Invitro Fertilization is done when either Artificial Insemination fails to produce a pregnancy, when the woman’s cause of infertility is a problem with her fallopian tubes that is preventing the egg and sperm uniting, or in cases of low sperm count.
Preparation for an IVF cycle usually flows in this way. First a woman’s body must be induced to create several eggs for retrieval. The more eggs retrieved the better the success rate. To cause a woman to develop several follicles, usually two different drugs are injected for the first half of the attempt cycle. These two drugs are Lupron and Pergonal. Lupron is given to prevent a premature surge of LH. Lupron is sometimes started during the end of the previous cycle, but must be started no later then the first or second day of your attempt cycle. Also on the first or second day of your cycle, an ultrasound will be done to make sure that you have no ovarian cysts. If cysts are present on your ovaries, they will have to be aspirated before Pergonal can be started.
On the third day of the attempt cycle Pergonal is started. Pergonal is usually taken for nine to ten days. On the fourth day of Pergonal your blood must be drawn in the morning for a rapid estrogen level and an ultrasound will be performed. In the afternoon you will be told how much Pergonal you will take that day. The blood test and ultrasound will be performed daily, and according to the results your Pergonal dosage will be adjusted.
Between day 8 and 10 of Pergonal you will be told to take an hCG shot instead of Pergonal. What day this happens on will depend on your blood and ultrasound results. You will give yourself the hCG injection exactly 36 hours before your egg retrieval is scheduled. If your retrieval is scheduled for 10:00 a.m. then you will give yourself the shot two days before at 10:00 p.m. so when you have the retrieval scheduled should be considered. Your husband will provide a sperm sample three hours before the egg retrieval is performed.
The developed eggs can be retrieved in one of two ways. The ‘old’ way was through laparoscopy which involved surgery to retrieve the eggs. A ‘new’ way to retrieve the developed eggs has been developed and does not involve surgery. In this procedure a transvaginal-guided needle with an ultrasound tip is used to not only see the eggs on the outside of the ovary, but those that are inside the ovary and could not be retrieved using the ‘old’ way. The developed eggs are retrieved by aspiration through the vaginal wall. This procedure is painful and is best done with either light sedation or light general anesthesia. Some women can do the procedure with out any sedation at all, but most need the services of an anesthesiologist.
The retrieved eggs and sperm are mixed together in a culture media and allowed to fertilize and grow for two days. In two days the woman returns to have a selected amount of fertilized eggs placed into her uterus. At this time a progesterone supplement can be started or the day following the IVF transfer. The progesterone is given by injection just like the Lupron and Pergonal. The progesterone will be continued until you period starts or for at least six weeks if you conceive. At the six week mark usually the placenta is producing it’s own progesterone and a supplement is no longer needed.
Cost for the various tests and procedures.
Below is a range of costs for different tests and procedures that your doctor may or may not perform. Discuss with your doctor what the cost will be on your first or second visit so you know what to expect in the future should you need to have any of these procedures done.
First visit with an RE $160 to $300
HSG $400 to $600 (includes cost of hospital and doctor)
Laparoscopy $2500 to $4000 (all charges including anesthesia, doctor & hospital)
Post Coital test $50 to $250
Semen Analysis $30 to $125
Endometrial Biopsy $300 to $600
FSH level test $50 to $150
LH level test $50 to $150
Progesterone level test $40 to $100
Ultrasound/Sonogram $125 to $400
IUI procedure $150 to $500
IVF procedure $8,000 to $12,000 (not including medications)
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