In Vitro Fertilization (IVF) Process

The Surrogate’s Role

In Vitro Fertilization and Uterine Embryo Transfer (IVF/UET) is a widely accepted assisted reproductive treatment for infertile couples worldwide. This technique has been utilized since its inception in the late 70’s. In the United States of America, IVF/UET began in early 1980 and it has been well received within the medical community and with infertile couples. In the mid 1980’s, the dimension of a third party (Surrogate) was added for those couples who could produce embryos through IVF, but the wife could not carry the pregnancy.

The criteria for consideration for IVF/UET is based on the Intended Mother’s and Surrogate’s reproductive ability, their general health, history of medical problems and the Intended Father’s reproductive abilities, as well.

As you may anticipate, this procedure is physically and emotionally demanding as well as very expensive. In view of these complexities, here is the general background of the procedures.

The IVF/UET Process

The IVF/UET process is divided into the following five (5) steps:

  1. Follicle Development
  2. Oocyte (Egg) Collection
  3. Oocyte Culture and In Vitro Fertilization
  4. Uterine Embryo Transfer to Intended Mother
  5. Luteal Phase Monitoring and Support

Steps 1 through 3 (completed by the Intended Mother or her Egg Donor and the medical laboratory)

After the eggs have been retrieved from the Intended Mother or Egg Donor, they are fertilized in a laboratory dish which is In Vitro Fertilization. The dishes are placed in an incubator set at the same temperature as the woman’s body. When the embryos have reached the expected stage of development, any embryos in excess of the number agreed upon for the embryo transfer, are frozen for future use.

Steps 4 & 5 (completed by the Surrogate)

The Surrogate is seen several times during the treatment cycle for the purpose of monitoring her endometrium (lining of the uterus). Prior to the embryo transfer, she takes several medications that prepare the endometrium to receive the embryos. The physician will determine when she must begin the daily progesterone injections and she is to continue them until ordered to stop by the physician.

The embryo transfer is performed with the Surrogate in a gynecological position and requires no anesthesia. After the proper cleansing procedures, a tiny plastic catheter is introduced into the uterus through the cervix and the embryos are transferred into the endometrial cavity. The Surrogate is required to stay in this position for a short period of time, and then the nurse will reposition her per the physician’s instructions and monitor her for the required time.

When the Surrogate is released after the embryo transfer, she will be taken to a hotel for complete bedrest; getting up only to use the bathroom. This regiment is continued for 2 more days. After this time, the Surrogate may resume her normal activities with the limitations provided to her by the physician at the time of the embryo transfer. Some of the limitations are:

  • Complete Pelvic Rest
  • No douching or sexual intercourse
  • Showers only – no tub baths
  • No strenuous activities – no exercising, running, heavy lifting including children, groceries, luggage, etc.

A pregnancy test will be performed two weeks following the embryo transfer. If a pregnancy occurs, the Surrogate will have several visits to the clinic to monitor the hormone level and the progress of the embryo(s). This monitoring is done by blood tests and ultrasound. If pregnancy does not occur, the physician will instruct the Surrogate when to stop the medications and when to expect her menstrual period.

Cycle Cancellation

The physician establishes the acceptable level of response to the treatment during the cycle. If at any point, the Intended Mother’s, her Egg Donor’s or the Surrogate’s response to the treatment falls below that established level, the physician will cancel the cycle.

Click here to read more details about the Intended Parent’s role in the IVF/UET process