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The IVF process

What does the process of IVF involve and what should you expect?

 

Women having IVF treatment will be given a course of fertility drugs. A nurse will train you on how to inject these drugs at home so you don't have to travel into the clinic every day. The type of course of drugs you undergo will be determined by your fertility specialist based on your individual clinical needs.

You may be advised to go on a short course of drugs, known as an antagonist protocol. In this instance you will start your stimulation injections on days two to three after your period begins, with another type of injection added on day six. Both will then be continued for an average of 14 days before you are ready to have your eggs collected.

Alternatively, if you are advised to go on a longer course of drugs, known as an agonist protocol, you will be given an ovarian suppressant injection seven days before your period is due and then injections of gonadotrophin for 10-14 days (starting on days five to twelve after your period begins. 

These courses of medication stimulate the development of follicles in the ovaries, which contain eggs. While you are taking medication you will be monitored very closely in order to determine the ideal timing for your egg collection. Ultrasound scans are performed regularly (approximately two or three times per week) at the Centre in the run-up to egg collection in order to see the developing follicles. Blood samples may also be taken to measure hormone levels alongside the scans.

A final, single injection of hormone is given 36 hours before your planned egg collection to ripen and mature the eggs prior to their removal. This is known as the 'trigger' injection and it causes you to begin ovulating.

The egg recovery is a short procedure, taking approximately 30 minutes. A fine needle is inserted through the upper vagina, guided by a vaginal ultrasound probe, to collect your eggs. Sedation is given to aid relaxation and minimise any discomfort. We recommend you take the day off work and most women are able to leave the clinic within three to four hours of the egg collection procedure.

If your partner is using their sperm for the IVF procedure, during the egg collection they will go in to our private men's room to produce a fresh sample. We ask that they abstain from ejaculating for at least three days, but no more than five days, beforehand as this ensures we have the healthiest possible sample.

Your eggs are taken into our laboratory to be mixed with your partner’s or donor’s sperm and cultured in the laboratory for 16-20 hours. They are then checked to see if any have fertilised.

Those that have been fertilised (now called embryos) are grown in the laboratory incubator for up to five days before being checked again. The best embryos will then be chosen to be used during the embryo transfer procedure.

Embryo transfer is a simple and painless procedure, which involves the transfer of fertilised embryos via a fine catheter inserted through the cervix into the uterus. Embryo transfer is usually carried out with the use of an ultrasound scan. The law allows a maximum of two embryos for women below 40 years of age and maximum of three embryos for women of 40 years and above.

Following embryo transfer you will undergo additional hormone treatment, receiving progesterone until a pregnancy test is performed 14 days after the egg collection. Progesterone can be administered as an injection, or vaginal or anal pessaries or suppository. You will return to the centre for a pregnancy blood test 14 days after your egg collection has taken place, regardless of whether you have begun a period.

If the pregnancy test is negative you will be offered a free follow-up appointment with one of our fertility specialists to discuss the cycle and your options. If you have a positive pregnancy test you will have a pregnancy scan three weeks later. 

Wikipedia has a fantastic page on IVF. Learn more here