IVF is the most effective form of assisted reproductive technology. IVF treatment involves the fertilisation of an egg (or eggs) outside the body. The treatment can be performed using your own eggs and sperm, or using either donated sperm or donated eggs, or both.
Your chances of having a healthy baby using IVF depend on many factors, such as your age and the cause of infertility. In addition, IVF can be time-consuming and expensive. Your doctor can help you understand how IVF works, the potential risks and whether this method of treating infertility is right for you.
Is IVF for me?
The doctor may recommend IVF if:
- you have been diagnosed with unexplained infertility
- your fallopian tubes are blocked
- other techniques such as fertility drugs or intrauterine insemination (IUI) have not been successful
- the male partner has fertility problems
- you are using your partner’s frozen sperm in your treatment and IUI is not suitable for you
- you are using donated eggs or your own frozen eggs in your treatment
- you are using embryo testing to avoid passing on a genetic condition to your child. How does IVF work?
- IVF techniques vary according to your individual circumstances and the approach of your clinic. Before your treatment starts, you will need to complete various consent forms. The couple may also need to have blood tests to screen for HIV, hepatitis B, hepatitis C, etc.Treatment then involves the following stages:
Step 1. Boosting the egg supply
You will be given a type of fertility hormone known as a gonadotrophin. You will usually take this as a daily injection for around 12 days. The hormone will increase the number of eggs you produce.
Step 2. Checking on progress
The clinic will monitor your progress throughout the drug treatment through vaginal ultrasound scans and, possibly, blood tests. Between 34 and 38 hours before your eggs are due to be collected you will be given a hormone injection- human chorionic gonadotrophin (hCG) to help your eggs mature.
Step 3. Collecting the eggs
Your eggs will be collected using ultrasound guidance while you are sedated. You may experience some cramps, feel a little sore and bruised and/or experience a small amount of bleeding from the vagina. After your eggs have been collected, you will be given medication in the form of pessaries, injection or gel to help prepare the lining of your womb for embryo transfer.
Step 4. Fertilising the eggs
Your eggs will be mixed with your husband’s or the donor’s sperm and cultured in the laboratory for 16–20 hours after which they are checked for signs of fertilisation.
Those that have been fertilised (now called embryos) will be grown in the laboratory incubator. The embryologist will monitor the development of the embryos and the best will then be chosen for transfer. Any remaining embryos of suitable quality can be frozen for future use.
Step 5. Embryo transfer
The number of embryos transferred is restricted because of the risks associated with multiple births. During the procedure, the doctor will insert a speculum into your vagina. A fine tube (catheter) is then passed through the cervix using ultrasound guidance. The embryos are passed down the tube into the womb.
This is normally a pain-free procedure and usually no sedation is necessary, but you may experience a little discomfort because you need a full bladder if ultrasound is used.
Around the time your partner’s eggs are collected, you will be asked to produce a sample of sperm.
The sperm will be washed and prepared so the active, normal sperm are separated from the poorer-quality sperm.
If you have stored sperm, it will be removed from frozen storage, thawed and prepared in the same way.
What is intra-cytoplasmic sperm injection (ICSI) and how does it work?
Intra-cytoplasmic sperm injection (ICSI) differs from conventional in vitro fertilisation (IVF) in that the embryologist selects a single sperm to be injected directly into an egg, instead of fertilisation taking place in a dish where many sperm are placed near an egg. ICSI enables fertilisation to happen when there are very few sperm available.
ICSI involves same steps as IVF. The method of fertilising the egg differs otherwise the procedure is similar. There are specific situations in which ICSI is recommended by the doctor.
Zero sperm count
If you have a zero sperm count, the sperm can be retrieved surgically by PESA, TESA or TESE