In Vitro Fertilization (IVF)
In natural conception, when an egg is ovulated each month, sufficient numbers of actively swimming sperm need to enter the cervix, work their way up the uterus and into the fallopian tubes. An egg must be released from the ovary and make its way down the tube to meet the sperm – the timing for all this needs to be right so that the egg and sperm can combine. Then, if the sperm successfully fertilizes the egg, the dividing egg makes it way back down to the uterus to implant into the lining of the womb.
A problem with any of these steps in the reproductive process may result in difficulties in becoming pregnant. There are a number of reasons why this process may not work efficiently and this is where IVF (in vitro fertilisation) can help. Whilst it is not a treatment cure for infertility, IVF can overcome issues that obstruct natural conception and help people who can’t conceive naturally to have a baby. The IVF procedure includes a number of steps:
- A woman’s ovaries are stimulated with fertility drugs to produce multiple mature eggs
- The eggs are then collected from her body
- Her eggs are then fertilized with her partner’s sperm in the embryology lab.
- The resulting embryos are cultured for three to five days
- One of the embryos is transferred back into her uterus
A typical IVF treatment takes approximately seven weeks from when you take your first drug, until your pregnancy test.
How does IVF work?
Getting pregnant is often more difficult than people think, especially as we get older. It’s helpful to be aware of the fertility issues that people can have when they are trying to conceive and how IVF works to address these problems.
Fallopian tube damage:
Endometriosis is a condition where tissue that normally grows in the uterus implants and grows in other places in your body and can cause scarring, which may block your Fallopian tubes. If you have mild endometriosis, a procedure known as a laparoscopy may improve your chances of a successful pregnancy. If your endometriosis is severe, you may still have a chance of getting pregnant naturally, however if you have damage to your Fallopian tubes your doctor is likely to recommend IVF. You may end up choosing IVF because you prefer this to surgery, or you may already have had surgery but not conceived. If you endometriosis is not severe enough for surgery but you haven’t conceived after a few years of trying then you may also consider IVF.
IVF and Egg quantity
In a normal menstrual cycle you release one egg each month. In an IVF treatment cycle, we are able give you a course of fertility drugs to stimulate the development of follicles in your ovary to produce a number of eggs, (your chances of becoming pregnant are greater with more eggs). We collect your eggs during a simple procedure and put them in to a special culture medium. We then safely transfer them to an incubator to provide exactly the right environment and temperature conditions for them. We spin the semen sample in a special media to isolate the good quality sperm and then wash this in another media to purify the sample. The next step is to fertilize your eggs with the sperm to form embryos. We then grow your precious embryos in carefully controlled conditions until they’re ready to be transferred into your womb. Usually we will transfer one embryo, and hopefully you may have surplus embryos which can be frozen and used either if initial treatment is not successful or if you wish to have another child.
Blastocyst Embryo Transfer
A Blastocyst is an embryo that has been developed in the laboratory for five or six days after insemination. A day 5 or 6 embryo is a much more advanced structure than a 3 day old embryo and the real advantage is the potentially higher live birth rate associated with this type of transfer.
By using PGS in an IVF treatment, our embryologists have up to an 85% chance of singling out embryos with abnormalities before transfer. This can improve IVF success rates and reduce both the chance of miscarriage.
Ovulatory issues have a significant impact on fertility. The process of maturing and releasing an egg, is essential when you’re trying to conceive, and there are a number of things which can interfere with ovulation. These include polycystic ovarian syndrome (PCOS) which can result in hormone imbalance and, among other symptoms, can cause irregular menstrual cycles. Women with PCOS may have difficulty getting pregnant because they do not ovulate in a regular pattern and if an egg is not being released it will be impossible for one to be fertilized naturally. In an IVF treatment cycle, the goal is to have the patient ovulate mature follicles.
With IVF we can develop a specific stimulation protocol for you to help optimize the number of eggs you produce in your cycle, monitoring you closely to establish the correct time to collect your eggs. We fertilize them in the lab with your partner’s sperm and monitor your embryos closely. When the time is right, we select for embryo transfer the one which we think has the highest chance of implanting successfully. If you’re concerned that PCOS is going to make it difficult for you to have a baby, try not to worry. Most women who suffer from this condition go on to have successful pregnancies. IVF is a very successful treatment for women who have PCOS and the large majority of women who have not managed to become pregnant with other treatments will be able to get pregnant and have a baby with IVF if they are under 40.