For a pregnancy to occur, an egg must be fertilised by a sperm. Naturally, this occurs following unprotected sexual intercourse. However, there are a number of medical conditions and factors that may prevent successful fertilisation.
IVF sidesteps these barriers by fertilising the egg with sperm in a laboratory dish. The newly formed embryo (fertilised egg) is then grown and transferred back into the woman’s uterus (womb), where it will develop for the remainder of the pregnancy.
Normally, one egg is released from a woman’s ovaries approximately every month. However, for IVF to increase the chances of a successful pregnancy, it helps to collect a number of eggs at one time. This requires stimulation of the ovaries with a self-injected medicine for 8–14 days. When the time is right, the eggs are collected. This is done in surgery, under sedation, and takes 20–30 minutes. On average, 8–12 eggs are collected, depending on a variety of factors, including age and medical conditions.
At the same time as the eggs are retrieved, sperm must be collected from the male partner — most often, this is done via self-collection on the day of egg retrieval. Alternatively, frozen sperm can be used, after thawing.
Once the egg and sperm are retrieved, they are combined in a laboratory dish. This can occur in one of two ways. Normally, we utilise standard insemination — the egg, which sits in a laboratory dish, is exposed to thousands of sperm. The fittest sperm will fertilise the egg and in this sense, the process is ‘natural’. However, if sperm counts are low or there are abnormalities of the sperm, an additional procedure called ICSI (intracytoplasmic sperm injection) may be used. As the name suggests, this involves direct injection of a sperm into the egg with the aim of fertilisation. It is important to note that not all eggs will be successfully fertilised.
If fertilisation is successful, the resulting embryos are grown in an incubator designed to mimic the conditions of the female body. In this incubator, the embryo will divide over the next 5 days, and will then be ready for transfer into the woman’s uterus. Unfortunately, not all embryos will survive to this point. Embryos that successfully reach this stage can be used fresh or frozen until required for transfer in a later IVF cycle.
Embryo transfer is a simple procedure. Under ultrasound guidance, the embryo is released into the uterus in the hope that it will ‘stick’ and result in a pregnancy. Generally, only one embryo is transferred at a time. The transfer is done using a long, thin instrument placed through the woman’s vagina and cervix. It feels similar to a pap test — there’s no use of anaesthetic, and the woman can promptly resume her day following the procedure.
Ten days after the embryo transfer, a blood test is done to see if the woman is pregnant.
If you’re concerned about your fertility and would like to seek advice from a fertility specialist, you will need a referral from your GP.
During your initial consultation, we work hard to understand the reasons for your fertility issues and tailor advice specific to your individual situation. This involves taking a thorough medical history from you, performing relevant examinations and ordering appropriate tests. We will consider a number of options for helping you conceive before making a decision about IVF.
If it is decided that IVF is appropriate, your fertility specialist will register you with Newlife IVF. At this stage, mandatory tests, such as screening for infectious diseases, will be conducted (if these have not been done previously).
A compulsory session with one of our counsellors is required before starting IVF treatment. Both partners (if applicable) must attend this meeting. We will also schedule a finance meeting with you to make sure you understand all the costs associated with your treatment. You will also meet with one of our fertility nurses, so they can take you through all the logistical details of your treatment, including any required medications and procedures. During these meetings, you will have ample opportunity to ask questions.
Once all of the above steps have been completed, you’re ready to start treatment.
Your fertility specialist will care for you throughout the first 10 weeks of your pregnancy. If your fertility specialist also practises obstetrics, you can choose to remain under their care for the duration of your pregnancy. If your fertility specialist does not practise obstetrics, they will arrange a referral to the obstetrician of your choice for ongoing pregnancy care.