% of the cases! This high success rate is the result of a meticulous egg retrieval technique. That benefits fertility patients who do not have many eggs during the natural cycle and minimal stimulation IVF. From the efficiency perspective, we would need to perform ten natural cycles to get ten eggs. Now you understand why using a follicle-stimulating hormone to mature multiple eggs per IVF cycle increases efficiency. In some patients, we are able to retrieve over 30 eggs per IVF cycle. The increased number of eggs improves the chances of success and reduces the need to perform additional IVF cycles. As reproductive treatments advance, new IVF drug combinations almost completely eliminate ovarian hyperstimulation syndrome (OHSS). This increases patient safety and avoids treatment complications from ovarian hyperstimulation. The ovarian stimulation is a science and world in itself, and there are many stimulation protocols and blood tests. Our well respected Los Angeles doctors will provide you with the best IVF protocol suited to your fertility problem.
EGG (OOCYTE) RETRIEVALThis surgical procedure is usually performed while the patient is asleep, but can be done under local anesthesia. Most of our patients undergoing natural IVF cycles and mini-IVF do not require anesthesia. The egg retrieval is also known as oocyte aspiration, ovum pick up, or only retrieval. A long ultrasound-guided needle is introduced through the vagina into the follicle. Rarely, the egg retrieval is done through the abdomen or during a laparoscopy. Typically, only a thin needle gets introduced into the body. The surgical risk is minimal, and modern ultrasound equipment can visualize the pelvic anatomy, including major blood vessels. Dr. Jovanovic has performed over ten thousand egg retrieval procedures to date. Once the eggs are taken to the laboratory, the high-tech In vitro fertilization begins! We all know that Southern California and Los Angeles do not have the best air, but the air in the IVF laboratory is clean and VOC free! This is accomplished with special filters in a Cleanroom environment. The incubators are supplied with special gas mixtures that resemble the uterus but without any infertility causing factors. The in vitro fertilization begins and continues over several days in a unique IVF incubator. The laboratory is considered the heart of an IVF clinic.In cases when only egg freezing is desired, the eggs are immediately frozen using a vitrification media. Since the entire procedure is completed in a single day, the egg freezing costs are generally less expensive. This option allows for preserving fertility in females who would otherwise cope with infertility in the future. Many women in Los Angeles can benefit from this option.
FERTILIZATIONThe first step is the penetration of sperm into the egg, also known as fertilization or natural insemination. Only highly competent sperm are able to accomplish this task spontaneously. Once sperm makes it inside, the male chromosomes are delivered into the egg. This way, the genetic material from the biological father and biological mother can fuse together. Some sperm incapable of naturally fertilizing the egg need to be forced inside. This microinjection of sperm into the oocyte is called intracytoplasmic sperm injection (ICSI) treatment. Intracytoplasmic sperm injection is used to treat severe male factor infertility and help individuals with inferior sperm count. Prior to the introduction of the sperm injection technique, IVF clinics would offer donated sperm to treat severe sperm.CultureOnce the embryo is formed, we can culture it up to 7 days in the laboratory and observe its development. The IVF laboratory is the heart of the fertility clinic. Skilled embryologists perform and monitor every step of the IVF process. They follow and grade the embryo development from the cleavage stage to a fully expanded blastocyst. We will typically wait for 5-7 days until the transfer. In addition to the optical scoring, we also utilize embryo biopsy and send the material for genetic testing. This is an optional procedure called preimplantation genetic testing (PGT) or preimplantation genetic screening (PGS). It can be employed to identify chromosomally or genetically abnormal embryos. A specialized reproductive genetics laboratory will provide us with the chromosomal status of the embryos.
TRANSFERThe embryo transfer process consists of replacing it into the uterus using a transfer catheter. This way, we guide it into the optimal spot in the uterus where it can implant and develop into a pregnancy. This is a highly manual procedure, and using a top fertility specialist will increase success rates for embryo implantation. You do not need to undergo anesthesia, and you should ideally NOT feel your transfer—the less traumatic the insertion, the higher the success rates for a positive pregnancy test. The embryo transfer can either be performed in the same IVF cycle as the egg retrieval and is called fresh embryo transfer. If the embryos have been previously frozen, it is called frozen embryo transfer. The most important decision is the number of embryos to transfer, and this will be a significant discussion topic with your reproductive specialist. After you leave our fertility center, you will be instructed to limit your activity for 36-72 hours.
SUPPORT OF IMPLANTATIONMaintaining a receptive endometrium and an adequate hormonal environment ensures that your embryo can attach and develop into a viable pregnancy. We can perform the pregnancy test and detect the pregnancy hormone (beta-hCG) seven to eight days after embryo transfer. We will continue the hormonal support until we are sure that your body is producing enough hormone on its own, and this will complete your IVF cycle. After that, once you graduate from our fertility clinic: the pregnancy can continue as in any other patient with no reproductive problems!
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