In Vitro Fertilisation is the process of fertilising eggs outside of the body. It is the basis of most fertility treatments. Our individualised approach means that every couple will vary in how their treatment is planned and managed.
Stimulation and monitoring
IVF cycles begin by taking hormonal injections for the ovary to develop a relatively high number of mature eggs during a treatment cycle. Monitoring by scans and blood tests is carried out throughout the treatment so we can track the response to the drugs.
At the ARGC, we aim to keep the amount of medication used during an IVF cycle to a minimum while still ensuring the best possible chances of success. Some people may prefer not to use any medication in which case a natural cycle IVF may be considered. This means only one or two eggs may be collected.
Egg collection and the sperm sample
When the eggs are ready, a ‘trigger’ injection is given that initiates the process of ovulation. Mature eggs will be collected approximately 36 hours later by a doctor during a short procedure called the ‘egg collection’.
Close to the time of egg collection, the sperm sample prepared in the laboratory to put with the eggs. If the sperm needs some help to fertilise the eggs, because there are low numbers of sperm or the sperm may be not be moving as quickly as they need to, we may suggest Intra-cytoplasmic sperm injection (ICSI). This is where the embryologist selects a single sperm and injects it into an egg to help it fertilise. Percutaneous Epididymal Sperm Aspiration (PESA) and Testicular Sperm Aspiration (TESA) are surgical techniques used to collect sperm if it is not produced in the ejaculate. The ARGC is proud to be a pioneer in the field of ICSI with a team of experienced embryologists who carry out the procedure.
The day after the egg collection, the eggs are examined to see how many have fertilised and started to develop as embryos. The embryos are cultured in the laboratory under specific conditions, which mimic the natural environment. Whenever possible, embryos are cultured for five days, at which time they reach ‘blastocyst’ stage, and it becomes easier to select the best embryos for transfer. Sometimes, based on your medical history it may be advised to genetically test the embryos in order to check that they have the correct number of chromosomes or are not carriers of a genetic condition.
Two to five days after the egg collection, depending on the age and medical history, an appropriate number of embryos (between one and three) will be selected and placed into the uterus. If any healthy embryos are left over, these can be frozen using a technique called vitrification and stored for future use. Two weeks after the egg collection, a pregnancy test is performed at the clinic.
A frozen embryo transfer (FET) cycle can be undertaken in either a natural or in a hormone controlled cycle. Monitoring using ultrasound scans and blood tests will be used throughout your treatment to identify the best time to thaw the embryos and place them back into your uterus.
Outcome of treatment
If the pregnancy test is positive, careful monitoring of your early pregnancy will continue using blood tests to adjust if necessary the medication prescribed to support the pregnancy. An ultrasound scan is usually performed two weeks later to check that the pregnancy is viable. You may then wish to return to their own gynaecologist or GP for further follow-up, alternatively, we may recommend further care at ARGC depending on your past history and the need for further medication. We ask all our patients to keep in touch throughout and notify us of the outcome of their pregnancy.
If the pregnancy test is negative you will be offered a review consultation to discuss further options.