What to expect at our Dallas IVF center
When your fertility treatment includes egg retrieval, you will be monitored for follicular growth. This applies to anyone pursuing IVF, donating eggs or opting for fertility preservation. Our Dallas IVF center team will ensure that you feel ready and know what to expect.
Using sonography, your physician will determine when your egg-containing follicles are mature and your oocytes (eggs) are ready for retrieval. You will be instructed to take hCG approximately 36 hours prior to oocyte retrieval. This injection will usually be in the evening. In the majority of cases, we recommend that the male partner collect the semen sample at our Dallas IVF center laboratory on the morning of the egg retrieval. If collecting the sample onsite is not feasible, please make arrangements with the laboratory prior to the egg retrieval.
Your Dallas IVF center team will call you almost every day
- Retrieval day The day of egg retrieval is called Day 0. Around the time of egg retrieval, your partner provides our Dallas IVF center with a semen sample. Routine IVF and/or ICSI will be performed about six hours after the egg retrieval – the sperm and the eggs are now being placed together.
- Day 1 Fertilization of the eggs is assessed early in the morning, 12-19 hours after IVF/ICSI. Normally, fertilized embryos will exhibit two pronuclei. Abnormal fertilized embryos are discarded. Non-fertilized embryos are kept separate for one or two more days to confirm that they did not fertilize. In general, the laboratory will call with fertilization results before 2 p.m. A Day 2 embryo transfer may be scheduled at this time.
- Day 2 We may not call with growth status of the Day 2 embryos; it depends on the number of fertilized embryos. The embryologist will advise you as to whether or not to expect a phone call on Day 2. The embryos are expected to have 2-4 cells. A transfer is possible today if extended culture will not assist in embryo selection, meaning the number of embryos available for transfer is equal to or less than the number of embryos desired for transfer. A Day 3 embryo transfer may be scheduled at this time.
- Day 3 We will call with growth status of the Day 3 embryos, between the 6-10 cell stage. Embryo transfer is possible if the quality of embryos now available for transfer is equal to or less than the number desired for transfer. A Day 5 embryo transfer may be scheduled at this time. In general, the laboratory will call with a Day 3 update by 2 p.m.
- Day 4 No clinical decisions are made on Day 4 and no calls are made because embryo grading is difficult and inaccurate at this stage. Embryos, expected to be at the morula stage, are left in the incubator, and they are better off undisturbed by temperature, light and pH fluctuations. No culture media changes are necessary on this day.
- Day 5 fresh transfer This is the most likely day for embryo transfer. Approximately 10-20% of embryos that fertilize normally on Day 1 will make good quality, Day 5 blastocysts. At this point, we can distinguish between the inner cell mass (baby) and the trophectoderm (placenta). This enables accurate selection of the best embryos, allowing us to transfer the smallest number of embryos and optimize pregnancy rates. The patient needs to be at the laboratory 30-45 minutes prior to the scheduled embryo transfer time. The embryos are not evaluated before patient arrival; therefore, no updates are possible until the time of transfer. Prior to transfer, the patient, partner, laboratory team member and physician will discuss the embryo quality and the desired number of embryos to transfer. This approach allows for minimal disturbance to the fragile incubator environment.
- Day 5 frozen cycle Embryos can be frozen (cryopreserved) on Day 5 if they have reached the expanded blastocyst stage. This is the window of opportunity for preimplantation genetic screening, PGS, or preimplantation genetic diagnosis. Most embryo cryopreservation takes place on Day 6.
- Day 6 A final telephone call will confirm the final disposition of all fresh or frozen embryos. In exceptional cases, embryo transfer is postponed to Day 6 to improve the ability to select viable embryos. Approximately 30% of patients will have additional embryos to cryopreserve.
The safety and security of your IVF cycle
During the time your eggs, sperm and embryos are at our Dallas IVF center, we ensure positive identification every step of the way. In addition to maintaining positive patient identification throughout every procedure, we have in place automated, computerized systems to constantly monitor embryo culture conditions. A minimum of two laboratory team members are always on standby should they be informed of an alarm condition.
To inquire about IVF, ICSI and genetic testing at our Dallas IVF center, please contact us here.