One of the most important steps in the IVF procedure is the egg retrieval process. In order to produce viable embryos for implantation, a number of ripe and mature eggs need to be retrieved from my egg donor's ovaries. Only then can the IVF procedure continue successfully.
Here are some of the basic facts about the egg retrieval process involved in IVF treatment:
Egg retrieval is the process whereby a woman's eggs are removed from her ovaries. These eggs are later mixed with a man's sperm in order to facilitate fertilization. In order for egg retrieval to occur, a woman must first have follicle production stimulated by particular hormones. Once a number of follicles (potential eggs) are produced, fertility specialists can then remove these eggs from the ovaries in order to attempt fertilization. If fertilization is successful, the embryos will be placed back in to the woman's uterus, or in my case, into the uterus of my Surrogate.
Egg follicles are fluid-filled sacs that are located inside both of a woman’s ovaries. A woman is born with millions of these eggs follicles, each of which contains an immature egg at its center. Each month, thanks to certain hormones, multiple follicles will begin to develop. The one follicle that is the strongest will attract most of the follicle-stimulating hormone (FSH), a hormone secreted by the pituitary gland, causing it to break open and release an egg while the remaining follicles die off. This is ovulation.
In order for IVF to be most effective, more than just one mature egg needs to be retrieved. A reproductive endocrinologist will attempt to remove all viable follicles that are present in my donors ovaries, so that multiple eggs can be fertilized. This means that my donor will need to have her follicles stimulated artificially. There are special medications that she will be required to take for approximately ten days in order to help stimulate the development of her follicles.
Timing is extremely important when it comes to the IVF retrieval process. If follicles develop too much, then the egg inside will become too mature for efficient fertilization. This can seriously affect the IVF process. For this reason, her ovaries will be monitored in order to keep an eye on her follicular development. This is typically done through ultrasound. When her follicles reach just the right maturity, egg retrieval can begin.
The egg retrieval process is a relatively simple one. Follicles from both her left and right ovary will be removed in a process known as follicular aspiration. Follicular aspiration involves inserting a hollow needle through the top of the vagina and into the ovaries. This needle is then used to suction out any follicles that may be present in the ovaries. In order to guide the needle into the appropriate area of the ovary, she will be given a transvaginal ultrasound.
Once the needle is in the proper position, it will be used to aspirate any follicles inside of the ovary. These follicles will be immediately examined under a microscope to ensure the presence of a viable egg. The follicles will then be placed in an incubator.
Depending upon age and the effect of fertility medications, most women have between 5 and 20 eggs removed during the egg retrieval process. The entire process typically takes between 15 and 30 minutes. Let's hope my donor's retrieval results in lots of viable eggs!!
After the egg retrieval, all viable eggs will be subjected to a procedure called ICSI or Intracytoplasmic sperm injection (pronounced "eeksee" or "icksy"), which is an in vitro fertilization procedure in which a single specimen of my sperm will be injected directly into an egg .
The following is a link to video where you can watch the ICSI procedure:
http://www.youtube.com/watch?feature=player_embedded&v=npY0NR6c6OA#!
All fertilized eggs will then be cultured overnight until they can be checked for fertilization. If fertilization occurs, the eggs will continue to grow in a sterile lab environment for 3-4 days after which time, the embryos will be transferred to my surrogate.
At this time, the number of embryos to be transferred is unknown and will be dictated by the egg retrieval procedure, the viability of the eggs and finally, the number of fertilized eggs (embryos) created during IVF. Naturally, the probability of a successful pregnancy increases based on the number of healthy embryos transferred to my surrogate (and so do the odds of multiple births or twins)!
Naturally,
I'm excited, scared and nervous, but intend to remain vigilant over the next
couple of weeks as my doctor's perform the greatest miracle of my life. It will
likely be several weeks before I have another update to share. In the meantime,
thank you everyone from the bottom of my heart for your continued love, support and prayers.
I remain
incredibly optimistic that I will become a Dad in 2013!!
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