Personalized In vitro fertilization (IVF)
At Midwest Fertility we perform IVF based on the patient's unique cycle. This means that we don't "batch" our IVF patients. We provide IVF on demand to our patients everyday. Some clinics in Indiana do IVF only once a month while some do IVF as infrequently as once every few months. We believe that in order to provide the best treatment, it should be according to the patient's individual needs and cycle.

View the IVF Patient Binder . If you have difficulty, you can also download the pdf version.

 

 
Assisted Reproductive Technology
  
Assisted Reproductive Technology, commonly called ART, refers to any infertility treatment that uses advanced technology to combine sperm and eggs outside the body in a laboratory.Most couples go through extensive infertility evaluation before considering ART.

What is in vitro fertilization? (IVF)
With in vitro fertilization the union of the egg and sperm happens in a laboratory environment. After fertilization and early embryo development some of the embryos will be transferred to the woman’s uterus.

The woman will receive a cycle of fertility drugs to stimulate the development of multiple eggs. During this time you’ll have regular blood tests to monitor hormone levels and vaginal ultrasounds to determine when your eggs are mature. You then come to our Carmel office to have the maturing eggs retrieved. Intravenous sedation makes this a painless procedure.

 Your physician will guide a needle through the vaginal wall to puncture the follicles and remove the available eggs. On the same day your eggs are removed, your husband’s sperm is collected and washed and placed in a Petri dish with your eggs. The dishes are placed in a protected environment specifically designed to mimic the fallopian tubes and womb. Our laboratory biologists monitor them for signs of fertilization and cell division. After 18 to 24 hours the biologists look for signs indicating the presence of a developing embryo. At the end of three or five days, the embryos are transferred back to the woman’s uterus for the development of a possible pregnancy.   
Assisted Fertility Services

Some infertile couples will choose to use lower-technology treatments, such as intrauterine insemination (IUI), before turning to ART. Others find that their chances at getting pregnant are optimal with ART.


Intrauterine Insemination
Intracytoplasmic Sperm Injection (ICSI)
Embryo Cryopreservation
Frozen Embryo Transfer
Blastocyst Transfer
Embryo Assisted Hatching
Pre-implantation Genetic Diagnosis (PGD)

 

 

 

 

Intrauterine Insemination (IUI)
This form of assisted reproduction places sperm in the uterus to improve your chances of conception. You will go through a cycle of injected fertility medicines to stimulate egg development before your IUI procedure. We’ll monitor you with vaginal ultrasounds and blood work to track your estradiol levels and the progress of the developing follicles. The IUI procedure is precisely timed with your ovulation.

Your partner’s sperm will be collected on the day of the IUI and is prepared by a technique called washing to ensure that the most robust sperm are used for the insemination.

Once the sperm is ready, your nurse will insert a small flexible catheter through the cervix and gently place the washed sperm in the uterus.
Most women say the IUI is not painful, similar to having your annual pap smear. There might be some cramping afterward. This may be from your ovulation, and not from the IUI. Also as you approach ovulation your cervix is slightly more open and this makes the procedure easier.

We will talk with you about how long before and after the IUI to abstain from intercourse, and if you need to rest after the IUI.

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Intracytoplasmic Sperm Injection (ICSI)Ordinarily millions of sperm will vie for the opportunity to fertilize a single egg. When fewer sperm are available, or there is any concern that it may be difficult to fertilize an egg, ICSI (pronounced ick-see) can be used to precisely insert a single sperm into the mature egg. ICSI can only be done in a laboratory environment in conjunction with an IVF procedure. see video

Embryo Cryopreservation
When you go through a cycle of IVF, you may have several embryos that develop. Ordinarily only two or three of these will be transferred in that first or ‘fresh’ cycle.  The others provide the opportunity for more pregnancy attempts. Saving them for later attempts avoids the risk of a high order multiple pregnancy. A multiple pregnancy carries more risk for both the mother and the babies.  A high order multiple pregnancy is not a desired outcome. The remaining embryos from the fresh cycle are frozen to be used for future embryo transfers.
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Frozen Embryo Transfer
Embryos that develop during a cycle of IVF may not all be transferred back to the woman’s uterus during that cycle. The ones that remain are frozen to be used in future cycles. Some women come to us with embryos that came from their previous treatment at another practice. We are happy to help with the transfer of these embryos for these women.
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Blastocyst Transfer
The blastocyst culture and day 5 embryo transfer procedure for in vitro fertilization facilitates selection of the best quality embryos for transfer to the uterus of the mother. The concept of embryo quality is a very important one for couples experiencing infertility. With blastocyst embryo transfer, we can transfer fewer embryos - reducing risks for multiple pregnancy - while keeping overall pregnancy rates high.
Definition of a blastocyst - an embryo that has developed for five to seven days after fertilization and has developed 2 distinct cell types and a central cavity filled with fluid (blastocoel cavity). The cells in a blastocyst have just started to differentiate. The surface cells that surround the cavity (just under the outer shell) are called the trophectoderm and will later develop into the placenta. The more centrally located group of cells are called the inner cell mass and will become the fetus.
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Embryo Assisted Hatching
In order for an embryo to implant in the nutrient rich lining of a woman’s uterus it must first break through its outer surface, called the zona pellucida. The zona pellucida is a type of shell and can sometimes be thick or tough so that it inhibits that critical ‘breaking out’. In our laboratory we are able to delicately create a small opening that makes hatching more likely to happen.
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Pre-implantation Genetic Diagnosis
A variety of tests can be done on the developing embryo before it is transferred to the woman’s uterus. The tests provided at Midwest Fertility Specialists can check for life-threatening conditions such as Tay Sachs and Sickle Cell Anemia as well as chromosomal abnormalities including Down’s syndrome. Technology allows for tests to determine the gender of the embryo, but these tests are not offered at Midwest Fertility.
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