In vitro fertilization (IVF) is a procedure designed to improve fertility in patients who have not been successful with ovulation induction or intrauterine insemination, or who are not candidates for those more conservative treatments. Eggs are surgically removed from the ovaries and fertilized with sperm in a laboratory environment. The fertilized egg, i.e. embryo, is then transferred into the uterus.

Who are good candidates for IVF?

• People who have absent or blocked fallopian tubes
• People who have endometriosis and haven’t been able to achieve pregnancy after medical or surgical treatment
• People who have ovulatory dysfunction who haven’t been able to achieve pregnancy after regular ovulation induction
• People experiencing unexplained infertility
• People whose partner has a very low sperm count
• People interested in preimplantation genetic testing (PGT) for chromosomal or genetic reasons

At the Johns Hopkins Fertility Center, we pride ourselves on our dedication to helping you achieve your family building goals. We have a particular interest in helping people who have had extensive challenges, possibly deemed "poor responders" and/or people with baseline elevation of the follicle-stimulating hormone. We will exhaust all of our efforts to assist our patients with having their own biological child.

What is the IVF process?

Follicular development. In order to stimulate follicles in the ovaries to produce healthy, mature eggs, a patient receives injectable hormones administered at home for an average of 11 days. (The Fertility Center provides orientation classes to help couples become comfortable with this process.)

Intensive follow-up every one to three days by blood test and ultrasound are important for appropriate medical treatment. The eggs develop inside fluid-filled cysts called follicles. Once the follicles reach maturity, the patient receives a different hormone to complete the maturation of the eggs. This is also administered at home by injection.

Egg retrieval. Egg retrieval can be performed on an outpatient basis, while the patient is under light sedation. Using ultrasound guidance, the follicles (containing the egg) are aspirated through the vagina to identify mature eggs.

Sperm preparation and egg fertilization. After the eggs are collected and classified, fertilization takes place using partner or donor sperm. Fertilization is carried out by conventional IVF (sperm and egg are combined in the lab using a special culture medium), providing that semen parameters are normal.

Embryo transfer. Once embryo development is confirmed, we will proceed with the embryo transfer. Embryo transfer is a process to place embryos into the uterine cavity by using a fine catheter that is passed through the cervix.

The embryo transfer procedure is guided by a trans-abdominal ultrasound five days after the egg retrieval, at the blastocyst stage. Any remaining embryos can be cryopreserved (frozen) in the lab for future use, if desired. The Johns Hopkins Fertility Center adheres to the American Society for Reproductive Medicine Guidelines on the number of embryos to transfer.

Pregnancy testing. The first pregnancy test is usually performed approximately 10 days after embryo transfer by blood testing. Pregnancy hormone levels are monitored by blood testing every few days in the early stages of pregnancy, followed by ultrasounds once the pregnancy is further developed. At some point before 10 weeks of gestation, you will be discharged to the care of your obstetrician for the remainder of the pregnancy.