Is IVF For You?

Is IVF for me?

Your doctor may recommend IVF if:

• You have been diagnosed with unexplained infertility
• Your fallopian tubes are blocked
• Other techniques such as fertility drugs have not been successful
• The male partner has fertility problems
• You are using donated eggs or your own frozen eggs in your treatment
• You are using embryo testing to avoid passing on a genetic condition to your child.

The IVF procedure

IVF is not one simple procedure, but a series of steps over several weeks. The steps involved in this procedure are:

• Stimulating the ovaries
• Collecting the eggs
• Fertilisation
• Embryo transfer

Stimulating the ovaries

Hormones are usually given to stimulate the ovaries to produce more than the usual one egg per cycle. This is to enable the collection of several eggs. The development of the eggs is monitored by blood tests and ultrasounds that ensure eggs are collected at precisely the right time.

• What do the drugs used in IVF treatment do? A combination of drugs, some containing fertility hormones, is used to make the ovaries produce more eggs than they normally would. This, in turn, leads to high levels of oestrogen being produced in the body.
• Which drugs are used? Two fertility drugs are commonly used to suppress the natural cycle and overstimulate egg production. Clomiphene is the hormone required in the latter stages of egg development. An antioestrogen, it is normally given as a fiveday course at the beginning of the menstrual cycle.Gonadotrophin injections (a naturally occuring hormone) are given on a daily basis to stimulate the ovaries to produce the eggs. Release of the eggs is then brought about using an injection of human chorionic gonadotrophin (hCG).
• How are the drugs administered? Two weeks after the first injection of anti-oestrogen drugs to suppress the natural cycle, gonadotrophins are injected to stimulate the ovaries to produce the eggs.Once the fertilised eggs are transferred back to the uterus, hormones are again given – in the form of injection or pessary – for two weeks after transfer. This encourages the lining of the uterus to grow and aids implantation of the embryos.
• What is the level of oestrogen after dose? The more eggs that are produced, then the higher the levels of oestrogen in the body. Amount of oestrogen can increase tenfold, though it is heightened for a period of around only three weeks.
• What are the side-effects? Lethargy, nausea, headaches or hot flushes may be experienced. There is an increased risk of ectopic pregnancy. Ovarian hyperstimulation syndrome, when too many eggs are produced in one cycle, can occur.

Collecting the eggs

When the time comes to collect the eggs, an ultrasound probe is placed in the vagina while the woman is under light sedation. The ultrasound monitor shows where the follicles are within the ovaries.
A fine needle is passed through the vaginal wall and into the ovaries. Each follicle (sac of fluid) in the ovary is pierced in order to collect its egg.

Fertilisation

A couple of hours after egg collection, the man provides a sample of semen. In a standard IVF treatment, the eggs are mixed with the sperm in a culture dish.
If an egg is fertilised by a sperm, a zygote or pre-embryo will begin to develop. The pre-embryo remains in the incubator for two to five days while it continues to grow and divide.

Embryo transfer

Once the embryos have grown to a predetermined size, one or two will be transferred back to the woman’s uterus at the appropriate time in her menstrual cycle. This procedure involves passing a very fine plastic tube (catheter) through the cervix and into the uterine cavity under ultrasound guidance.
Embryo transfer is very similar to a pap test. It is generally painless and usually involves no anaesthetic. Only one or two embryos are transferred at a time.
Two weeks after the transfer, blood is taken and tested to determine if the woman is pregnant.

For men

Around the time your partner’s eggs are collected, you will be asked to produce a sample of sperm. The sperm will be washed and prepared so the active, normal sperm are separated from the poorer-quality sperm. If you have stored sperm, it will be removed from frozen storage, thawed and prepared in the same way.

IVF – chance of success

Risks and side effects of IVF

There is no clear evidence that infertility medicines, if properly used, increase the risk of birth defects or cancer. The increase in the hormone oestrogen can cause breast tenderness, slight nausea, dizziness and slight abdominal swelling.
Occasionally, too many follicles develop and the levels of the hormone oestrogen rise too high, causing a condition called ovarian hyperstimulation syndrome (OHSS). This is an unpleasant experience, which may include marked abdominal swelling, nausea, vomiting and diarrhoea, lower abdominal pain and shortness of breath. OHSS is rarely severe enough to require hospitalisation.
There is also a theoretical risk (very rare) of damaging other organs, or causing infection or bleeding, with the collection needle.

Where to get help

• Your doctor
• Obstetrician or gynaecologist
• Your local community health centre
• Family planning clinic
• IVF clinic

Will you consider having In Vitro Fertilisation?