In vitro fertilization (IVF) is the joining of sperm and egg or eggs
outside a woman's body. Mature eggs are retrieved from the woman's
ovaries and mixed with sperm in the laboratory. The fertilized eggs
(embryos) are then transferred to the woman's uterus. If an
embryo successfully implants itself in the uterine wall, the woman
may become pregnant. If pregnancy occurs, the embryo grows and develops
naturally within the mother's uterus.
The IVF Program at the Center for Reproductive Medicine at Bryn Mawr
Hospital offers comprehensive services for individuals trying to achieve
pregnancy. Our services include:
Egg collection and insemination
Embryo cryopreservation, storage, thawing and transfer
Intracytoplasmic sperm injection (ICSI)
Gamete intrafallopian transfer (GIFT)
Patient information seminars
Reasons for IVF
IVF is suitable for couples who are infertile for any of several
reasons. Women who have been unable to conceive because of missing,
blocked or damaged fallopian tubes may become pregnant through IVF.
Women experiencing endometriosis are also good candidates for IVF.
IVF is an option for couples when the man has a low sperm count or poor
sperm motility. In some males with less-than-ideal sperm production or
movement, the sperm may have a difficult time traveling though the
female reproductive tract to meet the egg. Since IVF joins sperm and egg
outside the body—eliminating the sperm's travel—there is a greater
chance for successful fertilization. In cases of severe problems with
sperm quality, an assisted fertilization procedure (ICSI) can be
performed where a single sperm is injected into an egg to promote
Sometimes, despite a battery of tests and a thorough investigation,
doctors cannot find a cause for a couple's infertility. IVF is very
helpful after other treatment methods have failed.
The IVF Process
IVF is a multistep treatment method that requires precision and
efficiency at every stage. Our IVF team, in coordination with the
woman's doctor, uses the latest techniques in hormone therapy, egg
collection and embryo transfer to increase a couple's chance of having a
There are four steps to the IVF process:
Hormone Therapy: Ovulation—the release of a
mature egg from an ovary—is a prerequisite for pregnancy, either
naturally or through IVF. Normally the body's own hormones
stimulate one egg to ripen and release each month. This egg, if
fertilized by a sperm, will potentially develop into a
pregnancy. Research has shown IVF is more successful when
several eggs are obtained from the ovary just before ovulation
occurs. This increases the chance that at least one egg will be
fertilized during the IVF process. One way to induce or
stimulate several eggs to develop is to give the woman
injections of hormonal medications for about 10 days. The
woman's physician will monitor egg development through
ultrasound scans and blood tests. These tests help to determine
the precise dosage of hormone medication to administer and
predict when the eggs will be ready to retrieve.
Egg Collection: Through a procedure called
transvaginal egg retrieval, eggs are retrieved from a woman's
ovary using a thin needle that is guided by ultrasound. The
needle is inserted into the vaginal wall, where the ovaries are
easily accessed, and the eggs and their surrounding cells are
collected. This is an outpatient surgical procedure requiring
Insemination: The eggs are placed in a small
dish filled with special nutrients. The IVF team mixes the sperm
with the eggs and incubates them for 24 hours. If fertilization
occurs, the fertilized eggs (embryos) will be monitored to see
if they continue dividing normally.
Embryo Transfer: In approximately two to five
days after retrieving the eggs, the embryos are transferred to
the woman's uterus. This is a nonsurgical procedure that takes
only a few minutes. A thin tube, or catheter, is inserted via
the cervix. The embryos, contained in a drop of fluid, are
deposited in the uterus.
IVF with Donor Eggs
The use of donor eggs is an IVF option for women who can't produce
their own eggs. In IVF with donor eggs, the recipient undergoes
hormonal treatment to prepare her uterus for potential implantation.
Once donor eggs are available, they are fertilized with the recipient's
partner's sperm and placed in her uterus at the optimal time for
implantation. Ideally the donor's and recipient's cycles are
synchronized, but if this is not possible, the embryos may be frozen
(cryopreserved) until the recipient can be hormonally prepared for
According to the American Society of Reproductive Medicine guidelines
for egg donation, all egg donors are required to have psychological and
clinical screenings. Careful genetic, family and social histories of the
donor are also required. Donors are between the ages of 21 and 34 and
need to give their informed consent after acceptance by the IVF team.
Total anonymity is maintained for the donor as well as the recipient,
except when the egg donor and recipient are known to each other, as with
a relative or friend.
The Center for Reproductive Medicine works with all egg donors once
arrangements are made by the patient's physician.
IVF with Gestational Carrier
This is an option for women who have no uterus (due to either surgical
removal or congenital absence), impaired uterine function (due to
scarring or damage) or a medical condition that precludes carrying a
A gestational carrier is a woman who voluntarily contracts to become
pregnant with an embryo derived from the egg and sperm of a couple in
whom pregnancy is medically impossible or ill advised for the woman.
Unlike a surrogate mother, the carrier has no genetic relationship to
The genetic mother undergoes the ovulation induction and egg retrieval
phases of the IVF process, and her eggs are inseminated with her
partner's sperm in the laboratory. Once fertilization and early embryo
development have occurred, the embryos are placed into the uterus of the
carrier. Every attempt is made to synchronize the genetic mother's and
carrier's cycles, but if this cannot be accomplished, the embryos may be
cryopreserved and then thawed at the appropriate time.
The Center for Reproductive Medicine works with gestational carriers
once arrangements have been made by the patient's physician.
More embryos than recommended for transfer into the uterus may result
from the egg retrieval procedure. Researchers have shown that
transferring high numbers of embryos does not improve a woman's chance
of becoming pregnant; it only increases her chance of a multiple
gestation. Therefore, the couple must decide what to do with the
remaining embryos. The Center offers couples the option of freezing and
saving excess embryos, a procedure called cryopreservation. These
embryos can be thawed and transferred to the woman's uterus in a later
cycle if an earlier IVF attempt fails or if the couple wants a second
child. Cryopreservation potentially reduces the cost and eliminates the
egg collection step in subsequent cycles.
Intracytoplasmic sperm injection (ICSI) is an advanced
micromanipulation technique in which a single sperm is injected directly
into the egg using a microscopic glass needle. ICSI has revolutionized
the treatment of male infertility by overcoming barriers to sperm entry
into egg. Fertilization is possible even in cases with low sperm count
or compromised sperm function.
Assisted hatching is a technique for improving the implantation of
embryos obtained through IVF. With assisted hatching, a notch is made
into the zona pellucida, which is the protein layer surrounding the egg.
This aids the escape of the growing embryo, which helps in the
Gamete intrafallopian transfer (GIFT) is a surgical procedure that uses
a laparoscope to retrieve eggs from the ovaries and transfer them into
the fallopian tubes with sperm, so that fertilization can occur
naturally within the woman's body. With GIFT, the physician can
determine the woman's pelvic condition and treat most abnormalities,
such as scar tissue or endometriosis, at the same time. Healthy
fallopian tubes and adequate sperm are necessary for GIFT.
Bryn Mawr Hospital
New Appointments 1.866.CALL.MLH or 484.580.1000
Bryn Mawr Hospital
130 South Bryn Mawr Avenue
Bryn Mawr, PA 19010
For more information, call 1.866.CALL.MLH.