You will undergo daily injections of various ovarian stimulation medications over 8-12 days to stimulate multiple eggs in your ovaries. Once the egg(s) reach the proper size, you receive a final injection of hCG (human chorionic gonadotropin) or Leuprolide Acetate (Lupron) to spur the final maturation of the eggs.

Thirty-six hours after the trigger injection, the eggs are removed from the ovaries. Egg retrieval is a five to ten-minute procedure performed at RMA, during which anesthesia is administered to ensure your comfort. Guided by an ultrasound probe, your doctor will direct a needle into the follicles of the ovary to retrieve your eggs.

Most women are able to return home an hour or so after the procedure. Following retrieval, you will begin injections or vaginal delivery of progesterone to prepare the uterus for implantation.

Developing embryos are allowed to grow in the IVF laboratory for up to seven days until they reach the blastocyst stage of development – growing to about 200 cells. Published data supports improved implantation rates and outcomes with extended embryo culture.

If a patient opts for genetic screening, a sample of genetic material must be biopsied from the embryo for analysis. Embryo biopsy is a highly technical process and requires a skilled embryologist to perform the biopsy. Since 2010, RMA only performs blastocyst stage embryo biopsy. Published data supports that blastocyst stage biopsy (day 5) at the trophectoderm layer of the embryo is a safer method than cleavage-stage embryonic biopsy (day 3).

As an option for IVF patients, Pre-implantation Genetic Testing for Aneuploidy (PGT-A) allows a more evidence-based approach to selecting embryos to transfer during IVF. With RMA’s PGT-A platform, we can identify the healthiest embryos for transfer in advance of implantation. Embryos that are imbalanced, with too few or too many chromosomes, often result in a failed IVF cycle or miscarriage.

RMA only uses The Foundation for Embryonic Competence, a non-profit reference laboratory, for embryonic screening.

After the embryo has grown (the blastocyst stage of development) and the woman’s uterus is ready to receive the embryo, the embryo is transferred back to the uterus to implant and hopefully become a healthy pregnancy and delivery. While the embryo waits for the uterus to be ready – and while geneticists perform genetic testing on the embryo – the embryo is frozen awaiting transfer. This is called Frozen Embryo Transfer (FET), and at RMA, is the standard of care for all IVF patients.

FET has been shown to increase implantation rates and improve obstetrical outcomes. FET is also considered a healthier implantation process in that it allows for a better connection between the placenta and the mother. In addition, frozen cycles, versus fresh transfer cycles, show higher birth weight deliveries and lower risk of prematurity. FET also allows for optimal timing and a more natural transfer experience since the embryo can be cryopreserved or “frozen” until the patient’s hormone levels return to a more natural, receptive state, usually on their next cycle.