So you are considering fertility treatment. It’s an exciting but uncertain time for many. At Thérapie Fertility we know it can be very overwhelming when you take those first steps to consider your fertility options. And so, we’ve put together a series of easy guides to help you understand all the options available to you. Today, we will discuss IVF.
To put it simply, IVF or In Vitro Fertilisation is fertilisation that happens outside of the body. It is literally translated as ‘fertilisation in glass’.
The first successful IVF baby was born in 1987 in Manchester, England. Since then, millions of babies have been born through IVF treatment and modern fertility treatment has come on in leaps and bounds.
Ok… so let’s start at the beginning. There are a number of reasons why you might need to access IVF treatment. You may have already tried IUI and decided that it’s time to switch to an IVF cycle. Maybe you are a same sex couple trying to start your family. Or perhaps you are a single person who wants to become pregnant. Whatever your reasons for choosing IVF, read on to understand the process and find out how it all works.
This is something that everyone always wants to know at their first appointment! Will it work the first time around? How much money will I spend before we have a baby? Unfortunately there is no one right answer to that question. Most clinics will quote a success rate of around 30-35% per IVF cycle. As with all aspects of fertility treatment, this could vary dramatically depending on your individual circumstances. For some, they become pregnant on their first cycle of IVF. For others it can be a much longer process. Your doctor will talk to you about all of this and answer any questions you might have.
There are 4 main stages to an IVF cycle. These are ovarian stimulation and monitoring, egg retrieval, fertilisation and culture and finally the embryo transfer.
In a normal menstrual cycle, only one egg (sometimes two!) is released. The whole concept behind a cycle of IVF is that you are getting your body to supercharge that process. So instead of producing one egg, you are trying to produce multiple eggs. Some people will produce 3 or 4 eggs in a cycle of IVF and others up to 30. You begin the cycle of IVF by taking fertility medications which help your body to grow additional egg containing follicles.
Throughout the process of ovarian stimulation, you will be monitored via regular ultrasounds and blood tests. Once it is confirmed via ultrasound that your ovarian stimulation is complete, you will use a ‘trigger injection’ to ensure the final maturation of the eggs and they will begin to loosen from the follicle wall.
Approximately 36 hours after the trigger injection, the egg collection will be performed. This is under light sedation and usually takes between 20-30 minutes. A needle will be passed through the vaginal canal and into each ovarian follicle. The ovarian fluid will be extracted and then studied under a microscope to look for eggs.
Once you’ve retrieved your eggs, they will then be fertilised with the sperm of your partner or a sperm donor in a fertility lab by an embryologist. This can take place using standard IVF where the eggs are ‘mixed’ with sperm in hopes of fertilisation. You can also use a process called ICSI (intra cytoplasmic sperm injection) where a single sperm is selected and then injected directly into the egg.
The fertilised eggs will then be allowed to develop for either 3 to 5 days under the careful watch of the embryologist. An embryoscope can also be used to aid this process.
There are two options when it comes to the Embryo Transfer. You can have a fresh embryo transfer directly following on from your egg retrieval. Or you can do a frozen embryo transfer at a later date. There is a high rate of success using both fresh and frozen embryos and it really is up to your individual circumstances as to whether you want to do the transfer immediately or not.
The embryo transfer itself is very straightforward. You do not need to be under any sedation and it will only take 15 minutes or less. For most it will feel like a smear test, slightly uncomfortable but not painful and over before you know it!
Generally, only one embryo is transferred, or two in exceptional cases – this will depend on your individual circumstances and embryo quality. A catheter is inserted directly through the cervix and the embryo is passed through fluid into the womb. Once the transfer has taken place you will stay there resting for a period of time. You can then go about your day as normal. Even though it may feel like you want to stay still and protect the precious cargo you now have on board, it’s perfectly safe to continue on with your usual activities.
The waiting game…
Following on from your embryo transfer, you will have to play the waiting game. In approximately two weeks time you will be asked to return to the clinic to have your bloods taken and your HCG levels will be measured to check if the embryo transfer has been successful. HCG is the pregnancy hormone, and helps us to determine if your treatment has been successful or not.
This period of time is called the ‘two week wait’ and for most people it’s often the hardest part of the IVF process. You literally have to wait and see. It’s not advised to take a home pregnancy test during this period as they have been known to sometimes give a false positive/negative result, causing undue stress. However, most people will tell you that they secretly do one at home anyway. Either way, the best way to confirm a positive pregnancy is through the blood test.
Once you’ve had your bloods taken at our clinic, one of our team members will call you within 24 hours to give you the results. If it’s good news and there is an appropriate level of HCG in your blood, you will probably return another few days later to check that the HCG levels are rising as would be expected.
A couple of weeks later, all going well, you will be brought back to the clinic for an early pregnancy scan. At this point, if a viable pregnancy is confirmed you will be discharged back to the care of your own GP and maternity services.
If you have not become pregnant through the embryo transfer, it’s natural to feel disappointment and grief. Some may wish to plough on and continue the next stage of treatment and others may need to take some time to process it all. Whatever you need, your clinic is there to support you and help to make the best decision going forwards.