IVF is a type of fertility treatment where fertilisation takes place outside the body.
IVF treatment is suitable for people with a wide range of fertility issues and is one of the most commonly used and successful treatments available for many people.
BASIC FACTS
Natural conception is when a mature egg has been released from the ovaries after ovulation a male sperm fertilises woman's egg inside her body. The fertilised egg then attaches itself to the wall of the uterus, or womb, and begins developing. If natural conception is not possible, fertility treatment is an option.
IVF helps achieve pregnancy if conceiving naturally fails. Usually in IVF, the woman take medicines (fertility hormones) to stimulate the ovaries to produce several eggs. The eggs are then collected and mixed with sperm in a laboratory.
IVF means fertilising an egg with sperm outside the body (in vitro), and implanting embryo, most commonly on 5th day of its development in laboratory, to continue the pregnancy.
Percentages of babies conceived and born through IVF rises every year.
IVF HISTORY FACTS
On 25th of July 1978, the first "test-tube baby," Louise Brown, was born. Robert Edwards and Patrick Steptoe, who were part of this world success, are considered to be the pioneers of IVF.
Robert Edwards received the 2010 Nobel Prize in Physiology or Medicine "for the development of in-vitro fertilisation."
In July 2013 the first baby was born through IVF as a result of next-generation DNA sequencing, a new way of screening embryos that improves IVF success rates. DNA sequencing technology enables to screen embryos to identify those most likely to lead to successful pregnancies.
IVF PROCEDURE ITSELF
IVF is referred to as a 'cycle' of treatment as it involves a number of stages: suppressing natural hormone production, hormone treatment to boost egg supply, egg collection, mixing the eggs and sperm and finally, embryo transfer. How long it takes depends on your recommended treatment.
For most people, one cycle of IVF takes from four to six weeks. However, for medical reasons some women won't have the first stage of treatment (suppressing hormone production) which brings their treatment time down to around three weeks. IVF Specialist will advise on the most appropriate treatment.
IVF Treatment in steps
1. Suppressing the natural menstrual cycle
By hormonal medication, usually in the form of a daily injection applied for about two weeks, the natural menstrual cycle is suppressed.
There are different ways this can be done. One way is to suppress natural hormones before taking hormone medication to stimulate the ovaries. This treatment, often called a long protocol, involves taking a daily injection or nasal spray to suppress hormone production. A scan checks the woman's natural cycle is fully suppressed.
Clinics may use the 'antagonist protocol'. This involves taking medication (an antagonist) to suppress your hormones for a few days after you have taken the hormone medication (usually gonadotrophin) to boost the number of eggs the body produces.
2. Super ovulation
Hormone treatment (usually gonadotrophin) is started to boost the number of eggs the body produces. Fertility medication containing follicle stimulating hormone (FSH) are applied. FSH makes more eggs to mature. The process in the ovaries is monitored by ultrasound.
3. Egg/sperm collection
Matured eggs are collected. The eggs are collected whilst under sedation or general anaesthetic. The procedure takes around half an hour. A very thin needle is under the ultrasound monitoring inserted by the doctor into the ovary. The needle is equipped with a suction device, collecting the eggs from each ovary. Collected eggs are either fertilised or cryopreserved for later use.
Whilst the eggs are being collected, the man is asked to come to the clinic to produce a sperm sample/or donor frozen sperm is used to fertilise eggs.
4. Insemination and fertilisation
The best quality eggs collected are used for fertilisation process. Modern assisted reproduction methods for egg fertilisation are used, such as intracytoplasmic sperm injection (ICSI), when the sperm is directly injected into the egg. Frozen sperm, cryopreserved from some reason such as retrieved through testicular biopsy, may be also used. Studies show to be it as effective as fresh sperm in achieving a successful pregnancy.
If fertilisation happens, the resulting embryo(s), will be monitored in laboratory to check how it's/they're developing. The fertilised egg divides and developes to an embryo.
At this point, if required, pre-implantation genetic diagnosis (PGD) takes place. PGD tests for genetic abnormalities and disorders. Embryologist chooses the best developing embryos for transfer and cryopreservation.
Medication will help to prepare the lining of the womb by giving progesterone or human chorionic gonadotrophin (hCG). This is usually taken as a pessary or gel which you can insert yourself into the vagina / rectum.
5. Embryo transfer
Embryo transfer is a procedure whereby embryo is placed into the uterus. It is a simple, painless procedure very much like a routine gynaecological exam.
Embryo is placed in the uterus through a thin catheter. The doctor inserts a speculum into the woman's vagina to keep the vaginal walls open. Using ultrasound for accuracy, the doctor will then pass a catheter through the cervix and into the womb. From there, the embryos are passed through the tube and into the womb.
IVF IS FOR
In-vitro fertilisation is advised to be considered for women who have not been able to become pregnant through regular unprotected intercourse after one year of trying.
Recommended for:
- Women with blocked or damaged fallopian tubes.
- People with unexplained fertility problems, or who have tried other treatments that were unsuccessful.
- Men with low sperm counts or who have high numbers of sperm with an abnormal shape or movement. Where these problems are serious an additional procedure (intracytoplasmic sperm injection or ICSI) may be necessary.
- Women who have difficulty with ovulation and who haven't been successful with other treatments.
- Older women who are less likely to be successful with less invasive treatments.
- People using surrogacy.
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