In vitro fertilization (IVF)

The IVF procedure is actually a combination of several steps that may take place over a period of approximately 20 - 25 days.

Ovarian stimulation

Treatment cycles typically starts on the third day of menstruation and consist of a regimen of fertility medications to stimulate the development of multiple follicles of the ovaries. Depending on your treatment protocol, this may mean anywhere from one to four shots every day, for about a week to 10 days.

During this time ovaries are examined using ultrasound to analyse the development of the follicles and you may also be given blood tests to check your hormone levels. When follicles are judged to be adequate maturation via transvaginal ultrasound, human chorionic gonadotropin (hCG shot) is given. This agent would cause ovulation about 42 hours after injection, but a retrieval procedure takes place just prior to that, in order to recover the egg cells from the ovary.

Egg retrieval (Transvaginal oocyte retrieval)

The eggs are retrieved from the patient using a transvaginal technique involving an ultrasound-guided needle piercing to reach the ovaries. Through this needle follicles can be aspirated, and the follicular fluid is handed to our IVF laboratory. The number of eggs retrieved dependents on how the patient has reacted to the fertility drugs. The retrieval procedure takes about 15 minutes and is usually done under general anesthesia.

Collecting the sperm

On the day of egg retrieval your partner will provide a semen sample so your eggs can be fertilised. Semen is prepared for fertilisation by removing inactive cells and seminal fluid. Alternately, your eggs can be fertilised using donor sperm or frozen sperm, in which case the sperm will be thawed and ready for fertilisation.

Fertilisation

The eggs are stripped of surrounding cells and prepared for fertilisation. The sperm and the egg are incubated together in the culture media for about 18 hours. In most cases, the egg will be fertilised by that time and the fertilised egg will show two cells. The fertilised egg is passed to a special growth medium and left for about 48 hours until the egg has reached the 6-8 cell stage.

Selection

Embryos are graded by our embryologist based on the number of cells, evenness of growth and degree of fragmentation. Typically, embryos that have reached the 6-8 cell stage are transferred three days after retrieval.

Embryo transfer

The number to be transferred depends on the number available, the age of the woman and other health and diagnostic factors. Typically 2-3 embryos judged to be the "best" are transferred to the patient's uterus through a thin, plastic catheter, which goes through her vagina and cervix. The embryo transfer procedure takes about 15 minutes. The patients will have a blood test 10-12 days after the transfer to check if pregnant.