In Vitro Fertilisation (IVF) is used to treat a wide range of fertility problems including unexplained fertility. During the IVF process, the ovaries are stimulated to develop several eggs, these are removed from the ovaries and fertilised with sperm prepared in the laboratory. The fertilised egg then develops into an embryo which is replaced back into the womb.
Why is In Vitro Fertilisation (IVF) performed?
This treatment is an option which can help a woman to become pregnant, in the case of infertility problems, such as:
- Blocked or damaged fallopian tubes
- Advanced maternal age
- Male factor infertilities
- Unexplained infertility
What happens during In Vitro Fertilisation (IVF)?
IVF requires several steps to achieve ultimate success:
Naturally, the ovaries only produce one egg each month. However, if you are undergoing IVF treatment and only one egg is available, the chances of pregnancy are significantly reduced. With the use of some hormone medications we can control the ovaries, encouraging them to develop several eggs at the same time. This process is known as ovarian stimulation.
The eggs develop within tiny fluid filled sacs on the ovary, known as follicles. The follicles respond to the medication you’re taking every day and subsequently grow in size. As the eggs develop and mature to a point when they’re ready to be ovulated into the body. We track the development of the follicles by ultrasound and when they reach the correct size, you’ll need to take a final injection to start the ovulation process. However, before the follicles ovulate, we will collect eggs from them through a simple egg collection procedure.
The eggs are recovered from the ovaries using a fine needle, which is guided with an ultrasound probe directly into the follicles on the surface of the ovaries. The eggs are collected quickly and painlessly as the procedure is performed under sedation provided by an anaesthetist. Typically, the egg collection lasts fifteen to twenty minutes. The eggs are collected by the embryologists in the laboratory, after which they are quickly transferred to an incubator which almost identically matches the natural environment for the eggs.
If you’re undergoing treatment with a male partner they will accompany you to the clinic where the sperm must be produced or if using frozen or donor sperm the samples will be thawed on the morning of egg collection. The eggs and sperm are then mixed together in the laboratory in carefully controlled conditions. If the sperm quality is low, a procedure known as ICSI is necessary, the sperm will be microinjected into each mature egg at this time.
The embryos are transferred back into the uterus three to five days after the day of egg collection. The embryo transfer is usually a completely painless procedure similar to having a cervical smear test. Typically, in younger women with good quality embryos only one embryo, which has reach development to day 5 will be recommended for transfer back to the womb.
However, in women over 40 years old being treated with their own eggs, a maximum of 3 embryos may be transferred. The Aria team will make recommendations to each patient, individually based on the quality of the embryos and your own medical history.
When the embryos are transferred back into the body they’re placed in the middle of the cavity of the uterus. This procedure usually only takes just a few minutes. The embryos do not implant (embed) in the uterus straight away. This only occurs when the embryos are 6 or 7 days old.
To make the lining of the uterus as receptive as possible to the embryos you’ll be given progesterone pessaries. We will ask you to commence these the day following the egg collection and taken every day until a pregnancy test is performed 10-12 days after the embryo transfer. If you’re pregnant, these pessaries will be continued until 10 to 12 weeks of pregnancy.
The first step when considering any fertility treatment is to visit your GP, who can refer you on to a specialist, or to visit a private fertility specialist or clinic. Once at the clinic, the specialist will speak to you about your fertility history and conduct an necessary investigations.