The 10 Step IVF Process

Step 1- IVF Consult Appointment and Informational Session

The first step is to contact Seattle Reproductive Medicine (SRM) and schedule a comprehensive consultation with one of our physicians. A SRM physician will thoroughly review your medical records and ensure that IVF is appropriate. An individualized treatment plan is developed that includes orders for pre-cycle testing.

After your consult you will meet with a nurse for an informational session.  Your fertility nurse enables you to have a one on one contact throughout your cycle. At this appointment the nurse will give you a general description of an IVF cycle and review the screening process as well as time frame for completion. You will receive your IVF packet at this time.  Our fertility nurses understand the complex and delicate nature of treatment as a means to starting a family.  At this time, you will have an opportunity to discuss any questions or concerns that you may have regarding IVF.

Finally you will meet with a Financial Counselor to discuss your upcoming cycle. The financial department will be able to tell you the estimated cost for your treatment, procedures, and options. They will also discuss with you insurance coverage and payment options.

Step 2 - Completion of Required Tests and Uterine evaluations

Coordination of an IVF cycle is complex, exciting, and at times stressful. The American Society for Reproductive Medicine (ASRM) and the FDA set the screening requirements.  It is your responsibility to make sure that all items on your checklist are completed prior to starting stimulation medications.  If you have any questions please call and speak with your nurse or Medical Assistant.

An IVF cycle can take up to 3 months to complete from initial screening to the actual egg retrieval and embryo transfer.

**All screening requirements on your checklist must be completed!**

Step 3 - Informed Consent and Complete Treatment Plan

It is important that you and your partner are aware of the possible risks associated with IVF and understand the procedures involved.  This visit will be with your doctor and will allow you to ask any questions you may still have about the process and review of your completed checklist.  Your treatment consents will be signed at this time.  Please note:  a staff member must witness both signatures or you can have the consents notarized.

You will meet one more time with the Financial Counselor after your visit with the doctor to finalize your payment plan and options.

Step 4 - Create Calendar and Assign Day 1 Protocol Review

A calendar is created to outline your individual stimulation protocol developed by your physician and includes a schedule of medications and appointments for your IVF cycle.  This calendar is created only after the checklist items are completed.  An estimated day 1 is assigned according to the regularity of your menstrual cycle.  Your calendar will be sent to you via mail or email depending on your preference. Your individual protocol will be reviewed with you by your primary fertility nurse including your medications.

Step 5 - Injection Teaching          

We want to provide you with the best chance for success and part of this process is injection training.  During the injection class you will participate in hands on demonstration for injection technique.  This is part of your checklist

Step 6 - Suppression Check and Cycle Start

At this appointment the sonographer will measure your uterine lining and check you ovaries for any possible follicles or cyst.  If the ultrasound is normal a nurse will then review the individual calendar and confirm your Day 1 with additional instructions for medications, appointments, retrieval dates and embryo transfer dates.  As your IVF cycle proceeds you will have morning appointments with blood work and/or ultrasounds performed on Day 3, Day 5, and Day 8.  Further ultrasounds and blood tests are ordered as needed each day and may require changes in your medication dosage.  The nurse will call you after each of these appointments with the lab result and any further instructions.

Step 7 – Egg Recovery and Sperm Collection

Once you are ready for egg recovery as determined by a SRM physician, you will be given another medication (HCG) exactly 35 hours prior to the egg retrieval. This medication will bring the eggs to final maturity. The sonographic egg recovery (SER) involves the use of an ultrasound-guided needle to gently remove the eggs from theovaries. You will receive IV anesthesia during the procedure and should experience little or no discomfort. Your partner or donor sperm is collected on the day of the egg recovery.

Step 8 – Fertilization and Development of the Embryos

After the egg recovery, the embryologist prepares the eggs in the laboratory with the sperm.You will receivea preliminary report regarding the number of eggs retrieved by the physician prior to leaving the center that day.The following day, you will be called to discuss the number of eggs fertilized.

Step 9 – Embryo Transfer

The embryo transfer will take place 3-5 days after your egg recovery. On the day of your embryo transfer, the SRM physician will discuss with you the final embryology report and will recommend either transferring 1 or 2. The embryos are then transferred through the cervix into the uterus via a small catheter

Step 10 – Pregnancy Test

Fifteen days after the egg retrieval, you will return to SRM for a blood pregnancy test, called a quantitative hCG. If pregnant, SRM will have you repeat this blood test followed by one or more ultrasounds, before referring you to an obstetrician for ongoing care. With a positive pregnancy test, it will be necessary to continue the hormone medications for 6 more weeks in order to support early pregnancy.