In-Vitro Fertilization (IVF)

In 1978, in-vitro fertilization (IVF) was developed for women with blocked fallopian tubes. Since that time, it is now used for all causes of infertility.

At the Markham Fertility Centre, IVF offers the best chance of pregnancy for infertile couples, regardless of their primary problem. The explanation for high pregnancy rates is simple :

1. Fertilization is optimized by placing sperm and eggs in close proximity.

2. Excellent fertility drug regimens are used to, theoretically, produce the best quality eggs.

3. We can pick and choose your highest quality embryos for transfer, best optimized by blastocyst transfer.

IVF is an extensive procedure for a couple to undergo. After being stimulated with fertility medications, that requires the patient to have daily blood tests and ultrasound scans, a woman’s eggs are retrieved through a trans-vaginal probe under a light anesthetic. A sperm sample is obtained at the same time, and the eggs and sperm are mixed together into a small dish several hours later.

Over the next 24 hours, the number of fertilized eggs (embryos) can be identified and, eventually, graded. Embryos can be transferred 48 hours after egg retrieval (4-cell stage), 72 hours after retrieval (8-cell stage), 96 hours after retrieval (morula stage) or 120 hours following retrieval (blastocyst stage). 1 or 2 embryos are then transferred into the patient’s uterus (embryo transfer) with a small catheter, completely by-passing her fallopian tubes. All embryo transfers at the Markham Fertility Centre are performed under ultrasound guidance. If extra good quality embryos are remaining, they can be frozen for potential future embryo transfers.

Unlike any other reproductive techniques available, in-vitro fertilization remains the only test in which egg quality can be determined. It is the best test to determine whether or not a man’s sperm can fertilize a woman’s egg. It is the only procedure that can determine whether or not a couple can create an embryo and determine it’s subsequent quality.

After undergoing IVF, a couple should be able to get answers and insight into their infertility problem. If an egg or sperm problem is identified, correct treatment options can begin the very next cycle, and valuable time and expenses can be saved by knowing there the exact problem lies.

Some common examples of IVF experiences are as follows:

Problem: 12 mature eggs retrieved but only 2 fertilized.

Solution: If the eggs are felt to be of good quality, this indicates a sperm fertilization problem. Intra-cytoplasmic sperm injection (ICSI) would be the next logical step for the next cycle. At the Markham Fertility Centre, we recommend that couples have both IVF and ICSI for their 1st IVF cycle for this possibility. Approximately 5% of men with a normal semen analysis and SCSA (DNA fragmentation) will not fertilize at conventional IVF.

Problem: 14 eggs were retrieved but were of poor quality. Only 3 fertilized but the embryos were poor quality.

Solution: If the sperm DNA is normal, egg quality can be related to the stimulation protocol or a predisposing condition (polycystic ovarian disease). Some women have poor egg quality for unexplained reasons. Possible solutions to egg quality issues exist,but, ultimately, oocyte donation may be the only option.

Problem: Good eggs were retrieved and good quality blastocysts resulted but pregnancy didn’t occur.

Solution: If you have a high percentage of embryos that make it to the blastocyst stage, and they are of good quality, this may indicate that you have an implantation problem.


Factors Affecting Implantation