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"Doctor, we've been trying to conceive for two years. We had three failed ovulation inductions in our hometown and want to do IVF at Shengjing Hospital. We don't know the exact procedure or what we need to prepare?" In the reproductive clinic, 34-year-old Ms. Zhou and her husband were seeking help from the doctor. This is a common type of consultation that doctors at the Shengjing Hospital Reproductive Medicine Center face daily. A clear treatment pathway and thorough preoperative preparation are the foundation for improving diagnostic and treatment efficiency.
1. Overview of IVF at Shengjing Hospital
The Reproductive Medicine Center of Shengjing Hospital of China Medical University (formerly the Second Clinical College of China Medical University) is one of the nationally approved institutions for assisted reproductive technology and a key specialty in Liaoning Province. The center routinely offers the following technologies:
- In Vitro Fertilization-Embryo Transfer (IVF-ET): First-generation IVF, primarily for infertility caused by female tubal factors, ovulation disorders, endometriosis, etc.
- Intracytoplasmic Sperm Injection (ICSI): Second-generation IVF, mainly for severe male oligoasthenoteratozoospermia, low sperm motility, or previous IVF fertilization failure.
- Embryo Cryopreservation and Frozen Embryo Transfer: Freezing surplus good-quality embryos for transfer in subsequent cycles to increase cumulative pregnancy rates.
- Preimplantation Genetic Testing (PGT): For carriers of chromosomal abnormalities or single-gene disorders, genetic screening is performed before embryo implantation, subject to hospital ethics committee approval and national regulations.
Before consultation, it is important to understand that IVF is not the first choice for all infertility patients. After systematic examination and evaluation, a reproductive specialist determines if indications are met. Not all patients are suitable for an IVF cycle; conditions such as severe uterine abnormalities, uncontrolled infectious diseases, or severe mental illness require treatment of the primary issue first.
2. Detailed Treatment Process
The complete IVF cycle at Shengjing Hospital includes the following key steps, each directly impacting the final outcome.
Both partners attend the appointment together, bringing all previous medical records and test results. The doctor will take a detailed history of infertility, menstrual history, obstetric history, surgical history, and family genetic history, make a preliminary judgment on IVF indications, and order systematic tests.
Female partner needs: Sex hormone panel (FSH, LH, E2, etc.), Anti-Müllerian hormone (AMH), thyroid function, infectious disease screening, chromosome karyotype analysis, uterine ultrasound, and antral follicle count. Male partner needs: Semen analysis (including morphology, motility, concentration), infectious disease screening, chromosome karyotype analysis. Some tests have time limits and must be completed within their validity period.
Once all test results are available, both partners bring original and copies of their ID cards and marriage certificates to the hospital to create a file. The doctor develops an individualized ovarian stimulation protocol based on the woman's age, ovarian reserve, medical history, and test results. Common protocols include the long protocol, antagonist protocol, and mild stimulation protocol.
After starting the cycle, the woman receives daily injections of ovarian stimulation medication and returns to the hospital regularly for follicle development monitoring (ultrasound + sex hormones). The average stimulation duration is 10-14 days, requiring 3-5 follow-up visits. The doctor adjusts medication dosage based on follicle size and hormone levels.
When follicles are mature (usually 1-3 leading follicles ≥18mm in diameter), a trigger shot of human chorionic gonadotropin (hCG) or GnRH agonist is administered. Transvaginal ultrasound-guided egg retrieval is performed 36 hours later under intravenous sedation or analgesia. The procedure takes about 15-20 minutes, and patients can be discharged after 1-2 hours of observation if no complications arise.
On the day of egg retrieval, the male partner provides a semen sample. Laboratory technicians process the eggs and sperm, achieving fertilization via IVF or ICSI. Embryos develop in an incubator for 3-6 days. The doctor decides on the transfer strategy based on embryo quality and quantity. Transfer typically occurs on day 3 (cleavage stage) or day 5-6 (blastocyst stage) after egg retrieval.
Under abdominal ultrasound guidance, 1-2 good-quality embryos are placed into the uterine cavity using a soft catheter. The transfer is painless and requires no anesthesia. Patients rest in a supine position for 20-30 minutes before discharge. Surplus good-quality embryos can be cryopreserved.
After transfer, progesterone medications (injections or vaginal gel) are used to support luteal function and maintain endometrial receptivity. A blood test for β-hCG is performed 12-14 days after transfer to confirm pregnancy. If successful, luteal support continues until 8-12 weeks of gestation. If not, medication is stopped, menstruation occurs, and a frozen embryo transfer or a new cycle can be scheduled.
3. Timeline and Cycle Planning
How long does a complete IVF cycle take? This is one of the most common patient concerns. Below is an approximate timeline for each stage:
| Stage | Time Required | Notes |
|---|---|---|
| Initial Consultation & Tests | 2-4 weeks | Female hormone tests (FSH, AMH) should be done on days 2-4 of menstruation. Male semen analysis requires 2-7 days of abstinence. Chromosome results take about 10-14 days. |
| File Creation & Protocol | 1-2 weeks | All test results must be within their validity period; some tests (e.g., infectious disease screening) are valid for 3-6 months. |
| Ovarian Stimulation | 10-14 days | Frequent clinic visits are needed, averaging 3-5 follow-ups. Arrange work and life accordingly; avoid strenuous exercise. |
| Egg Retrieval & Embryo Culture | 3-6 days | Rest for 1-2 days after retrieval to avoid ascites and infection. Embryos are cultured until day 3 or day 5-6 for transfer. |
| Transfer & Pregnancy Test | 12-14 days | Maintain normal activities after transfer; avoid strict bed rest. Consult your doctor before stopping any non-essential medications before the pregnancy test. |
From the initial consultation to pregnancy confirmation, a complete cycle typically takes 2-3 months. If opting for frozen embryo transfer, scheduling is more flexible but requires endometrial preparation at specific points in the menstrual cycle.
4. Key Test Indicators Explained
Reproductive specialists use a series of test indicators to assess a patient's fertility potential and develop individualized plans. The most core indicators are:
Core Female Indicators
- AMH (Anti-Müllerian Hormone): The gold standard for ovarian reserve. AMH > 1.1 ng/mL indicates normal reserve, 0.5-1.0 ng/mL indicates diminished reserve, and < 0.5 ng/mL indicates severely diminished reserve. AMH levels are not affected by the menstrual cycle and can be tested anytime.
- FSH (Follicle-Stimulating Hormone): Tested on days 2-4 of menstruation. FSH < 8 IU/L suggests good ovarian function, 8-12 IU/L warrants caution for declining reserve, and > 12 IU/L indicates diminished ovarian reserve. FSH levels increase with age.
- Antral Follicle Count (AFC): Counts antral follicles (2-10mm) in both ovaries via transvaginal ultrasound. AFC 5-10 is normal; < 5 suggests diminished reserve. AFC is an important predictor of ovarian stimulation response.
- Uterine Cavity Assessment: Includes evaluation of uterine shape, endometrial thickness, presence of polyps or adhesions. Abnormalities need to be addressed beforehand as they can affect embryo implantation.
Core Male Indicators
- Semen Analysis: Includes sperm concentration (normal ≥ 15×10⁶/mL), motility (PR+NP ≥ 40%), and morphology (normal forms ≥ 4%). Values below reference ranges indicate the need for further evaluation or consideration of ICSI.
- Sperm DNA Fragmentation Index (DFI): DFI > 30% may affect fertilization rates and embryo development, and is related to male age, lifestyle, and reproductive tract infections.
5. Considerations by Age Group
Age is the most critical independent factor affecting IVF success rates. Ovarian response, embryo quality, and pregnancy outcomes vary significantly across age groups.
| Age Group | Ovarian Reserve Characteristics | Ovarian Stimulation Strategy | Special Considerations |
|---|---|---|---|
| < 35 years | Relatively adequate reserve, higher egg yield, good egg quality | Standard protocols like antagonist or long protocol are suitable | Focus on ruling out non-age factors like tubal or male issues |
| 35-40 years | Reserve begins to decline, egg quality decreases, aneuploidy rate increases | Mild stimulation or addition of growth hormone; more individualized protocols | Consider PGT to reduce miscarriage risk |
| > 40 years | Significantly diminished reserve, fewer eggs retrieved, embryo aneuploidy rate exceeds 50% | Primarily mild stimulation or natural cycle protocols; emphasize embryo accumulation | Thorough communication about success rate expectations; consider egg donation eligibility |
For women over 40, reproductive specialists at Shengjing Hospital emphasize that the risk of chromosomal abnormalities in embryos increases significantly with each additional year. Therefore, older patients are advised to complete genetic counseling before IVF to fully understand age-related risks and success rates.
6. Doctor's Decision-Making Logic
At the Shengjing Hospital Reproductive Medicine Center, doctors follow this decision-making pathway when formulating IVF plans:
- Step 1: Determine Indications and Contraindications. Clarify whether the cause of infertility falls within the scope of IVF treatment, and rule out contraindications such as uncontrolled medical or surgical diseases, acute reproductive tract infections, or unstable malignancies.
- Step 2: Assess Ovarian Reserve and Choose Stimulation Protocol. Based on AMH, AFC, FSH, and age, patients are categorized as high, normal, or low responders. High responders need caution against Ovarian Hyperstimulation Syndrome (OHSS), while low responders may require mild stimulation or adjuvant medications.
- Step 3: Decide Fertilization Method. Primarily based on male semen analysis results and previous fertilization history. IVF is chosen for female factors with normal semen; ICSI is chosen for male factors or previous IVF fertilization failure.
- Step 4: Develop Transfer Strategy. Considers embryo quantity, quality, patient age, and uterine condition. Typically, one blastocyst or two cleavage-stage embryos are transferred for women under 35; two blastocysts for ages 35-40; for women over 40, the decision is based on embryo grading and patient preference.
7. Most Commonly Overlooked Details
Based on observations from practitioners at the Shengjing Hospital Reproductive Center, the following details are most often overlooked by patients but significantly impact cycle progress:
- Test Validity Periods: Infectious disease screenings (Hepatitis B, C, HIV, Syphilis) are valid for 3-6 months. Chromosome karyotype analysis is valid for life, but some hospitals require reports within the last 2 years. Confirm which tests need to be repeated before your visit to avoid unnecessary expenses.
- Complete Documentation: Original and copies of both partners' ID cards and marriage certificates are required for file creation. Information must match the individuals; any changes need to be addressed beforehand. Missing documents prevent file creation and directly delay the cycle.
- Missed or Incorrect Medication During Stimulation: Ovarian stimulation medications must be injected strictly according to the prescribed schedule, with no more than a 1-hour deviation per day. Missing or incorrect doses can lead to stalled follicle development or premature ovulation, forcing cycle cancellation.
- Lifestyle Details Around Transfer: Strict bed rest is not required after transfer; prolonged bed rest can actually hinder pelvic blood circulation. Maintain a normal routine, avoiding heavy lifting, strenuous exercise, sexual intercourse, and baths. Avoid raw, cold, or spicy foods to prevent diarrhea.
- Psychological State Fluctuations: Anxiety and stress can affect endocrine levels and inhibit sex hormone secretion. The Shengjing Hospital Reproductive Center offers a psychological counseling clinic; patients in need are advised to book in advance and maintain emotional stability during the cycle.
8. Frequently Asked Questions
Below are the most common questions from patients at the Shengjing Hospital Reproductive Medicine Center outpatient clinic, along with answers based on clinical practice:
Does IVF hurt?
Injections during ovarian stimulation are similar to regular intramuscular injections; some medications may cause mild stinging. Egg retrieval is performed under intravenous sedation or analgesia and is painless; some patients experience mild lower abdominal bloating afterward, which usually resolves in 1-2 days. Embryo transfer is painless.
How much time off work is needed?
During ovarian stimulation, the woman needs 3-5 follow-up visits, each lasting half a day to a full day. Rest for 1-2 days after egg retrieval. Rest for 1-2 days after transfer. The total time off work for the entire cycle is approximately 5-10 working days, depending on individual circumstances and company leave policies.
Can I exercise during the IVF cycle?
Avoid strenuous exercise, jumping, or rapid running during ovarian stimulation to prevent ovarian torsion or rupture of enlarged ovaries. Gentle activities like walking or yoga are fine. Similarly, avoid strenuous exercise after transfer, but strict bed rest is not necessary.
What if the first IVF cycle fails?
After a failed first transfer, the doctor will analyze possible causes with the patient: embryo factors, uterine factors, endocrine factors, or immune factors. If frozen embryos are available, a frozen embryo transfer can be scheduled. If a new egg retrieval is needed, the cycle will begin after adjusting the protocol. A single failure does not necessarily indicate a poor overall prognosis; it needs to be assessed based on the specific situation.
Does the male partner need to be involved throughout?
The male partner needs to be present for at least three key points: the initial consultation, file creation, and the day of sperm retrieval. Some tests (like semen analysis and chromosome testing) require the male partner's personal attendance. The male partner's understanding and support significantly impact the female partner's psychological state during treatment.
This article is compiled based on public information from the Reproductive Medicine Center of Shengjing Hospital of China Medical University and general knowledge in the assisted reproductive technology field. Content was last updated in 2025. Please confirm the latest procedures and policies through official hospital channels before your visit.
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