IVF Sequence of Events

What to Expect – IVF Sequence of Events

Day 0

The patient and their partner will have their egg retrieval on this day. Once the retrieval and the semen has been analyzed, an Embryologist will inform the patient of how many eggs were retrieved, how the sperm sample looks, and what will be the fertilization procedure utilized for the cycle (insemination or ICSI). After this discussion occurs, the patient and her partner may go home.

Day 1

The patient will receive a call on this day to receive her Fertilization Report from an Embryologist. The call will come approximately between the hours of 9:00 AM to 3:00 PM. The patient will also be able to ask questions regarding the cycle. The IVF nurse will also call the patient to check in on the patient and to set up a schedule for the next few days with a possible transfer time for day 3.

Day 2

The embryos will be developing during this time and it is important to allow for them to stay within the controlled incubator environment during this formative time. No assessments or updates will be performed at this time.

Day 3

This is the first potential day for transfer. The Embryologists will assess embryo development in the morning and coordinate with the physician. The physician will make a decision regarding the day of transfer.

If day 3 is the day of transfer, than the physician will make a recommendation for the number of embryos to transfer based on embryo quality, with regard to a set of guidelines by the Society of Assisted Reproductive Technologies (SART), a governing body for fertility clinics in the United States that encourages safe practices among IVF clinics, as well as the age of the patient, and her medical history. The patient will then be notified by an IVF nurse whether she will need to come in for the pre-specified time for a day 3 transfer or whether the embryos will need to develop further for a day 5 transfer.

If it is a day 3 transfer, the patient will arrive approximately an hour before her scheduled time of transfer and will be escorted to a private room where she will need to fill out paperwork with a St. David’s Nurse. After the paperwork is completed, the Embryologist will come and speak with the patient regarding the status of the embryos and what the physician recommends. The physician will also stop by to talk with the patient prior to the transfer.

Once in the OR, the patient will have her ID wrist band verified by an embryologist and the transfer will proceed from that point. Extra attention will be made to verify the number of embryos to transfer and the ID of the patient once the physician is present as well. Overall, the transfer procedure will take approximately 20 minutes.

The patient will then return to their private room and rest for 20 minutes prior to leaving the facility.

Day 4

Very much like day 2, the embryos will be developing at this time. It is crucial that they be kept within the controlled incubator environment. No assessments or updates will be performed at this time.

Day 5

This is the second potential day for transfer. Again, the Embryologists will assess embryo development in the morning and coordinate with the physician. The physician will make a recommendation for the number of embryos to transfer based on embryo quality, with regard to a set of guidelines by the Society of Assisted Reproductive Technologies (SART), a governing body for fertility clinics in the United States that encourages safe practices among IVF clinics, as well as the age of the patient, and her medical history.

The patient will arrive approximately an hour before her scheduled time of transfer and will be escorted to a private room where she will need to fill out paperwork with a St. David’s Nurse. After the paperwork is completed, the Embryologist will come and speak with the patient regarding the status of the embryos and what the physician recommends. The physician will also stop by to talk with the patient prior to the transfer.

Once in the OR, the patient will have her ID wrist band verified by an embryologist and the transfer will proceed from that point. Extra attention will be made to verify the number of embryos to transfer and the ID of the patient once the physician is present as well. Overall, the transfer procedure will take approximately 20 minutes.

The patient will then return to their private room and rest for 20 minutes prior to leaving the facility.

Day 6 and Day 7

The remaining embryos left in culture will be allowed to develop into viable, freeze quality Blastocysts until the end of day 6. In order to be considered viable on day 6 and day 7, the embryo must reach a Blastocyst stage. Any embryos that do not reach a Blastocyst stage will be discarded on day 6 due to poor embryo development.

If any embryo looks close to becoming a freeze quality Blastocyst, those particular embryos will be allowed to culture until day 7 to have an entire additional day to reach freeze quality status. If the embryos do not develop into viable Blastocysts by the end of day 7, they will be discarded due to poor embryo development.

At Ovation Fertility Austin, we want to provide our patients who are candidates for embryo freezing the best possibility at having a successful Frozen Embryo Transfer in the future. An embryo not considered freeze quality means that it does not possess the characteristics needed to ensure that the embryo will survive the thawing process if an Embryologist were to freeze it. In order to be considered a freeze quality embryo (also, a viable embryo) on day 5, day 6, or day 7, the embryo must reach a Blastocyst stage. It must possess an inner cell mass, which will ultimately give rise to the fetus with continued development. That inner cell mass must also be surrounded by a layer of Trophectoderm cells that ultimately give rise to the placenta. No viable pregnancy could result within an embryo that lacks one or both of these two important traits. To that end, we wish to ensure all of our patients the best possible chance to achieve a healthy pregnancy and birth.