In vitro fertilization (IVF)
In vitro fertilization is the most advanced procedure in the assisted reproductive technology repertoire. Literally meaning, "fertilized in glass," in vitro fertilization is a procedure where the egg and sperm are combined in the laboratory, incubated and subsequently transferred into a woman's uterus.
A few of the specific IVF procedures are further defined by the number of days in which an egg is cultured before it is transferred. A standard transfer includes an culture period that is anywhere from 2-3 days, while a blastocyst transfer allows the eggs to be cultured for an additional 2-3 days. Since close to half of standard 2-3 day old embryos are chromosomally abnormal, a blastocyst transfer allows the embryos to develop to the blastocyst (5-day-old) stage while in the laboratory. During those five days the chromosomally abnormal embryos are often selected out naturally, and the more chromosomally normal embryos can be selected for transfer. Usually, only the best embryos have the ability to grow to the blastocyst stage and the Implantation rate per blastocyst transferred is twice that of 3-day-old embryos.
Depending on the recommendation of your doctor and your specific treatment plan, UCSD Regional Fertility Center offers two additional IVF procedures that can be conducted before the embryo is transferred. These procedures are ICSI and assisted hatching. The ICSI (intracytoplasmic sperm injection) procedure is a treatment specifically used for male factor infertility. With this procedure the IVF cycle is conducted exactly in the same manner as a typical IVF cycle. However, after the eggs are retrieved, instead of mixing the sperm with the egg, the embryologist utilizes a thin glass pipette to immobilize the sperm, suck it up into the pipette, and then inject it directly into the egg's cytoplasm.
The assisted hatching procedure, like ICSI, is carried out by a technique known as micromanipulation. In small dishes the embryos, which now contain an average of six to eight cells, are stabilized by a holding pipette, while on the opposite side a small pipette containing acidified Tyrode's solution creates a small defect in the zona. Assisted hatching was developed in response to this theory that some women may fail multiple cycles of standard IVF because their eggs have a thicker shell. By creating a minor defect in the zona (shell) the result is a greater chance of the embryo "hatching," or shedding its shell, allowing for a better chance of implantation in the endometrium. In our studies, assisted hatching had improved the success rate in women between 35 and 40 so much that it began exceeding the results of our women under 35.
Last updated: September 21, 2009
Author: Dr. V. Gabriel Garzo
"Dr. Garzo was recommended to my husband and I after six and a half years of struggling to start a family. After my initial conversation with Dr. Garzo I felt a new sense of hope. I was immediately put in touch with Angela to get all the necessary paper work and testing in order for both us and our donor. Since we were doing this long distance there have been many conversations with Angela, each one instilling more and more confidence that this would actually happen. If Angela was not available I was attended to by one of the other nurses. They are all really great! I never felt like I was asking a stupid question or had a concern that was not valid. In less than a year of working with the team at RP we are so thrilled to say that we are expecting our first child! It was the genuine concern for us, the professionalism and the can do attitude of everyone in the office that we attribute this success to! Thank you!"
