At Perch Fertility, we believe proper preparation can make all the difference in the success of an IVF cycle. Before starting any treatment, Dr. Meir Olcha and his clinical team will review your general health, lifestyle, nutrition, and any previous medical records in order to optimize your body’s response. 

Once an appropriate protocol is created, your IVF cycle will begin with ovarian stimulation. The goal of ovarian stimulation is to encourage the ovaries to produce multiple eggs instead of the single egg typically released during a natural menstrual cycle. 

Retrieving multiple eggs improves the chances of a successful IVF outcome. 

The following steps are performed for ovarian stimulation.

• The follicular phase of your menstrual cycle begins on the first day of your menstrual period and ends just before ovulation. During this phase, fertility medications are administered to stimulate the growth of multiple follicles in your ovaries.
• Fertility medications, including but not limited to follicle-stimulating hormone (FSH) are administered to stimulate the ovaries. These hormones mimic the natural hormonal process that occurs during a menstrual cycle. 
• Throughout the stimulation phase, your fertility specialist will closely monitor your response to the medication. Blood tests and ultrasounds may be conducted to assess hormone levels and follicle development.
• Once the follicles are mature, a trigger shot is administered to induce ovulation and prepare the eggs for retrieval. This final injection mimics the natural surge of luteinizing hormone that typically occurs just before ovulation. 

Note that we will tailor the dosage and type of medications used for ovarian stimulation to your individual needs based on factors such as your age, medical history, and response to previous treatments.

After ovarian stimulation, the mature eggs are retrieved from your ovaries through a minor surgical procedure called transvaginal ultrasound aspiration. This is a minimally invasive procedure performed under anesthesia to ensure your comfort although it can be done with local anesthetic in certain situations.

Egg retrieval is typically performed 34-36 hours after the trigger shot.

During the procedure, a thin needle is guided through the vaginal wall and into the ovaries, using ultrasound imaging for precise placement. The needle is gently inserted into each follicle, and the eggs are carefully aspirated. At this stage, the goal is to carefully aspirate as many eggs as possible.

Our fertility specialist closely monitors the procedure to ensure safety and effectiveness. The egg retrieval process takes about 20-30 minutes.

After the procedure, you may experience mild discomfort or cramping. However, most patients recover quickly and are able to return home the same day. Our team will provide you with specific instructions on how to care for yourself during the recovery period.

Sperm Collection and Testing

The sperm used for the IVF process may be obtained from a sample collected from the partner through either ejaculation or surgical retrieval. Depending on the situation, donor sperm can also be used to fertilize eggs. At Perch Fertility, we also offer men the option to freeze their sperm in advance. 

Sperm freezing can be a useful option for men in the following cases.

• If the partner will not be available on the day of egg retrieval, sperm freezing can be a convenient measure.
• They are undergoing cancer treatment or other medical procedures that may affect fertility.
• They are delaying fatherhood due to personal or professional reasons.
• They want to take a precautionary measure (have a backup) due to fertility concerns.

Once the eggs are retrieved, they are combined with sperm in the lab for fertilization. The choice of fertilization method depends on your individual circumstances.

• Conventional insemination means the sperm and eggs are placed together in a dish, allowing fertilization to occur naturally. 
• Intracytoplasmic Sperm Injection (ICSI) involves a specialized technique where a single sperm is injected directly into an egg using a microneedle. This method can increase fertilization success in general. It can also be particularly useful in cases of severe male infertility, such as low sperm count, poor sperm quality, and abnormal sperm morphology. It can also help in cases where specific genetic testing needs to be performed on the embryo and DNA contamination must be avoided.

We monitor the fertilization process closely to ensure that the embryos develop normally. The healthiest embryos will then be selected for transfer.

Fertilization marks the beginning of embryonic development and is essential for achieving pregnancy. By optimizing fertilization techniques, we can increase the chances of creating healthy embryos for transfer.

After fertilization, the embryos are monitored for growth and development over the next 3 to 7 days. During this period, we evaluate the quality of the embryos to determine which are most likely to result in a successful pregnancy.

An embryo must develop to the blastocyst stage to be considered suitable for transfer to the uterus. This stage represents a significant developmental milestone, as the embryo has developed into a hollow ball of cells.

While some fertilized eggs do not progress to the blastocyst stage, a significant number can successfully develop. For example, if seven eggs are fertilized, approximately three or four may reach the blastocyst stage depending on the age of the female undergoing the egg retrieval. The remaining embryos may not develop properly or may be discarded.

All embryos deemed suitable for transfer are then separated from the non-viable ones and either sampled for DNA and cryopreserved or cryopreserved directly, without DNA sampling, for future use.

Once the embryos have been developed, the healthiest ones are selected for transfer into the uterus. This procedure is straightforward, typically painless, and requires no anesthesia.

For the embryo transfer process, you will be positioned on an examination table, and a thin catheter is gently inserted through the vagina and cervix into the uterus. The selected embryos are carefully placed into the uterus through the catheter.

The embryo transfer is the final step in the IVF process. It is a crucial moment that could lead to a successful pregnancy. Our team will review the options with you and help in carefully selecting the most appropriate embryo for transfer to maximize your chances of success.

The exact timing of egg retrieval and embryo transfer may vary depending on your individual factors. Our fertility specialist will determine and discuss the optimal timing for your cycle.

After the embryo transfer, there is a waiting period of approximately two weeks before a pregnancy test can be performed. This period can be emotionally challenging as you eagerly await the results. And our team offers support and guidance for anxious couples.

Post-Transfer Care
During this waiting period, it's important to follow our fertility expert, Dr. Olcha’s instructions for post-transfer care. This may include taking medications to support the early period of the pregnancy and avoiding strenuous activity.

Pregnancy Test
After approximately 10 days, a pregnancy test will determine if the embryo has successfully implanted in the uterine lining. This test can be performed at home.

Regardless of the outcome, our team is here to provide support and guidance. If the pregnancy test is positive, we will discuss the next steps in your pregnancy care. If the test is negative, we will work with you to explore other options and develop a personalized treatment plan.