In-Vitro Fertilisation (IVF) is the process by which eggs are taken from a woman’s body, fertilised with sperm in a petri dish and, after a few days of incubation, replaced back into her body. Literally translated, in vitro fertilisation means fertilisation in glass.
The fundamental biological requirements of conception are eggs, sperm, a womb and no obstructions in the female reproductive tract. The classic purpose for IVF is to treat tubal blockage. The reasons for pursuing treatment using IVF have since been extended to include: prolonged unexplained infertility, endometriosis, social infertility, the treatment of male factor problems with intra-cytoplasmic sperm injection and, more recently, to reduce the chance of transmitting infection or genetic disease.
Your Doctor may recommend IVF to increase your likelihood of falling pregnant if you or your partner have:
The drugs used in the controlled ovarian hyperstimulation stage of the procedure are designed to “hijack” your normal menstrual cycle, stimulating the ovaries to produce more than one egg. Therefore, any symptoms that you associate with your normal cycle will be exaggerated by this process. These can include: moodiness, hot flushes, dizziness, mild abdominal discomfort, bloating and tiredness.
IVF treatment involves six main stages:
The first stage of the IVF process is generally the longest, taking place over the course of one to three weeks. Similar to ovulation induction and artificial insemination, COH involves the administration of hormones to stimulate your ovaries. We will monitor your response to the medication closely, using regular blood tests and ultrasound. Unlike ovulation induction and artificial insemination, the aim in COH is to produce multiple follicles, rather than just one or two.
When your follicles approach maturity and your oestrogen level reaches its peak, you will be instructed to administer your trigger medication, a time-sensitive medication determines the time of your TVOA approximately 36 hours later. It is a quick procedure that can take place either in an operating theatre under a general anaesthetic, or under a local anaesthetic in our treatment room.
Once the eggs have been collected from your ovaries and the semen sample has been prepared, the eggs and sperm are brought together in the laboratory. In a highly controlled environment, we add thousands of washed sperm to the eggs, with the aim that one sperm will fertilise each egg. The fertilisation process takes place without any scientific manipulation.
The morning following IVF, the scientists in the laboratory (Embryologists) will assess your eggs for fertilisation. Keeping you advised along the way, your embryos will then be grown, or cultured, in the laboratory for up to six days.
At Fertility North, embryo transfers take place between day 1 (when the embryos tend to be a single cell) and day 6 (where the embryos should have achieved the blastocyst stage, with hundreds of cells).
During your embryo transfer, the doctor will very gently insert a speculum into your vagina, as your GP would for a Pap smear, and a fine, soft tube is then carefully passed through the cervix allowing the embryo to be placed carefully into your uterus.
In the fortnight after your embryo transfer, your hormone levels will be monitored and supported, if necessary, until the outcome of your cycle is known.
The main risks of IVF are most easily categorised by the stage in the IVF procedure:
The main risks associated with stimulation arise from either too much or too little stimulation.
Too much may result in Ovarian Hyperstimulation Syndrome (OHSS). In this, over sensitivity to the drugs used causes so many eggs to develop that they produce such high levels of circulating hormones that they become toxic. To protect against this potentially dangerous situation, any resulting embryos must be frozen, as pregnancy would make the condition worse and more prolonged. Particularly bad cases of OHSS can result in the complete cancellation of a treatment cycle.
Too little response to the drugs results in too few eggs. This sometimes also necessitates the cancellation of a cycle or the collection of just a small number of eggs for fertilisation.
While any system is susceptible to human error, Fertility North boasts a robust quality management system, RI Witness system and standardised double checking. These are implemented at every sample at every step, to produce the safest process possible for your eggs, sperm and embryos.
Similarly, high standards in equipment quality, maintenance and planned replacement are designed to minimise the risk of equipment failure and subsequent damage to your material.
This is usually the easiest part of the whole IVF process and for most women is very much like having a pap smear. Some women can have a particularly narrow or unusually shaped cervix which can make the process more difficult and uncomfortable. In the rare event that the doctor is unable to pass the catheter through the cervix, the procedure can be performed under anaesthetic in the operating theatre.
If more than one embryo is transferred there is an increased risk of a multiple pregnancy. Multiple pregnancies are associated with increased risk and therefore must be regarded as a potential complication. In accordance with the Reproductive Technology Accreditation Committee (RTAC) Code of Practice, Fertility North takes every possible step to avoid this.
Provision of an unsuitable semen sample on the part of the male partner may necessitate either a repeat sample, or if that is not possible, an emergency surgical collection may be required, or the eggs may be frozen. This is obviously a rare event and is only an issue where there is a recognized semen problem.
The thought of launching straight into IVF can be incredibly daunting – the physical and financial cost of IVF, the rollercoaster of emotions. But it doesn’t have to be that way. Fertility North will only recommend IVF to patients where its use is warranted, we prefer to explore less invasive and less expensive options wherever we can.
If you would like to learn more about our affordable IVF prices and competitive IVF success rates, or if you would like to get started on your treatment journey with us, please contact our friendly administration team.