In vitro fertilization (IVF) is a well-established technique for creating embryos by fertilizing the egg with the sperm in a laboratory. The resulting embryo(s) can then be transferred to the woman’s uterus. The fertilisation process can be carried out using a conventional IVF technique or by intracytoplasmic sperm injection (ICSI).
In vitro fertilisation (IVF) is recommended for:
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At your first visit to an IVI clinic the doctor will fully explain all suitable treatments available. So that you can choose the best treatment for you. The team at IVI will work with you to ensure that you fully understand and feel in control of your treatment.
Ovarian stimulation during an IVF cycle consists of daily injections that stimulate the ovaries to produce more eggs than the usual. Only a single egg is matured and ovulated each month naturally. Hopefully by stimulating the ovaries to produce more eggs, a larger number of embryos will be created.
Depending on the protocol used and how quickly the patient responds, the stimulation phase of the cycle can take between 10 and 20 days. During treatment 4 ultrasound scans are carried out and a blood test may also be taken at these visits to measure the amount of estradiol (a hormone produced by the ovaries). The scans and blood tests monitor how the follicles (fluid filled sacs in which the eggs develop and mature) are growing.
When the follicles have reached the optimum size the egg collection is scheduled. An injection of hCG is administered to mature the eggs in the follicles. This injection is given approximately 36 hours before the egg collection is scheduled.
Egg collection takes about 30 minutes, you will be given drugs to make you sleepy, so that you do not feel any kind of discomfort during the procedure. With the help of a scan probe, a very fine needle is passed through the vaginal wall and into the ovary to collect the eggs. Usually, around 80% of follicles contain an egg. Once the procedure is finished you will need to stay in the clinic at least an hour but you can go home the same day. You’ll need someone to pick you up; you mustn’t drive for the rest of the day, because of the anaesthetic.
Sperm Samples
Once the egg collection has been performed and the eggs collected, a sperm sample will be required. If your treatment uses a fresh sperm sample, it will be provided on the same day as the eggs. You provide the sample at the clinic, in one of our andrology (men’s) rooms.
If you already have sperm in storage, or have chosen a sperm donor, the sample will be thawed on the same day that the eggs are collected.
The sperm sample will be prepared by the embryologists to ensure the most motile sperm are used for fertilizing the eggs.
Fertilisation can be carried out using conventional IVF. This involves placing an egg in a culture dish together with approximately 100,000 sperm. If there are insufficient numbers of sperm or the motility is reduced the embryologists may select a single sperm and inject it directly into an egg. This technique is called Intracytoplasmis sperm injection (ICSI).
The day after your egg collection the eggs are checked to see if they have fertilised. The embryos are graded as they develop and the monitoring can continue up to six days after egg collection. Not every embryo will carry on developing so the decision about when to complete the embryo transfer will depend on the number and quality of your embryos.
Embryo transfer
The procedure can feel like a smear test. It usually takes around 15 minutes. A tiny drop of culture medium containing one or two embryos is carefully deposited in the uterus using a thin catheter. You will need to have a full bladder for embryo transfer as an abdominal ultrasound scan is carried out during the transfer to ensure the embryo placement within the uterus is optimised.
At IVI we recommend single embryo transfer (SET). Recent studies show that multiple pregnancies carry a much greater risk of low birth weight, perinatal and infant mortality, and preterm delivery and disability. If you have high quality embryos, choosing to transfer more than one embryo does not increase the chances of becoming pregnant only the chances of having a multiple pregnancy and the associated risks.
Embryo Freezing
If you decided before treatment to store any further good quality embryos for further cycles, you’ll be consulted again, and it will happen at this stage.