IVF – in vitro fertilisation – is a technique available to women with fertility problems who are trying to have a baby. The process involves an egg being removed from the woman’s ovaries and fertilised with sperm in a laboratory. Once the egg has been fertilised, the embryo is placed back into the woman’s womb to grow and develop into a healthy baby. The treatment can be performed using your own eggs and sperm, or by using donated eggs or sperm.
How do I know if IVF is for me?
IVF treatment will usually be recommended if you match certain criteria. For example, if:
- You’ve been diagnosed with infertility
- Your fallopian tubes are blocked
- Your male partner has fertility problems
- Fertility drugs haven’t been successful
What happens during IVF?
IVF techniques will vary from person to person. A fertility specialist will talk you through the process prior to beginning your treatment, which will typically involve the following:
- Suppressing your monthly menstrual cycle
You’ll be given a medication that will suppress your natural menstrual cycle. You can administer this medication yourself via a daily injection or a nasal spray. This treatment will continue for around two weeks.
- Boosting the egg supply with hormone injections
Once your natural cycle has been suppressed, you’ll be given a type of fertility hormone known as a gonadotrophic. You’ll usually have to take this as a daily injection for up to 12 days and this will help increase the number of eggs you produce. Women respond to fertility drugs in many different ways – you might experience strong side effects, but your doctor will monitor you closely so that you are cared for if this happens.
- Checking the progress
Ultrasound scans will be offered to monitor how many eggs you’re producing and how they’re responding. Around 34-38 hours before your eggs are due to be collected, you’ll be given a hormone injection to help them mature. This is likely to be human chorionic gonadotrophin (hCG).
- Collecting the eggs and sperm retrieval
An ultrasound is used to detect when your eggs are ready to be retrieved. Your doctor will then remove the eggs from your ovaries, using a fine, hollow needle attached to an ultrasound scan probe. The probe helps locate the follicles that contain the eggs. You might feel mild discomfort during the procedure but it shouldn’t last, and if you do feel pain later your fertility specialist will prescribe you painkillers.
While your eggs are being collected, your partner will be asked to provide a fresh sperm donation. If you’re using donated sperm, a frozen sample will be taken from storage. The sperm will then be combined with the eggs in a dish and left to culture in an incubator.
- Fertilisation and embryo transfer
After 16-20 hours, the dish is checked to see if any eggs have been fertilised. If they have, they’ll be kept for between two to five days before being transferred back into the uterus. In some cases, each egg may need to be injected individually with a single sperm. This is called intracytoplasmic sperm injection or ICSI (check out our Jargon Buster for a full list of fertility terms and definitions). You can also read about ICSI on the Human Fertilisation and Embryology Authority website.
The fertilised eggs continue to grow in a laboratory for up to six days before being transferred into the womb. The best one or two embryos will be chosen to transfer. Some clinics offer a pre-implantation test called comprehensive chromosome screening (CCS) – this screens embryos before they’re transferred – and only the embryos that are predicted to have a full set of chromosomes are selected.
After egg collection, you’ll be given hormone medication to help prepare the lining of the womb to receive the embryo. This is usually given as a pessary (placed inside the vagina), an injection or a gel.
- Embryo transfer
At this stage, the embryos are transferred into the womb using a thin tube called a catheter, which is passed into the vagina. This procedure is much simpler than egg collection and similar to having a cervical screening test (smear test), so you won’t need to be under general anaesthetic.
The number of embryos that are transferred is usually dependent on age. This will be discussed with you prior to the transfer.
Around the time that your partner’s eggs are collected, you’ll be asked to produce a sample of sperm. The sperm will be washed and prepared so that 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 should I do next?
You can book an appointment with your GP to see how you can improve your chances of having a baby. You may then be referred to a fertility specialist who can offer you treatments such as IVF.
If you’re considering IVF, be sure to gather as much information as possible, and ask your doctor about the chances of success associated with your age group and what care or patient support is available throughout the process.