In Vitro Fertilisation (IVF)

In vitro fertilisation (IVF) is a type of assisted reproductive technology that involves fertilising eggs with sperm in a laboratory to create embryos.

What does an IVF treatment involve?

 

An IVF treatment involves undergoing ovarian stimulation with the aim of generating a multiple number of eggs. The eggs, once fertilised in the laboratory with sperm from a male partner or donor, begin to develop into embryos. The highest quality embryo will be transferred to the uterus with the purpose of achieving a pregnancy. Embryologists will cryopreserve any remaining embryos for future use.

This treatment improves the chances of conceiving for several reasons:

  • The ovaries are stimulated with gonadotropins to grow a multiple number of ovarian follicles. By controlling the growth and maturation of the follicles, more than one egg can be retrieved from the ovaries in a single cycle, increasing the chances of pregnancy by having multiple eggs to fertilise and develop into viable embryos.
  • The sperm sample, from either the male partner or a sperm donor, is prepared in the laboratory to ensure it contains only the highest quality sperm.
  • Once the eggs are fertilised, the embryos are monitored as they grow in the laboratory and embryologist select the embryo with the best developmental potential to be transferred.
  • The embryo transfer is scheduled to take place at a time that is optimal for implantation in relation to the thickness of the endometrium.

In which cases is it recommended?

IVF treatment is recommended in the following cases:

The IVF process – step-by-step

Ovarian stimulation
1

Ovarian stimulation

Treatment begins with ovarian stimulation, which involves taking daily injections of hormones self-administered at home. This step is timed to the menstrual cycle and lasts for approximately 10 – 12 days. Women normally produce one egg with each natural cycle. Ovarian stimulation increases the chances of success by encouraging multiple follicles to grow and allows a greater number of eggs to be collected.

Follicular tracking and preparation
2

Follicular tracking and preparation

During ovarian stimulation, the growth of the follicles is closely monitoring with regular ultrasound scans until our specialists can verify the follicles have reached an adequate number and size.

Egg collection
3

Egg collection

Once the follicles have reached the right stage in their development, we induce ovulation using a trigger injection. An egg collection is scheduled 36 hours later. During this short surgical procedure, clinicians aspirate the follicles to collect the eggs contained inside. An egg collection is performed under sedation and lasts for no more than 15 – 20 minute to avoid any possible discomfort.

IVF or ICSI
4

IVF or ICSI

The eggs are fertilised in the laboratory by introducing a prepared sperm sample from the male partner or a donor.

There are two ways to fertilise the eggs:

  • Conventional IVF: This involves mixing each egg with drops of prepared semen in a culture dish to simulate the natural fertilisation process.

  • Intracytoplasmic Sperm Injection (ICSI): This technique involves injecting a single, healthy sperm cell into the centre of a mature egg to assist fertilisation.
  • Embryo culture
    5

    Embryo culture

    Embryo culture lasts for 5 – 6 days. After fertilisation, the embryos begin their development in special incubators with a culture medium that provides them with everything they need to grow. During this time, embryologists monitor and analyse their development in order to assess their quality.

    Embryo transfer
    6

    Embryo transfer

    Before the transfer, we assess the thickness of the endometrium to ensure it is optimal to receive the embryo and facilitate pregnancy. The best quality embryo is transferred to the womb using a thin catheter. An embryo transfer is a quick and simple procedure and does not require anaesthesia.

    Pregnancy test
    7

    Pregnancy test

    A blood pregnancy test is scheduled 11 – 12 days later. If the result is positive, an early pregnancy scan is scheduled 20 days later. Once discharged, you can begin your antenatal care with the NHS or a private provider.

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    Frequently Asked Questions

    ‘In vitro’ means outside of the body. By allowing fertilisation to take place in the controlled environment of the laboratory, we can help patients overcome a wide range of fertility problems. To start with, a woman’s eggs are obtained using follicular aspiration and introduced to an optimised sperm sample. We can do this using conventional IVF or intracytoplasmic injection (ICSI). After 5 – 6 days of careful monitoring, the developing embryos are ready for transfer to the woman’s uterus.

    IVF has higher live birth rates than less complex treatments such as IUI. With IVF, we can evaluate the ovarian reserve and gain important information about egg and embryo quality. In cases of male factor infertility, ICSI can be performed as part of IVF. ICSI is an assisted fertilisation technique that helps men overcome problems caused by semen abnormalities. With ICSI, we only need one spermatozoon to fertilise the oocyte therefore, it can treat the most severe cases of male infertility.

    IVF is often used to overcome infertility caused by tubal blockages. Blocked fallopian tubes can occur for a number of reasons, including endometriosis, pelvic diseases and inflammation. In these circumstances, it is not possible for the sperm to reach the egg without an intervention such as IVF.

    The approximate cost of an In Vitro Fertilisation (IVF) treatment varies depending on your specific requirements. All our IVF packages include the essential parts of your IVF treatment, such as monitoring blood tests and scans, egg collection, sperm preparation and embryo creation. The amount of medication required during a treatment cycle varies from patient to patient, so we must charge for this separately. Following your initial consultation at IVI, we will provide a treatment plan with a complete breakdown of costs, including medication, so you will know the final total before you proceed.

    From start to finish, an IVF cycle takes approximately 4 – 5 weeks. This includes:

    • Pre-treatment tests and treatment planning
    • Ovarian stimulation
    • Egg collection, fertilisation and embryo development
    • Embryo transfer
    • The duration until the blood pregnancy test (10 – 12 days after the transfer)

    The chance of having a successful outcome with IVF depends on a number of factors, with age being the variable with the most impact. Fertility decreases with age, and this is largely due to a natural decline in egg quantity and egg quality. For this reason, the chances of IVF success decrease as women get older. This means that while it is still possible, it may require more attempts than someone who is younger. This is why we advise women over 35 to see a specialist if they have not been able to get pregnant within six months of trying to conceive.

    By personalising stimulation protocols to the needs of each patient, IVI achieves IVF success rates nearly double the UK national average for women of all ages. You can view our success rates here.

    Ultimately, there is no reason why an IVF cycle should be painful.

    An egg collection is a short surgical procedure performed under sedation, so you should not feel any pain. You may experience some abdominal discomfort and light swelling after your egg collection; however, these temporary symptoms should disappear after the first few days.

    Nearly all women undergoing IVF will require hormones in the form of daily injections for 1 – 2 weeks. As pain is a subjective experience, these injections may be more uncomfortable for some patients. In any case, any discomfort caused by the injections only lasts a few seconds.

    Embryo implantation normally occurs within 6 – 8 days of fertilisation. This coincides with the embryo reaching the blastocyst stage. An embryo transfer normally takes place 5 days after fertilisation and within days, the blastocyst hatches from its outer shell (zona pellucida) and starts to attach itself to the endometrium.

    At the start of your treatment, it is unlikely you will notice any side effects. However, you may begin to experience abdominal discomfort and bloating as the ovarian stimulation progresses. This is due to the ovaries increasing in size because of your medication. Some patients describe it as a feeling of pressure in their abdomen where the ovaries are located. Some patients may also experience light bruising around the injection area.

    The duration of ovarian stimulation varies from person to person depending on how the ovaries respond to the medication as well as the type of protocol indicated by their consultant. Normally, we schedule the egg collection when the follicular growth is adequate, typically when the follicles reach 16 – 18mm in size. For most patients, the stimulation phase lasts 10 – 12 days.

    An egg collection, also known as an egg retrieval, is the procedure we perform to obtain the mature eggs from the ovarian follicles. We do by aspirating the fluid from each ovarian follicle using a small needle. The clinician passes the needle through the vaginal wall guided by ultrasound. It is a simple procedure, taking approximately 15 – 20 minutes, during which time we will sedate you. For this reason, the egg collection itself will not hurt, although it is common to experience some discomfort after the procedure. This will disappear in a matter of hours.

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