In Vitro Fertilization (IVF)

Your Personalized Fertility Treatment

In Vitro Fertilization or “IVF” is the process of combining an egg and sperm in a laboratory dish (“in vitro” – “in glass”). Following successful fertilization, embryos are transferred into the uterus.

What is Involved in the IVF Process?

While IVF may initially seem overwhelming, the NRM team is here to answer your questions and guide you through the process.

IVF Consult. Your first step is to schedule a consult. Our specialized providers will talk with you to determine if IVF is the best therapy for you.
After reviewing your history and any previous fertility treatments or testing, we will determine what type of testing you need prior to your IVF.
IVF plan. Once testing is complete, we develop an IVF plan specifically for you — based on your test results and history. Your IVF coordinator will provide you with a calendar that will give you day- by- day instructions of medication use and initial appointment dates.
Medication instruction. A member of our nursing team will provide one-on-one instruction regarding how to mix and administer your IVF medications and injections.
IVF Stimulation. IVF is designed to stimulate multiple follicles on your ovaries (inside each follicle is one egg). In order to maximize your success while minimizing any risks, you will be monitored closely during stimulation with frequent ultrasound and lab work. We will be in constant communication during this time. Based on your response to the medication, we may make adjustments to maximize your chances of success. Your oocyte (egg) retrieval will then be timed based on the size of your follicles in conjunction with your hormone levels.
Oocyte Retrieval. Your physician will determine the timing of your final “trigger shot” to begin the process of egg maturation and ovulation—preparing you for egg retrieval. Egg retrieval is a minor surgical procedure that our physicians perform in the surgical suite of our office. You will be given sedation by an anesthesiologist and the retrieval will be performed under ultrasound guidance. Most patients tolerate this procedure very well with minimal discomfort.
Laboratory Reports. Egg fertilization and embryo development will occur over the next 5-7 days in the laboratory. During this time, we will keep you updated on the status of your embryos. A normal attrition (decrease) of eggs to embryos is expected—this means that while you may have a high number of eggs retrieved, we expect only a portion of those to be mature and fertilize, and then only a portion of those will develop into good quality embryos. The specific percentage decrease depends on your particular diagnosis, age, and fertility history. The goal is to have 1-2 high quality embryos for transfer into your uterus. We follow ASRM guidelines regarding the number of embryos to transfer based on your age and quality of your embryos. Any remaining embryos may be vitrified (frozen into a “glass-like” state) and stored for future use.
Embryo Transfer. Your embryos may be:
a. Transferred fresh, 5 days after the egg retrieval, if your hormone levels allow and this was your plan with your physician.
b. Biopsied for testing (PGT-A) if indicated and then frozen while awaiting for test results — if this was part of your treatment plan.
c. Frozen while awaiting menses and normalization of hormones before transfer the next cycle ("Freeze All"). Whether you transfer Fresh vs. Frozen embryos is a medical decision, pending your safety based on your hormone profile, your individualized success rates with fresh vs frozen, and also based on whether your plan includes genetic testing or PGT-A.

Once you are ready for transfer, you will not need any sedation for the embryo transfer and you will be able to watch the transfer occur on ultrasound with any support person you would like to be present. You will then be given a date to return for your pregnancy test!

Intracytoplasmic Sperm Injection (ICSI)

Our embryologists are experts in performing ICSI, an IVF procedure in which a single sperm is injected directly into an egg.

How is ICSI performed?

At NRM, experienced embryologists perform ICSI under a microscope. While stabilizing a mature egg, a single, immobilized sperm is directly injected through the zona pellucida or “shell” of the egg into the inner part of the oocyte (cytoplasm). The sperm is then released into the oocyte. The following day, the eggs are inspected for normal fertilization.

Our embryologists have over 50 years of laboratory experience. Combined with our up-to-date embryology laboratory, NRM strives to offer you the highest chance of success in your IVF cycle.

Why Choose NRM in Vermont?

We strive to provide you the highest quality care available and to maximize your individual chances of success, while supporting your needs along the way.

Specialized team of providers and staff devoted to the ever-changing field of reproductive medicine and to you.
State-of-the-art facility with continuously updated laboratory technologies to maximize the chances for successful implantation and pregnancy.
Calm, comfortable environment to support your needs and minimize stress.
Vermont provides a safe-haven for reproductive rights and fertility care, ensuring you, your embryos, and your children are protected.

We realize there is a lot of information to digest. We’re here to help. Your next step is toschedule a consultation so that we can meet with you in person, gather the appropriate test results and date, and then work with you to develop a personalized treatment plan designed to provide you the most cost effective path to a successful outcome.