Step 6 Monitoring
While the Donor is administering the fertility medications, she is required to be monitored by routine estradiol levels and trans-vaginal pelvic ultrasounds in order to follow the rate of follicular growth and resultant estradiol levels. When the physician determines the time is optimal for timing the egg retrieval, the Donor will receive a final injection called hCG, which will mature the eggs for retrieval. At the same time, the Recipient is monitored by periodic estradiol levels and ultrasound evaluations for endometrial thickness.
Step 7 Egg Retrieval
The most commonly used method of egg retrieval is trans-vaginal ultrasound directed needle aspiration. This is a minor surgical procedure and is performed under intravenous sedation and general anesthesia, but without intubation. A vaginal probe (transducer) is placed in the vagina and a needle is inserted through a needle guide attached to the probe. The ultrasound image allows the physician to accurately guide the needle through the vagina directly into the follicles for aspiration under direct visualization. The process takes about 30 minutes. Following the retrieval, the donor recuperates for 1 – 2 hours and is then discharged to resume light daily activities.
Step 8 Fertilization and Embryo Transfer
Fertilization, the union of the sperm and egg, is a very complex process that occurs in the laboratory hence the term "in-vitro" which translates to "in glass". The eggs retrieved are examined by the embryologist and then placed in a specialized culture medium in preparation for insemination with sperm. A masturbated sperm sample is enhanced by a highly specialized process prior to being placed with the eggs. Approximately 72 hours following ovum retrieval, selected embryo(s) are transferred to the Recipient's uterus. If there are embryos of sufficient quality remaining, they may be cryopreserved for subsequent transfers.
The embryo transfer procedure usually requires no anesthesia. A catheter is inserted through the cervix into the uterus, and the embryos are gently and carefully placed into the uterine cavity. The Recipient is maintained in a recumbent position for approximately fifteen minutes and then discharged.
Step 9 Post Embryo Transfer Management and Follow-up
The Recipient will need to take daily hormone injections in order to sustain an optimal environment for the embryo implantation. Approximately two weeks after the embryo transfer, two pregnancy tests are performed. If the Beta-hCG titer is rising, this indicates that implantation has taken place. Hormone injections will then be continued until 12 weeks of gestation at which time the placenta will supply all the hormones necessary to sustain the pregnancy. In the interim, ultrasound examination(s) will be performed to definitively diagnose pregnancy between 5 to 6 weeks after the embryo transfer. If the pregnancy test is negative, all hormonal treatments are discontinued and menstruation will usually ensue within two weeks.
We've got everything crossed
pregnant bellies being rubbed for luck across the world
and prayers going up for today and this week!
Hanne & Tommy!
We will have a follicle count to post by this afternoon.