In Vitro Fertilisation
In vitro fertilisation (IVF), also called ‘test tube baby treatment’ is a treatment that has helped several thousand couples achieve the joys of parenthood. This information will tell you about the treatment that North West Fertility offers with regard to IVF. If you have had the treatment elsewhere some of what you read will be familiar but the techniques we use may not be the same as those you know about.
Your treatment will need the co-operation of your GP or family doctor and it is best if he or she refers you to the Unit. Usually your GP knows a lot about your medical background, which is a great help to the Unit staff. Also, if you do not become pregnant, your GP will still be able to help.
IVF is carried out by a team consisting of Gynaecologists, Nurses and Embryologists, Seminologists and Counsellors, with the help of an Andrologist (male specialist). Most of or all of these individuals will at some time be involved in your care.
What is IVF?
IVF involves collecting eggs from the ovary, putting them together with sperm in a dish, and if they fertilise, putting the embryo or embryos that result back in the womb.
Preparing Sperm
What happens during IVF?
Preparation for Treatment:
Following consultation and initial investigations, the female partner will start treatment approximately 1 week before a menstrual period is due. This treatment will consist of a daily injection or nasal spray, which will have the effect of switching off the pituitary gland temporarily, so that we can control the ovaries more carefully during the Stimulation Phase of the treatment. This process is called Pituitary Down Regulation. After a few days a menstrual period should start and you should continue with the daily injection until instructed to stop.
Ovarian Stimulation:
During
a normal menstrual cycle, 1 or occasionally 2 eggs are produced and
mechanisms within the body stop the development of other eggs. However,
during IVF treatment we wish to stimulate more eggs so that there is a
greater chance of producing a number of healthy embryos.
Ovarian
Stimulation involves a daily injection of Follicle Stimulating Hormones
(FSH) in addition to the Down Regulation injection. The fertility drugs
will need to be given every day for about 10 or 11 days. Most women
prefer to give their own injections, or ask their partners to give them
to them. We provide a training session to show you how to give the
injections, which are given just under the skin or into the muscle of
your buttock, rather than into a vein. If you prefer us to administer
the injections, we can make the necessary arrangements for you. During
the stimulation phase of the treatment you will need to attend your
unit for ultrasound scan, so that we can monitor the response to the
treatment.
At the end of the stimulation phase, we will
instruct you to have a final injection of Human Chorionic Godanotrophin
(HCG). This matures the eggs, which should be ready for collection 36
hours later. Since we collect eggs in the morning this means that your
final injection will need to be given late at night, almost always
sometime between 9.30 p.m. and 2.30 a.m.
It is important that
you also refer to our information on Ovulation Stimulation to
understand any possible side-effects of the treatment.
Egg Collection:
Approximately
36 hours after the HCG injection, we perform the Egg Collection
procedure. This is performed under intravenous sedation (or general
anaesthetic if required). A fine needle is passed alongside the
transvaginal ultrasound probe, through the skin at the top of the
vagina and into the ovary. The fluid in each ovarian follicle is gently
extracted and given to the Embryologist for examination. The procedure
takes between 10 and 30 minutes. This will be discussed with you in
more detail before you start your treatment. If you are receiving
treatment at Chester or Leighton Hospital, your partner will be
responsible for transporting the collected eggs, in a specially
designed incubator provided for you, to the Hewitt Centre in Liverpool.
Semen Sample
On the day of the egg
collection, the male partner will be asked to produce a semen sample
around the time of the egg collection. For patients having treatment at
Chester or Leighton Hospital, the samples can be produced in a
dedicated facility at the Hospitals and transported to the Hewitt
Centre, along with the transport incubator.
Embryology
In
the Laboratory the semen will be prepared and the eggs inseminated. The
day after egg collection the eggs are examined to see if fertilisation
has occurred.
Not all eggs fertilise properly and only the healthy ones are used.
Embyros in Incubator
Embryo Transfer
All embryo transfers take place at the Hewitt Centre. This occurs normally 2 or 3 days after egg collection. Only eggs that are fertilised normally and are developing are placed into the womb. The procedure is usually quick and painless. A fine plastic tube containing the embryos is passed through the neck of the womb (cervix) and 1 or 2 embryos are placed high into the womb. After your embryo transfer you will be given further advice about your aftercare from the staff before you go home.
After Transfer
We recommend that you take a hormone called Progesterone, which is given in the form of a pessary/suppository until you perform a pregnancy test 14 days after embryo transfer. These drugs are used to ensure that the most favourable environment for implantation of embryos is present.
Pregnancy Testing
This can be performed 2 weeks after the embryo transfer process . We would recommend that you perform this on an early morning specimen of urine. A pregnancy test can be performed in the privacy of your own home or at the unit, depending on your wishes. We ask you to contact us with the result of your pregnancy test to arrange appropriate care.
If you are pregnant we will be able to offer Pregnancy Advice and arrange for you to receive Antenatal care. If the treatment has not worked, there may be information that we have gained from the treatment cycle that may explain why you may not have become pregnant naturally, and there may be information that would alter the course of management in a future treatment cycle.
If at any time you have any questions or queries, please do not hesitate to contact your Treatment Unit. If at any stage you wish to see one of our Counsellors, this can be arranged. Please see our counselling page for details.