1. A combination of medications is used to stimulate the woman’s ovaries to produce many eggs in one cycle, in a process called controlled ovarian stimulation (COS).
2. The mature eggs are removed from the woman’s ovaries – usually through a slim needle inserted through the wall of the vagina.
3.  The eggs are examined and placed into a culture dish in the lab. At the proper time, they are mixed with specially prepared sperm. Later, if fertilization occurs, the resulting embryos are grown in the lab for a few days.
4. One or more embryos are transferred back into the woman’s uterus, where an embryo may implant and result in an ongoing pregnancy.
5.  A pregnancy test is given. If conception does not occur, all steps of the cycle should be evaluated by the treatment team and discussed with the patient in a follow-up meeting.

For most couples, whether or not to undergo IVF is a major decision that requires them to assess many medical, emotional and financial factors. Before deciding, you may want to speak with others who have gone through the process (successfully and not), an infertility counselor, and/or a support group. These are a few of the questions to discuss with your doctor:

• Why are you recommending IVF for me?
• What are my alternatives to using IVF?
• What are the risks of each step in the process?
• What is it like for most women as they go through each step? (This will help you predict what the impact may be on your time, physical well-being and emotions).
• What is my chance to become pregnant and deliver a baby as a result of this treatment?
• How does that compare to my chances with other treatments or no treatment at all?

Depending on your fertility problems, you may decide to use lower-tech treatments or no treatment at all. In addition, two IVF alternatives are available at some programs, although their use has declined greatly.

In gamete intrafallopian transfer (GIFT), the first two steps are the same as IVF. But, instead of fertilizing the eggs in the laboratory, a mixture of sperm and eggs is placed into one or both of the woman’s fallopian tubes. In GIFT, fertilization and the embryos’ travel to the uterus occur in the natural environment of the fallopian tubes. GIFT usually involves a surgical procedure and requires that at least one of a woman’s tubes be open and healthy. Because general anesthesia is usually required, GIFT is considered riskier and usually costs more than IVF. Another procedure, zygote intrafallopian transfer (ZIFT), combines elements of IVF and GIFT. The first three steps are similar to IVF. However, instead of transferring the embryos into the uterus, they are placed into one or both

The general term assisted reproductive technologies (ART) is used for all treatments that involve removing a woman’s eggs and combining them with sperm outside the body, including IVF, GIFT and ZIF

“The waiting rooms are filled with people whose total life is going through these programs. It was hard to juggle between working and IVF, but I’m glad I didn’t just sit there for a month, Now iam a proud Nalongo.” IVF PATIENT

IVF is not a uniform treatment. To carry out a treatment cycle, several decisions must be made, including:

• What dose of fertility drugs to use?
• When to retrieve the eggs?
• How long to culture the embryos before inserting them into the uterus?
• How many embryos to transfer to the uterus in a cycle?
• Whether to freeze embryos for later cycles?

Make certain that you understand the impact these choices could have on your chance of pregnancy and on treatment decisions you may be asked to make later on. What additional treatments or procedures may be recommended?

Depending on your condition or your response to previous treatments, variations on IVF may be suggested. Intracytoplasmic sperm injection (ICSI) is used to increase the chance of fertilization. Instead of mixing sperm and eggs and waiting for fertilization to occur, a single sperm is injected directly into each egg.

Assisted hatching is used to increase the chance that an embryo will implant in the uterus. A small opening is created to make it easier for the developing embryo to emerge from the protective shell that surrounds it. Blastocyst transfer : Instead of transferring embryos after two or three days in the lab, they are grown to the many-celled blastocyst stage and transferred on day five. By this point, surviving embryos have a higher chance of establishing a pregnancy, so fewer are usually transferred.