In Vitro Fertilization (IVF)
Cutting-edge reproductive technologies delivered with a human touch.
About In Vitro Fertilization (IVF)
In Vitro Fertilization (IVF) is the most effective and advanced fertility treatment available. IVF is the process whereby ovaries are stimulated with medications to produce multiple mature eggs. The eggs are then extracted from the body in an egg retrieval procedure. Markham Fertility Centre is the only clinic in Ontario to offer pain-free egg retrieval thanks to our relationship with anesthesiologists who attend every single egg retrieval. Once retrieved, your eggs are then combined with sperm in our laboratory to create embryos in a secure and monitored environment until they are ready to be transferred or frozen for future use. In some cases, patients may choose to do genetic testing on their embryos. This can help to select and prioritize embryos for transfer while reducing the chance of a miscarriage. There are lots of considerations before choosing IVF. You will decide with your physician if IVF is the right treatment for you. Here are some of those reasons why someone might proceed with IVF:
Advanced ovary age (generally over 40 years of age)
Poor sperm quality and/or quantity
Fallopian tube blockage
Recurrent pregnancy loss
Multiple failed IUI cycles
A history of pelvic inflammatory disease (PID), endometriosis or pelvic adhesions
Preservation of fertility for couples who want to have children in the future
Patients requiring an egg donor and/or surrogate
Patients who are carriers of or have a genetic condition with the goal to select embryos without those genetic traits (click here to learn more)
Reciprocal IVF - for same sex couples where one partner provides the eggs while the other carries the pregnancy
While pregnancy rates vary considerably depending on individual circumstances, they are generally 3 to 4 times higher than other treatments like IUI. A patient under the age of 35 can expect a live birth rate of 50% with IVF, whereas IUI offers a 10-15% chance of pregnancy. While the time to pregnancy can be shorter with IVF, it is more involved and more costly. In some cases, IVF may be the only fertility treatment option, but if other options are possible, we will ensure you have all the information needed to make an informed decision.
Your IVF Journey Begins Here
An IVF cycle typically takes 2-3 weeks to complete. An IVF cycle may last longer depending on the protocol chosen and whether you choose to transfer fresh or frozen embryos following an egg retrieval. IVF is an involved process, and we will counsel you on the emotional, physical, and cost aspects of a treatment so you know what to expect. Knowing what to expect in advance of treatment will make the journey much easier. Below is a typical IVF timeline.
The first step is to determine whether IVF is the right approach given your personal circumstances, medical history, and goals. Generally speaking, it takes 2 to 3 months from the initial consultation before you might be ready to start an IVF cycle.
Preparing to Start your IVF Cycle
Your nursing team will help you prepare for your IVF cycle. At this time, you will complete your treatment consent forms, attend an education session with a nurse, and learn how to administer medications. Your nurse will also provide you with a tentative schedule of appointments, which will include appointments for bloodwork and ultrasound monitoring. Don’t be afraid to ask questions at any time throughout the process.
Starting your Cycle (Day 1)
You will report your first day of full flow (Day 1) in our patient portal. This will alert your nursing team who will prepare for your cycle start and communicate with you about next steps.
Ovarian Stimulation (Days 10-12)
Stimulating your ovaries to produce eggs typically lasts 10-12 days. During this time you will be taking injectable medications and will have three to five in-person morning appointments at the clinic where we will monitor your hormones and measure ovarian follicles using a vaginal ultrasound. Your physician will closely monitor your stimulation to ensure the optimal number and maturity of your eggs at the time of retrieval.
Trigger Day (36 hrs before egg retrieval)
Once your follicles are at an optimal size and number, you will take a medication called a “trigger” at a very specific time. Trigger medication causes the ovaries to prepare to release your eggs so that they are ready for retrieval 36 hours later.
Egg Retrieval (~ Day 12)
Prepare to spend 1-2 hours at the clinic on the day of egg retrieval and arrange for someone to pick you up. The egg retrieval itself is done under deep sedation with an anesthesiologist to ensure your safety and comfort. The procedure lasts approximately 20 minutes. You may experience some minor discomfort after the procedure. Most patients resume normal activities the next day.
Post Egg Retrieval (Days 13-20)
After the retrieval, your eggs will be evaluated by one of our expert embryologists. The embryologist will combine the sperm with your eggs to fertilize them. This may involve ICSI, an advanced technique where a single sperm is injected into each egg. Over the next 5 to 7 days, our embryologists will monitor the growth of your embryos. This can be a tense time as you wait to learn how well your embryos are doing.
Embryo Transfer (~ Day 20)
There are two possibilities for an embryo transfer. If you have a fresh embryo transfer, the procedure will take place 3 to 5 days after egg retrieval. An embryo will be inserted into your uterus with a special catheter. The procedure only takes 10 to 15 minutes and discomfort is minimal. Any extra embryos will be frozen for a future cycle called a Frozen Embryo Transfer (FET). An alternative approach is to have all of your embryos frozen and perform a frozen embryo transfer when you are ready. There are a number of reasons why you may freeze all your embryos, including genetic testing. Click here for more information on FETs.
Pregnancy Test (14 days after embryo transfer)
If you chose to proceed with a fresh embryo transfer, we will ask you to come into the clinic for a pregnancy test. If you have the test done before 11:30am on a weekday, we will have your results ready the same day. Waiting for a pregnancy result can be difficult. Click here for some strategies to cope with the waiting period. If you have a positive result, we will book an ultrasound exam to confirm pregnancy. If the result is negative, we will meet with you to review the cycle and talk about options.