At Michigan Reproductive Medicine, we have performed thousands of successful IVF procedures, making us one of the leaders in the field of In Vitro Fertilization in Michigan. Our thousands of babies are living proof. The MRM fertility center is widely known for its high success rates for in vitro fertilization procedures.
What is IVF?
“In vitro” is a Latin phrase that means “in glass.” In vitro fertilization (IVF) provides a controlled environment that significantly enhances the opportunity for fertilization of the oocyte, or egg. IVF combines egg with sperm in a laboratory dish containing a culture solution that provides nutrients to support the fertilization and development of the egg. The fertilization process is monitored microscopically for up to a six-day period, during which successfully fertilized eggs develop into embryos. Then, our team of embryologists carefully examines the quality of the embryos to determine which embryos will be selected for genetic testing, embryo transfer or cryopreservation.
In Vitro Fertilization vs. Surgery for Tubal Infertility
MRM has pioneered significant advancements in IVF as well as surgical infertility treatments. Deciding which treatment to use (IVF or surgery) depends on several factors, including female age, health, expected pregnancy rates, operative risks and recovery time.
Accurate Diagnosis of Tubal Infertility
A major cause of infertility are conditions that impede egg and embryo transport into and through your natural incubator and escalator called the fallopian tube. Past infection, surgery and endometriosis are known causes for tubal factor infertility. Knowing the type of tubal problem and the extent of tubal damage you have is crucial in determining the best treatment choice. MRM utilizes the latest diagnostic techniques such as saline infusion sonohysterogram (SIS) with 2-D and 3-D ultrasound imaging or hysterosalpingogram (HSG) for examination of the architecture of the uterus and determining whether the fallopian tubes are open. These tests have limitations and may not detect significant scarring around the ovaries or the tubes, even when the tubes are confirmed to be open. A more invasive, yet minimally invasive, procedure called a laparoscopy would be necessary to distinguish this type of detail at high resolution. This is why getting an accurate diagnosis is such a vital first step. The easiest way to accomplish this is to call MRM at (248) 593-6990. We will help you arrange a consultation with our physicians.
Advantages of IVF:
- Significantly higher monthly pregnancy rates (known as fecundability)
- Possibility of extra embryos that may be cryopreserved (frozen) for a subsequent pregnancy attempt. Elective Single Embryo Transfer (eSET) is highly recommended to decrease chance of twin or greater pregnancy.
- Less invasive; lower operative risk, shorter recovery time
- Lower risk of ectopic (tubal) pregnancy than surgical repair of fallopian tubes where pregnancy is dependent upon normal function of the fallopian tube
Benefits of Surgery:
- Offers the potential for many future pregnancies without additional treatment. Surgery may include laparoscopy to remove adhesions (scarring), repair fallopian tubes, remove fibroid tumors or endometriosis. Surgery may include hysteroscopy removing and repairing abnormalities inside the uterus such as polyps, adhesions, fibroid tumors or abnormal formations of the uterus from birth such as a septum. Sometimes surgery is necessary in advance of intended IVF treatment to improve access to the ovaries for egg retrieval or remove a severely damaged and blocked fallopian tube that has accumulated water within it called a hydrosalpinx. The presence of such an abnormal fallopian tube actually reduces the chance of success with IVF. Improved success is restored when such an abnormal fallopian tube is removed completely or disconnected from the uterus prior to IVF and an embryo transfer.
- Eliminates the risks of increased multiple pregnancy and hyperstimulation reactions that may occur with IVF medications. However, surgery repairing damaged fallopian tubes or removing adhesions and endometriosis may increase the risk of a pregnancy forming outside of the uterus called an ectopic pregnancy.
At MRM, our physicians will fully discuss the merits of each approach with you to help you determine the best treatment option.
Step-By-Step Overview of the In Vitro Fertilization (IVF) Treatment Process
IVF is an important option in fertility treatment. At MRM, our physicians have extensive experience in all aspects of IVF treatment and offer you the highest standard of care available in any IVF program. This difference has made our facility the fertility center of choice for thousands of couples dealing with infertility in Michigan, northern Ohio and Canada. Our excellent success rates are due in part to the unparalleled expertise of our fertility team and our state-of-the-art IVF lab facilities. IVF patients go through a carefully structured program. Here’s what you can expect during the process:
Your Personal (and Private) IVF Orientation
When you schedule a personal IVF orientation, this visit will be specifically for and about you. This is not a group orientation that is shared with multiple couples. There are three main parts of your IVF orientation:
Step 1: You will meet with your physician.
Our physicians will review the medical history of both you and your partner, addressing any and all questions or concerns you may have, and the reasons for selecting IVF therapy. We will review the process, medications, applied treatments and technologies, safety and chance for success in an easy to understand way. Our physicians often suggest you will become a “budding embryologist”. It is important that you have an opportunity to learn about your care plan and set expectations that are well supported. This will help us do our very best to succeed in having a healthy baby.
Step 2: You meet with your clinical nurse coordinator.
Your clinical nurse coordinator is a specially trained member of your fertility team who will oversee your IVF journey at MRM. She will review your diagnosis, go over the details of your desired treatment plan, and then schedule all the necessary procedures to be performed in our office. She will happily answer your IVF treatment questions and assist you throughout the entire IVF process.
Step 3: You receive a financial consultation specific for IVF
In vitro fertilization procedure plans may involve significant financial commitment for those whose insurance does not cover IVF treatment. There are several types of IVF therapy, each with different costs: standard ovarian stimulation IVF, Mini-IVF, and Natural Cycle IVF. Mini-IVF and Natural Cycle IVF are lower in cost, but may require more cycles of treatment to achieve your goal of success. Please check with your insurance company regarding coverage.
At MRM, we want you to be fully informed of the financial options and alternatives that are available. This way, you can feel comfortable with managing the procedure cost before beginning your IVF treatment plan. IVF financing at MRM includes a variety of flexible options to support your overall plan for building a family. Please call us at (248) 593-6990 or contact us with your questions. Our helpful, caring fertility counselors welcome the opportunity to assist you. They will be happy to explain the full range of financing options we offer. If you didn’t think you could afford IVF, think again – you may be pleasantly surprised!
We understand that the IVF procedure can seem intimidating, so we strive to make sure you are comfortable and confident about the process at each step of your treatment. Personal IVF orientations can be scheduled by calling MRM at (248) 593-6990 or by clicking here to contact us.
Pretreatment Preparation for IVF
In order to ensure you have the most positive outcome from your IVF procedure at MRM, we carefully review the preliminary evaluation of both partners. At this time, if appropriate, we may prescribe stress reduction measures and other pretreatment procedures. If indicated, we will perform laboratory testing, infectious disease screening, uterine evaluation, and male fertility testing.
Start of IVF Therapy
Two to four weeks after you finish your testing and diagnosis, you’ll begin taking medication to prepare your ovaries and eggs for IVF therapy. The protocol will depend on the type of IVF planned: standard ovarian stimulation IVF, Mini-IVF and Natural Cycle IVF.
Step 1: Controlled Ovarian Hyperstimulation (COH)
The goal of controlled ovarian hyperstimulation, or COH, is to recruit and recover more eggs than the single egg usually available in a natural cycle. COH is achieved through the use of oral fertility drugs such as Letrozole, clomiphene citrate and injectable hormonal medications called gonadotropins. Before starting the medications, our team will perform a baseline pelvic ultrasound to evaluate the uterus and ovaries in the resting state. During COH, we will monitor you closely through a combination of ultrasound and blood testing.
Step 2: Monitoring Visits
To accurately monitor egg development, we obtain a series of ultrasounds and blood tests for hormone levels. Ultrasound allows your doctor to physically see the development in the follicle of the oocyte and surrounding cells. Blood tests show how the hormonal function of the follicle is progressing. Collectively, this information enables your IVF team at MRM to follow the development, growth, and maturity of the follicle. This process typically requires from five to seven office visits.
Step 3: hCG or Lupron Injection
Approximately 36 hours before the actual egg retrieval, you will give yourself an injection with a special medication called hCG (human chorionic gonadotropin) or an alternative of Lupron. hCG acts to stimulate ovulation and the release of the eggs from the surrounding cells (follicle). If there’s any concern about ovarian hyperstimulation syndrome (OHSS), there will be no hCG injection in order to prevent OHSS from occurring.
Step 4: Transvaginal Retrieval of Eggs; the IVF Lab
Retrieving the mature eggs from your ovaries is made more comfortable with the care of a certified anesthesiology team who administers an intravenous anesthetic. Risks of this procedure are minimal.
Your male partner or donor provides a semen specimen; our IVF lab specialists called embryologists then perform the actual in vitro fertilization procedure.
In cases where male infertility is a factor, such as low sperm count and/or motility, or if there are problems with the shape (morphology) of the sperm, normal in vitro fertilization is not used. In these cases, intracytoplasmic sperm injection (ICSI), an infertility treatment involving direct injection of a single sperm into each egg, can be employed in order to improve your chances of conception.
Our IVF lab also can provide embryo biopsy for preimplantation genetic testing to ensure that each embryo selected is free from specific genetic abnormalities; gender determination is also possible. The preimplantation genetic testing process requires that ICSI be performed. Preimplantation genetic testing allows for optimal embryo quality selection and greater confidence for success of any single embryo. This provides ease of mind to transfer a single embryo and substantially reduce the risk of a multiple gestation pregnancy. As our physicians often say, “More isn’t better, better is better.” One baby at a time is safest for babies and moms. Preimplantation genetic testing improves our precision in identifying embryo quality which assists in selection of the healthiest embryo for transfer. This helps to increase the chances of a successful pregnancy.
Step 5: IVF Lab Reports
Your in vitro fertilization procedure is followed closely by Michigan Reproductive Medicine fertility specialists (including our physicians and IVF lab specialists). They conduct frequent reviews of the status of your fertilization and the quality of your developing embryo(s). They also confer about decisions leading up to the transfer of the developed embryo back into your uterus. You can expect the embryos to develop for about 5 days in blastocyst culture prior to making a final determination about quality and quantity of viable embryos to either transfer to the uterus or to freeze for later.
Step 6: Embryo Transfer
Our physicians and the IVF team will meet with you and make a presentation regarding your embryo development, which will include digital photographs on an iPad for your review prior to the transfer. Our physicians and the IVF team will discuss the number of embryos that should be transferred to give you the best chance of a successful pregnancy and the lowest likelihood of high-order multiple births, such as triplets. As always, any questions and concerns you might have will be carefully and compassionately answered. Some or all embryos may be cryopreserved and stored for future embryo transfer during a frozen embryo transfer (FET) cycle. This choice may be selected prior to the start of IVF therapy depending on your unique situation and planning.
Step 7: Pregnancy Test #1
Your first pregnancy test following IVF will be performed approximately 10 days after the embryo transfer. During this time, you’ll be taking a progesterone supplement to help support the uterine lining. This stage of the IVF procedure is an emotional time, and we will be there with you every step of the way.
Step 8. Pregnancy Test #2
When your first pregnancy test is positive, we recommend a sequence of pregnancy test blood hCG levels about every three days, expecting at least a doubling of the blood hCG level with every subsequent test.
Step 9: Ultrasound #1
An ultrasound will be scheduled about one and a half to three weeks after your first positive pregnancy test. Your hCG blood level is usually above 10,000, and you are between 6 and 7 weeks of pregnancy. We are looking for embryo location, number of embryos, size of embryo and heart rate. If findings are reassuring on all counts, our experience indicates at least a two thirds chance the pregnancy will go well all the way to term.
Step 10: Ultrasound #2
The greatest risk time for miscarriage is between 6 and 8 weeks of pregnancy. For this reason, we recommend a second ultrasound be performed at 9 to 10 weeks of pregnancy. If we observe good fetal growth, fetal movement of arms, legs, body or head and good heart rate, we observe about a 94% chance the pregnancy will go well. You should be on the exciting path to parenthood! That kind of reassurance is key to graduating from our care to your obstetrician. We do like baby bump visits, and we absolutely love baby visits nine months later!
Choosing the Best Fertility Center
When facing infertility and your desire to build a family, one of the most important decisions you will make is where to go for your treatment. So how do you select the best fertility clinic?
Because accurate diagnosis is paramount, you want to find a fertility center with the latest diagnostic technologies. Beyond diagnosis, you want to know who makes up the medical practice and how it operates.
Our Physicians and Our Fertility Specialty Team:
At MRM, our physicians and our fertility specialty team are some of the most renowned experts in the field. MRM is the recognized leader in egg freezing technology, having the first baby in Michigan born from use of a frozen egg in 2010 and having the Michigan Egg Bank, one of the first and few frozen egg banks in the United States. MRM is also an oncofertility leader, preserving fertility through egg freezing for women with cancer. They can then use their eggs to have their family after defeating the disease with chemotherapy drugs that would have otherwise destroyed their eggs. MRM is also a strong advocate of family building for LGBTQ members of our community. Please see our physicians’ profiles for more details.
The Team Approach
Our practice believes in a team approach to fertility treatment, drawing on the talents of multiple and complimentary medical and allied health disciplines to give you the best possible outcome.
Everything You Need, All Under One Roof
Our Bloomfield Hills location is streamlined, incorporating medical offices, a state of the art IVF lab and specially designed surgical center under one roof for your comfort and convenience.
Questions about IVF? Call MRM and come in for a consultation!
If you are considering in vitro fertilization and want to know if IVF may be right for you, see one of our expert physicians at MRM for a consultation.
Please call us at (248) 593-6990 or contact us with your questions. Our helpful, caring fertility counselors welcome the opportunity to assist you.