A typical IVF treatment cycle consists of:
IVF means In Vitro Fertilisation. This is where the fertilisation of the egg by the sperm takes place literally in glass (In Vitro) outside the body, in our laboratory. Your IVF specialist will discuss your infertility with you in detail. If the decision has been made to proceed to IVF or a related procedure you will be given verbal information during the consultation about the procedure you will have, the likely effects and the success rates. You will then see a nurse coordinator.
Prior to starting treatment both partners will have a check for blood groups, Hepatitis B, Hepatitis C, HIV and Vitamin D. Rubella immunity, chlamydia and anticardiolipin antibodies will also be checked in women.
An up-to-date semen analysis will be arranged with our laboratory.
We aim to use a combination of drugs to stimulate the ovaries so that you may develop a number of follicles. We can then recover eggs from these follicles for fertilisation and embryo development.
The drugs used will be chosen to suit what we believe to be your clinical needs. We will assess your age, infertility type and previous responses to IVF treatment (if applicable).
Injections usually span a 7-12 day period prior to an ultrasound scan. The ultrasound scan takes about 10 minutes depending on the number of follicles to be measured. It is important to remember that the ultrasound cannot determine if there is a healthy egg in the follicle, as these eggs are microscopic.
The average number of eggs we retrieve is 10 but this can vary.
A cycle may be cancelled if egg numbers are predicted to be greater than 20.
Following the ultrasound a blood sample may be collected for hormone assessment.
By using this information and the number of days of stimulation which you have had, we can best decide the most appropriate day for retrieving the eggs for fertilisation.
On the day of egg pick up you will arrive at Albury Day Surgery half an hour before your procedure having fasted for the previous six hours. You will be admitted to hospital and prepared for theatre.
Arrangement will be made for the semen collection and the semen sample will be given to the scientists.
In theatre the gynaecologist will guide a needle through the vagina into the ovaries and proceed to empty the fluid from the follicles. This fluid is then passed through to the scientist who, using a microscope, will search for the eggs. The procedure lasts about 20-30 minutes and is normally conducted under General Anaesthetic.
A semen sample is required, or in some cases, more than one sample is necessary on the day of the egg collection.
It is important to re-emphasise here that if the man anticipates having any problems with collecting the specimen he should speak to the coordinator well before the day of egg retrieval so that alternative arrangements can be made. If necessary, a special condom can be used which does not harm the sperm, or semen can be frozen and stored as a backup.
Once the eggs have been collected, they are placed in culture dishes in the incubator. When the sperm sample has been collected, the scientists separate the more normal and more motile (moving) sperm. These sperm are used for the insemination.
The day after insemination, the eggs are checked to confirm that fertilisation has occurred. 70% of eggs will usually fertilise. Most of these fertilised eggs will divide to form embryos. A small proportion will not develop into embryos.
An IVF scientist will phone you the day after the egg retrieval to give you the fertilisation details and arrangements for the embryo transfer.
This simple procedure is performed at Albury Day Surgery. The embryos are transferred into the cavity of the uterus using a very fine catheter which is passed through the cervix (neck of the uterus). This procedure is normally no more uncomfortable than a pap smear test and no anaesthetic is required. It helps if you empty your bladder just before the embryo transfer is performed. Your partner may be present at the procedure.
You should be able to leave Albury Day Surgery 10-15 minutes after this procedure is performed and you should be able to return to work that day.
Arrangements will be made for you to have a pregnancy test performed on the appropriate day after embryo transfer. This test should be done even if bleeding has occurred because some pregnancies can continue despite vaginal bleeding. Importantly, some women can have an ectopic pregnancy following IVF and embryo transfer and have what seems to be a normal period. If you do not have the pregnancy test we will not be alerted to the possibility of an ectopic pregnancy.
If you are using Crinone, progesterone pessaries and/or hCG injections post embryo transfer, you may not have had a period by the time your pregnancy test is done. This is because the function of these drugs is to support the lining of the uterus thus sometimes preventing a menstrual period from occurring.
For those who become pregnant, ultrasound examination will be arranged for a date three weeks after the positive pregnancy test.
This ultrasound scan is to determine that there is a viable (living) pregnancy inside the uterus. About 18-20% of all pregnancies diagnosed on a blood test will be found to be non viable.
Should you not be pregnant you may wish to wait a while before undertaking further treatment. A feeling of disappointment and sometimes despair is common at this time and this is one of the important times for you to feel able to call our nurse coordinators, counsellor or gynaecologist.
It is important that you have a realistic view of your chances of success with treatment.