In Vitro Fertilization (IVF) is one of the most widely discussed fertility treatments out there. But, what does it involve? TFP Fertility Group, one of the UK’s largest IVF providers and fertility specialists, gives a ‘beginners guide to IVF’, with advice on what to expect from IVF treatment, in a straightforward and simple format.
What You need To know About IVF
What is IVF?
In short, IVF involves fertilising an egg with a sperm in an incubator, with the aim of achieving a pregnancy.
After stimulation, eggs are collected from the ovaries following stimulation with drugs. The eggs are then fertilised with sperm in the laboratory. The fertilised egg (embryo) is then allowed to develop for up to 5 days, before being transferred back into the womb.
Who Requires IVF Treatment?
After your initial tests, your consultant will review your results and advise you on the best fertility treatment options for you. Patients are often surprised to hear that IVF is not the only treatment option available to them. That said, IVF is usually the first fertility treatment for patients with certain conditions.
These conditions commonly include tubal ligation, tubal disease or severe male infertility. In the case of tubal ligation or tubal disease where tubes are blocked, a pregnancy can be achieved by bypassing the fallopian tubes.
Other diagnoses where IVF treatment can increase the chances of a successful pregnancy include endometriosis, advanced age, ovulatory disorders, unexplained infertility and delay in conceiving. Treatments such as intracytoplasmic sperm injection (ICSI) allow one healthy sperm to be injected into an egg, allowing patients the opportunity to overcome male infertility.
The key steps in the IVF process include:
Step 1:
Enquiry - It is not necessary for you to have a referral from your GP in order to begin treatment. With TFP Fertility Group, you can self-refer by getting in touch directly.
If you are eligible for NHS IVF treatment, then your GP or referral clinic will be able to inform you if you are able to receive treatment.
Step 2:
Preliminary tests - For your doctor to make an informed decision about your treatment at your first consultation, they will need some preliminary test results. These tests include an ovarian reserve and semen assessment.
What’s involved in fertility testing?
Tests for ovarian reserve include:
- AMH test (Anti-Müllerian Hormone)
- Transvaginal scan (internal scan) to count the number of follicles (small fluid-filled sacs)
Further tests may be required based on the type of fertility treatment that you require. These can include:
- Tubular patency test (HyCoSy)
- Saline sonogram and 3D scan (to assess the cavity of the womb)
- Sperm Analysis
- Screening for infectious diseases (this is required prior to starting fertility treatment)
Step 3:
Beginning Treatment - On day 1 of your period, you will need to call your clinic. You will be instructed to begin the treatment plan, which you have discussed in-depth during your consenting appointment with a member of the nursing team. It may be necessary for you to regulate your cycle by taking medication prior to starting the treatment.
Step 4:
Stimulation - An important part of your IVF treatment involves stimulating the ovaries, in order to allow the clinic to collect multiple eggs. Naturally, your body will typically release one egg during your monthly cycle and so to collect more than one, stimulation is necessary.
What is involved with stimulation?
To stimulate your ovaries, you need to administer injections at home – during an earlier appointment you will be shown how to do this.
During the first 2 weeks of your stimulation, the growth of egg producing follicles will be monitored. The clinic will conduct this monitoring through scans (typically 1-3 scans) and blood tests.
Appointments for this are held at the clinic and they are typically short (around 20-30 minutes) and the results will become available on the same day. The exact timings of these appointments will be tailored to the individual needs of each patient.
Step 5:
Stimulation period ends - The monitoring of the growth of your egg-producing follicles will allow us to know when the best time is to end your stimulation period. In order to end your stimulation process, a trigger injection needs to be administered as this matures the eggs within the follicle, making them ready for collection. The clinic will advise you of the optimum time to administer this injection. Typically, 80% of follicles contain an egg.
Step 6:
Egg collection - In the hours following your trigger injection, you will have an appointment for your eggs to be collected. During your appointment, you will undergo a procedure in theatre, for which you will be given a sedative. The sedative is mild and will cause you to become sleepy.
The procedure will take around 30 minutes, after which you will rest at the clinic before being allowed home the same day.
Step 7:
Sperm collection - Depending on your treatment, your means of sperm collection will be determined before you begin your IVF treatment.
Step 8:
Insemination - Once egg and sperm collection has taken place, insemination can occur. The sperm sample provided is tested to select the best sperm for use during insemination. The way in which insemination occurs is different, depending on your treatment plan.
Step 9:
Embryo development - Shortly after egg collection, you may start taking drugs that help prepare the lining of your uterus to receive an embryo and support your pregnancy.
Step 10:
Embryo transfer - Your consultant will decide the best time for your embryo transfer to take place, typically this will occur 5 days after your egg collection. Factors such as the number and quality of your embryos are taken into consideration by the consultant.
Step 11:
‘The Wait’ - Step 14 is a two-week wait to see if your embryo transfer has been successful. Typically you will need to wait 15 days after egg collection before you take a pregnancy test around two weeks later.
For more information about TFP Fertility Group, visit www.tfp-fertility.com