In Vitro Fertilization (IVF)
IVF can be a powerful option which leverages advancements in science and medicine to help you wherever you might be in your fertility journey. Still, it is an emotionally, financially, and physically demanding process for many women.
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Conceivable helps women and couples alleviate these burdens, all while connecting you to some of the top performing IVF clinics in the world.
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IVF has three main component parts:
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Egg Stimulation and Retrieval (some women do this alone and reserve for future use, a.k.a Egg Freezing)
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Egg Fertilization and Embryo Development
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Embryo Transfer
You don't have to sacrifice quality and comfort for an affordable option. Conceivable can help make sure of it.
Assessment
The most powerful step you can take to begin understanding what your personal egg-freezing experience will be like is to understand some of your key indicators.
Every individual's circumstances are different, but in general, you'll want to be equipped with your personal results for a few key metrics and tests.
Anti-Mullerian
Hormone
(AMH)
A hormone produced by the cells surrounding the follicles. Your AMH often correlates with the number of eggs your body will produce with ovarian stimulation.
Follicle Stimulating
Hormone
(FSH)
A hormone responsible for the growth of ovarian follicles before ovulation. Your FSH levels help to indicate what kind of stimulation will be required for follicle growth.
Antral Follicle Count
(AFC)
A measure of your ovarian reserve which indicates the number of follicles present in each ovary. The number of follicles can correlate to the number of eggs collected.
In addition to your own metrics, if you are pursuing IVF with a male partner, you will want to undergo a series of tests to understand how or whether sperm health may factor into your fertility.
Semen Analysis
Evaluates sperm for the following:
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Count and concentration within a single sample
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Motility, or the efficiency of sperm movement
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Morphology, or the size and shape of sperm
Stimulation
The goal of ovarian stimulation is to obtain the greatest number of healthy eggs from your ovaries.
Eggs begin in a small “antral” follicle in your ovary. In a typical menstrual cycle, several follicles are present in your ovaries, but only one egg matures to ovulation while the others disintegrate. The stimulation process gently prompts all follicles to mature the eggs present in larger numbers than during a typical cycle using hormones which are naturally present in your body.
Beginning shortly after the start of your menstrual cycle, you will begin a regimen of hormone injections which will stimulate egg development. Your progress is monitored every 2-3 days during 20 to 30 minute, in-person visits with your doctor. Your progress will be monitored, and your medication plan may be modified over the course of the stimulation to adjust with your response. In total, the stimulation can last about 10-12 days.
Beginning of Menstrual Cycle
Doctor's Visit
Your doctor will evaluate your response to your regimen and may prescribe modifications to the plan to ensure you proceed through the stimulation as successfully as possible.
Regimen End and Trigger Injection
Based on your follicle growth, your doctor will instruct you to stop further administration of your regimen. Shortly after, you will administer a "Trigger" injection exactly 36 hours before your scheduled retrieval.
Start of Hormone Regimen
Generally you can begin your hormone regimen on day 2 or 3 of your cycle. Based on your personal circumstances and your doctor's assessment, your doctor will inform your specific start date.
Continued Stimulation and Doctor's Visits
You will continue your prescribed regimen as instructed by your doctor. Your follicle growth will be monitored every 2-3 days leading up to your retrieval. Based on the growth of your follicles (assessed by ultrasound) and hormone levels (assessed by blood test), your medications may be adjusted throughout.
Egg Retrieval
Your retrieval will be scheduled for exactly 36 hours after you are instructed to administer your trigger injection.
Procedures are generally scheduled for the morning, and you'll need to abstain from eating or drinking for the 12 hours leading up.
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You will check in 1 hour before your scheduled procedure time and given a private suite. You will change and a nurse will walk you through your schedule for the day.
The procedure itself lasts approximately 15 or 20 minutes, and you will be sedated for the duration. You will have as much time as you prefer in your suite, though most people only require 1 - 2 hours before they are prepared to return to their homes.
Before you head home, you will meet with your doctor to discuss the outcome of the procedure and make plans for monitoring and next steps.
Sperm Retrieval
With a Male Partner
If you have a male partner providing a sample and he accompanies you overseas, you can schedule a sperm retrieval for the same day as your egg retrieval procedure. The most common method of sperm collection is by ejaculation of a sample on site in a private room at your clinic. Some patients elect instead to collect the sample at home and bring it to the clinic within 1-2 hours of ejaculation.
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Prior to fertilization of any kind, the sperm is carefully processed by a team of on-site embryologists and evaluated for motility (their ability to move efficiently) and health. The highest performing sperm are washed and a particular density of the sperm is achieved in order to optimize fertilization.
If your male partner does not accompany you overseas, you can have the specimen shipped from your home country, which Conceivable will work with your clinic to coordinate.
With a Sperm Donor
Additionally, Conceivable and your clinic can work together to identify donor sperm from a European sperm bank. European donor banks are completely anonymous and do not impose the same wait times as experienced in the United States and other countries.
Fertilization
Following your successful egg retrieval, your doctor will identify your mature eggs and fertilize them on site using one of two methods:
(1) Conventional Insemination, or
(2) Intracytoplasmic Sperm Injection (ICSI)
Based on your specific circumstances and needs, your doctor will determine the best approach and whether additional procedures are required to increase the likelihood of a successful pregnancy.
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The resulting embryos require approximately 5 days to develop at the clinic's on-site lab where they are monitored daily for their speed of development, formation, and size. Your embryologist will then select the highest quality embryos for implantation, or "transfer". Embryos can also be frozen for future use.
Transfer
Depending on the speed of development for your embryos, your transfer will be scheduled between 2-5 days after egg retrieval and fertilization.
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The transfer procedure will take place in a doctor's office and is generally painless, but you may be given a mild sedative to assist with any discomfort or cramping.
The insertion is performed via use of a catheter through the cervix and into the uterus. A syringe containing 1 or more embryos will be attached to the catheter, and your embryos will be gently transferred into your uterus.
You will return to your home country, and approximately 10 days after your transfer, a blood test will confirm whether the embryo attached to the lining of the uterus and your procedure has resulted in a successful pregnancy.
FAQs
Understanding your fertility treatment options can feel daunting, but it does not need to be. We've captured some of our most frequently asked questions below, but we understand that no two cases are alike.
Should you want to learn more, you can schedule a free consultation with a Conceivable Concierge at any time.
What kind of success rates should I expect?
Europe is the world's leader in Assisted Reproductive Technologies, and our partner clinics have success rates that match or exceed the top clinics in the United States.
How long does the process take.
If you have already undergone egg-retrieval and storage, the IVF process requires approximately 1 week.
If you have not yet undergone egg-retrieval, the process requires approximately 2-3 weeks, starting from the beginning of your menstrual cycle.
I am undergoing IVF with a male partner. When should he join me.
While many couples prefer to be together for the entire duration of the process, schedules can often limit their ability to do so. Your partner should join no later than the date of your egg-retrieval to facilitate on-site fertilization.
Do your partners facilitate egg or sperm donation?
Yes. Our partner clinics facilitate egg and sperm donation from banks in which samples undergo rigorous medical and psychological tests. A Conceivable Concierge can help you better understand and evaluate these options.
How many embryos will the clinic transfer at one time?
In general, only one embryo is transferred at once to avoid the complications often associated with multiple pregnancies.
What kind of testing is done on my embryos?
Embryo Selection and Carrier Screening are both available to you through each of our partner clinics. Your Conceivable Concierge can help you understand more about the process and costs.
Is embryo transfer painful?
For most women, the procedure is completely painless and can be compared to the sensation of IUI. Typically, a woman feels only the speculum and nothing else.
What is recovery like?
It is generally recommended to perform no strenuous activity for the full day following your transfer, but routine activities can resume by the next day. In rare cases of ovarian hyperstimulation, your doctor may recommend reduced activity for a few days.
What happens to embryos that aren't transferred?
Non-transferred embryos can be frozen on-site should you elect to do so. With most of our clinics, at minimum the first year of freezing is included with your care.
What happens if I do not use all my frozen embryos?
We can facilitate anonymous donation to scientific research, anonymous donation to other women or couples, or you can elect to have them disposed. Conceivable works to certify that your preferences and elections are made correctly.
Can I drink alcohol?
In moderation. As a general guideline, you should limit alcohol intake to no more than 4 drinks per week. However, you should consult with your doctor about your specific circumstances.
Can I drink coffee?
Most research suggests that there is no link between moderate caffeine intake and worsened outcomes, but high caffeine intake should be avoided. Up to 2 cups of coffee per day should not impact your success rate.
Can I have sex?
For the first few days of ovarian stimulation, and with use of a condom as your likelihood of a multiple pregnancy is increased with an increased follicle count. In general, it is recommended to practice abstinence for the week leading up to your retrieval.
Can I work out?
You should not have to adjust your work out regimen for the first 5 days of your stimulation. After that point, only low-impact activities are recommended. After your retrieval and embryo transfer, you should abstain from exercise for approximately 1 week.
Can I bring my embryos back to the US?
Should you desire, and through the use of a 3rd party which Conceivable can work with your clinic to coordinate. By law, you may not transfer the embryos yourself. You should discuss the risks associated with physical transfer of embryos with your doctor.
Will my doctor speak English?
Yes. Conceivable's partner clinics have dedicated physician and support staff exclusively for Conceivable patients. All Conceivable-assigned staff have native-level language proficiency.
