What is ivf process

A little more than a day before your eggs are scheduled to be retrieved from your body, you'll receive a hormone injection that will help your eggs mature quickly.

Then, you'll have a minor surgical procedure — called follicular aspiration — to remove the eggs. This is generally done as an outpatient surgery in your doctor's office, according to the NIH. During the procedure, your doctor will use an ultrasound to guide a thin needle into each of your ovaries through your vagina. The needle has a device attached to it that suctions the eggs out one at a time. If this part sounds painful, don't worry — you'll probably be given medication beforehand so that you won't feel any discomfort.

You may experience some cramping afterward, but this usually disappears within a day, the NIH explains. While your eggs are being removed, your partner will provide a sperm sample. You also may choose to use donor sperm.

The sperm are then put through a high-speed wash and spin cycle in order to find the healthiest ones. Now comes the part of IVF that everyone's the most familiar with — combining the best sperm with your best eggs. This stage is called insemination. Maintaining a healthy weight and avoiding alcohol, smoking and caffeine during treatment may improve your chances of having a baby with IVF. IVF doesn't always result in pregnancy, and it can be both physically and emotionally demanding.

You should be offered counselling to help you through the process. Page last reviewed: 18 October Next review due: 18 October Who can have IVF? What happens during IVF IVF involves 6 main stages: suppressing your natural cycle — your menstrual cycle is suppressed with medicine helping your ovaries produce extra eggs — medicine is used to encourage your ovaries to produce more than 1 egg at a time monitoring your progress and maturing your eggs — an ultrasound scan is carried out to check the development of the eggs, and medicine is used to help them mature collecting the eggs — a needle is inserted through your vagina and into your ovaries to remove the eggs fertilising the eggs — the eggs are mixed with the sperm for a few days to allow them to be fertilised transferring the embryo s — 1 or 2 fertilised eggs embryos are placed into your womb Once the embryo s has been transferred into your womb, you'll need to wait 2 weeks before taking a pregnancy test to see if the treatment has worked.

Chances of success The success rate of IVF depends on the age of the woman having treatment, as well as the cause of the infertility if it's known. The Human Fertilisation and Embryo Authority HFEA has more information about in vitro fertilisation IVF , including the latest success rates Maintaining a healthy weight and avoiding alcohol, smoking and caffeine during treatment may improve your chances of having a baby with IVF. There are also a number of health risks involved, including: side effects from the medicines used during treatment, such as hot flushes and headaches multiple births such as twins or triplets — this can be dangerous for both the mother and the children an ectopic pregnancy — where the embryo implants in the fallopian tubes, rather than in the womb ovarian hyperstimulation syndrome OHSS — where the ovaries overreact to the medicines used during IVF Read more about support available during and after IVF and the risks of IVF.

On the morning of your egg collection your partner will need to provide a fresh semen sperm sample, so we can immediately fertilise your eggs. Collected eggs are taken to the laboratory and placed in culture medium to prepare them for fertilisation later that day.

In IVF, prepared sperm and eggs are placed together in a dish where fertilisation occurs. In ICSI, an individual sperm is selected by a highly experienced embryologist, and, under very delicate microscopic control, the egg is injected with this single sperm. The egg and sperm are then placed in individual incubators at 37 degrees to mimic the temperature of the human body. The next day, scientists will examine the eggs to determine if fertilisation has occurred, and will call you to advise you of the development of the embryos.

Embryo transfer is a simple day surgery procedure and usually takes place five days after the egg collection. The embryos are transferred into the uterus through a very fine catheter passed through the cervix, a procedure similar to a pap smear. In some cases we may recommend transferring embryos earlier. Any extra embryos not used during a treatment cycle that are suitable for freezing can be stored for the future.

Your nurse will organise an appointment for you to have a blood test two weeks after the embryo transfer. Occasionally, women can still have a period despite being pregnant, so this blood test will occur even if your period has commenced. We do not recommend the use of urinary pregnancy test kits, as the hormone medication given throughout treatment could produce an incorrect reading.

Your pregnancy blood test results are usually available by mid afternoon. If the pregnancy test is positive, we will arrange an ultrasound scan approximately three weeks later. IVF treatment is tailored to your specific needs by your fertility specialist. Most patients who undergo IVF will be prescribed one of two main treatment protocols Long Down Regulation and Antagonist treatment cycles.

Approximately 3 weeks after your period starts you will have a blood test and begin pre-IVF treatment [GnRH analogue] in the form of a Synarel nasal spray or Lucrin injection to control your natural hormones before the fertility medication starts.

About 12 days later another blood test will be taken to make sure your own hormones are low [or down regulated] and you will be instructed when to begin daily hormone Follicle Stimulating Hormone injections [Gonal-F or Puregon]. You will continue taking the Synarel or Lucrin throughout this time. You will be monitored closely with blood tests and ultrasounds until you have an optimum number and size of developed follicles. Once you are ready will we advise when to have your hCG trigger injection and schedule your egg collection 36 hours later.

After egg collection you will use supplemental progesterone either as a vaginal gel, pessary or subcutaneous injections until your pregnancy test two weeks later. Antagonist treatment uses injectable drugs called antagonists to prevent premature ovulation. It is the most commonly used treatment protocol because the shorter cycle makes it more convenient for patients and reduces the risk of hyper-stimulation.

Starting on the second day of your period you will have a blood test and providing all your hormone levels are low, you will be advised to begin Follicle Stimulating Hormone FSH injections [Gonal-F or Puregon] that day. After four days of injections you start a second injection [Cetrotide or Orgalutron] to switch off your own hormones and prevent premature release of the eggs.

Once you are ready will we advise when to have your hCG trigger injection and schedule your egg collection 36 hours later After egg collection you will use supplemental progesterone either as a vaginal gel, pessary or subcutaneous injections until your pregnancy test two weeks later. Today, we're gonna talk about the protocols we use in an IVF cycle.

What we're trying to do is get you pregnant, and this is the way we're gonna be doing it. We start on day two, usually, giving injections of FSH. That's the hormone that normally comes from your brain to tell your ovaries what to do, and what we give you is a synthetic version of that at a much higher dose than your brain normally does so we get lots of eggs. So we start that on day two and in most cases, that's a daily injection in your tummy, like a diabetic does for their insulin injections, with a little pen which has got a tiny little needle on it, and that happens every day.

And then at day five or six, we start a second injection. So the first one was to try and make as many eggs as possible. The second injection, which is on a daily basis, called an antagonist, a GnRH antagonist, cetrotide or orgalutran, that is to stop you ovulating, stop you releasing the eggs before we get to collect them. Obviously, it would be a waste of a cycle if you ovulated yourself before we were able to harvest them.

So you're taking two injections a day, usually at the same time, it's recommended they're taken in the evening but the time is not vital, it doesn't need to be on the same hour every day, but in the evenings on a regular basis. From that point on, you'll probably probably have one or two or three blood tests and ultrasound scans, transvaginal ultrasound scans, to watch the follicles growing and to measure the hormones that are being produced by those follicles.

Then the specialist will see those results on a daily basis and make decisions about whether to change the dosage of the drugs that you're using, or to make that final decision of it's time. It's time to collect the eggs. At that point, time is then set for the egg collection to take place. When the eggs are ready for collection, they need a final maturing injection, an injection that makes the eggs go from 46 chromosomes to It's what happens in nature, just before ovulation, so that your 23 chromosomes can meet up with the 23 chromosomes of the sperm, and that requires a trigger injection, it's called.

These days we use a synthetic version of the pregnancy hormone hCG, but we also can use hCG itself. And that is given quite precisely, and you will be told by your nurses to be precise about taking that, 'cause once we give the injection, we know the eggs are gonna be released at about 40 hours after that.

So what we're doing is timing your egg collection to be between 36 and 38 hours after the injection is given. So if we've set a time, say tomorrow morning, eight o'clock in the morning to do the egg collection, you will have had your injection at eight o'clock last night.

Once you have had that injection, then as I say, you're gonna be coming to the egg collection room 36 to 38 hours later, eggs are collected, then we begin what is called luteal phase support. In every IVF cycle, to make sure the lining of the womb is good, we need to keep progesterone levels high, and that's done either with pessaries or tablets in the vagina.

That's fairly uniform throughout cycles. You can use hCG injections instead of the progesterone pessaries, but that has a risk of causing hyperstimulation, so we rarely use it. So that's the short protocol. I'll just run it again. Starts on day two, daily injections, starting on day five, another set of injections, the trigger injection, egg collection, and then luteal phase support. That's the majority.

That came to pass about a decade ago in Australia. It's called a long down-reg protocol. That begins in the third week of the cycle before the cycle that we're going to collect the eggs.

So 21 days on a normal cycle, we will do a blood test to make sure you've ovulated, and after that, we will be giving you either a nasal spray or an injection to switch off the ovaries, so that when we get to the day of your period, the ovaries are quiet, there's no activity, and then we start the daily injections of the FSH. Again, those injections will continue all the way through until the day of the trigger injection. That's about, usually, an average of 11 days of injections.

Could be 10, could be up to 14, but the average is around 11 days. Same injection as we talked about in the short protocol at that point, but we've already switched off your pituitary gland with a nasal spray or the downregulation agonist injections. Again, there'll be the same monitoring with bloods and ultrasounds, and a decision will be made by your specialists that it's time to collect the eggs and the trigger will be provided. Again, it's the same trigger, 36 hours before the operation, to collect your eggs.

The luteal phase support, again, is identical to a short protocol. There are other protocols. Some people would do natural cycles where you only get one egg and you don't need any medication. In some countries around the world, Japan's one of them, where the drugs aren't covered by Medicare, natural cycles are done a lot, but it means you need to have lots of cycles to get the same cumulative pregnancy rate as we get in Australia, so it's usually not the way to go.

Some people will start the injections later to get one or two eggs only. Again, it's a numbers game. The more eggs you have, the more chance ultimately you have of getting pregnant. In some cases, we even go as far as the long, long downregulation. So we started on day one of a cycle, not in the cycle that you're gonna be having the egg collection, but a month later.

Some people do that where there's endometriosis, for instance.