This involves the fertilisation of eggs with sperm in an incubator in the laboratory.
IVF treatment requires more eggs than in a natural cycle so the ovaries are stimulated to increase the number of mature eggs available for fertilisation. The eggs are collected from the ovaries using ultrasound guidance. The sperm from the partner or a donor are specially prepared and mixed with the eggs in the laboratory to allow fertilisation to occur.
After three to five days in the incubator, one or two of the resulting embryos are transferred to the woman’s uterus through the cervix and hopefully they will then develop as they would in a normal pregnancy. This is particularly applicable to women whose fallopian tubes are absent or damaged. IVF is also appropriate for other fertility problems such as endometriosis, unexplained infertility and male infertility, as well as the egg donation programme.
In conventional IVF at least 100,000 sperm must be placed with each egg to have a realistic chance of achieving fertilisation.
ICSI treatment involves the injection of a single sperm directly into each egg. The treatment leading up to and after ICSI is identical to the conventional IVF cycle.
As only a small number of sperm are required for ICSI, this treatment is appropriate for couples where the man has low numbers of normal, motile sperm and would be unsuitable for treatment with IVF unless donor sperm is used. In addition, because the sperm does not have to penetrate the egg membrane itself, it is also suitable for couples who have had unexplained failure of fertilisation in previous IVF treatment. ICSI is only recommended in cases of proven male factor infertility.
Most patients have long protocol IVF, which starts with suppressing your hormones so we can take control of when you ovulate. This is called down-regulation, and at this clinic it’s done with daily injections, using a medication called Agonists. Later on, you take injections to stimulate your ovaries to produce follicles that will contain the mature eggs. Some patients have short protocol IVF in which the tablets aren’t required. The most appropriate protocol for you will be discussed during your consultations.
Simply Fertility also offers Antagonist cycles. The advantage of Antagonist cycles is that treatment can be tailored closely to your individual needs. You take injections over a shorter period, minimising any discomfort and reducing the overall cost of medication. Another advantage is a reduced risk of ovarian hyperstimulation.
Embryos are monitored carefully and graded as they develop, and in the past were usually transferred 2-3 days after egg collection routinely. Now we routinely culture to the Blastocyst stage. Blastocyst culture involves allowing embryos to mature further (beyond ‘day 3’) in laboratory conditions before attempting to transfer them. In natural conception, embryos would not normally reach the uterus until day 5; this is called the blastocyst stage of development.
Blastocyst culture is available in our laboratory, and each patient’s cycle is assessed to see whether blastocyst culture is recommended. Generally, if 2 or more good quality embryos are available on day 3, blastocyst culture may be recommended. Blastocyst culture is available to all patients and is part of our IVF package.