A vaginal ultrasound is used to guide a needle into the ovaries to remove small masses called follicles while the woman is put under local anesthesia for a short time. This process is not painful but the woman may   experience some discomfort for a few days   after.  The follicles are taken to the lab where an   aspiration is preformed. Each follicle may   contain  one, two or even no eggs. On average,   3-10 eggs are retrieved per procedure.

Fertilization
After retrieval, each egg is usually fertilized using a process called Intra Cytoplasmic Sperm Injection   (ICSI).  The fertilization process usually occurs   within the first six hours after the egg retrieval   and  anywhere from 60-85% of the eggs will   fertilize. The doctor uses techniques to aid in the embryo growth which include placing fertilized embryos on a bed of specially prepared cells in an attempt to mimic the tubal environment where fertilization occurs. These cells help remove toxic substances, release embryonic growth factors and prepare the outer covering of the embryos for implantation. As they grow, the embryo’s cells multiply very rapidly.

PGD is optional. It is used to screen “Day 3” embryos called blastomere for missing or additional chromosomes such as, Down’s Syndrome or single gene mutations. It has been found that many embryos that look normal are actually abnormal. Normal appearing embryos often fail to implant or result in miscarriage. By combining IVF and PGD, the poor quality embryos are eliminated and only the healthy embryos are transferred. In this chase, the patient may be able to transfer fewer embryos because the rate of implantation is vastly improved compared to normal IVF. On “Day 3”, one cell is removed from each of the growing 6 or 8 cell stage embryos. On “Day 4”, the genetic analysis is preformed and on “Day 5”, the results are known and the healthiest embryos are transferred to the woman’s uterus. Also, In this process, it is possible to determine the "sex" of the embryo before it is transferred.

Embryos are transferred to the uterus through a small tube called a catheter. This process does not require any anesthesia and is painless. The embryos are placed in a small amount of fluid inside the catheter, which is passed through the cervix. The embryos are placed in a manner so they reach the top part of the uterus. Doctors and researchers recommend being completely still for a least one half hour prior to the transfer but there is no research suggesting that this aids in implantation.