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IVF 101

You’ve tracked your ovulation, scheduled intercourse, and have been to all the doctor appointments… and still no baby. What now? If you have explored all options available to you, this may be the year you decide that in vitro fertilization (IVF) is the way to make your family a reality. But there are more than a few things you need to know. Even reading about the medical and science terms involved in the process can be overwhelming but armed with the right information and team of doctors, it doesn’t have to be.

“I am dedicated to helping my patients navigate their fertility journey: from investigation to diagnosis and through treatment,” says Dr. Jason Min, reproductive endocrinologist and reproductive surgeon at the Calgary Regional Fertility Program (RFP). “Ultimately, I hope each and every one is successful. The best part of my job is when patients drop in to show me their children. The joy in their eyes is so compelling - the joy that children can bring.”

The basics

According to the RFP website, in vitro fertilization means “fertilization in glass” or in the laboratory. IVF is a process by which egg cells are fertilized by sperm outside the body.

The process involves hormonally controlling the ovulatory process, removing ova (eggs) from the woman’s ovaries, and letting sperm fertilize them in a fluid culture medium.

Following fertilization and cell division after a number of days in a humidity and temperature-controlled incubator, the embryo is transferred into the patient’s uterus with the intent of establishing a successful pregnancy.

“[The] rapid pace of research and change is leading to greater efficiency and access to reproductive services for patients - it is an exciting and incredibly emotionally rewarding field to be a part of,” says Dr. Tom Gotz with RFP.

The steps

The RFP lists six main sequential steps involved in the IVF process:

Preparation for an IVF cycle, which may include additional blood testing, ultrasound, and lifestyle changes.

Ovarian suppression and overstimulation. In order to increase the chance of a successful IVF cycle, doctors stop the woman’s regular cycle and use an ovarian stimulant to produce many eggs.

Egg retrieval is accomplished by inserting a vaginal ultrasound probe with a hollow bore aspiration needle attached into the vagina. The procedure is performed while the patient is under narcotic conscious sedation.

Insemination, fertilization, and embryo assessment. A semen sample is usually collected one to three hours following egg retrieval. Once the eggs and sperm have been collected, either conventional or Intracytoplasmic Sperm Injection (ICSI) insemination is carried out.

Embryo transfer usually occurs on the third or fifth day following egg retrieval. The procedure of embryo transfer is comparable to a pap smear.

Luteal phase support/early pregnancy follow-up. In order to support the endometrial lining at time of implantation and early pregnancy, supplemental progesterone is given. Progesterone supplementation is usually started the day after oocyte retrieval for luteal phase support following embryo transfer. 

A laboratory blood test for pregnancy (hCG) will be arranged for day 16 post embryo transfer if a transfer was done on day 3, or 14 days post embryo transfer if the transfer was done on day 5.

The cost

IVF is an intricate process that includes detailed scientific research, specialized medical experts, and high-tech equipment. All fertility treatments including IVF are uninsured services and are not covered under the Alberta Health Care Plan. Depending on the particular process you require, costs can vary from $10,000 to $15,000. Patients are responsible for all expenses related to their IVF treatment. These medical expenses may be able to be claimed on your personal income taxes as a medical expense tax credit. Some private insurance plans may cover parts of the cost of IVF treatment and/or medications.

The chances

According to the Canadian Fertility & Andrology Society website, a woman under 35 years of age can expect a 41 percent chance of delivering a child per embryo transfer. However, the chance of live birth drops as the woman ages. A woman’s likelihood of delivering a child through a single cycle of IVF drops to 34 percent between 35 and 37 years of age, 24 percent between 38 and 40 years of age, 11 percent between 41 and 42 years of age, and 6 percent after 43 years of age.

“RFP is one of the oldest IVF programs in Canada and has consistently provided excellent success rates for our patients using well-researched, established techniques and procedure” says Dr. Min.

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