An egg and sperm are placed together in a culture medium. Here fertilisation occurs and the resulting embryos can be returned to the mother for implantation. Any remaining suitable embryos are stored for future use.

What is IVF?

IVF is basically where a woman’s egg is combined with a man’s sperm in the lab to encourage fertilisation. To get to this point, hormone injections are used to stimulate the growth of follicles, and hopefully eggs. Once the egg and sperm fertilise to create an embryo, up to five days later the embryo is transferred into the uterus.

Which couples benefit from IVF?

Usually, IVF is performed in couples who have attempted IUI unsuccessfully and investigations such as a Laparoscopy have not highlighted any anatomical issues or a laparoscopy has shown fallopian tubes are blocked.

What investigations will be performed before commencing IVF?

Overall health

At your consultation with your Fertility Specialist, you will have received advice about overall well-being, cycle charts and timed intercourse. In some cases, IUI may have been attempted using fertility drugs.

Female functionality

Because the embryo is transferred to the uterus, it is important that the female has no obvious reproductive abnormalities. Blood tests and ultrasound will have shown if you are ovulating, however, your Fertility Specialist may advise an investigation called a Laparoscopy. This will confirm that the female “bits” are working properly, in other words, that you are ovulating normally and have open fallopian tubes.

Sperm analysis

The male sperm will also be checked to ensure that the sperm is of a high quality. Our andrology lab will ensure, according to World Health Organisation (WHO) guidelines that the sperm analysis is within the recommended parameters.

The IVF treatment — step by step

  1. We begin the cycle before. 7 days after ovulation (normally day 21–23) we check your progesterone level and if it is high enough, you begin Synarel spray, GnRH androgen.
  2. With your period, we begin ovulation induction which is controlled by encouraging eggs to mature by stimulating the growth of follicles using fertility hormones (Follicle stimulating hormone or FSH).
  3. Your cycle is monitored regularly by measuring hormone levels in the blood to individualise drug doses and by trans-vaginal ultrasound scanning to identify the development of your follicles, most of which contain an egg.
  4. When the follicles have reached their target size of 18–20 mm, and E2 is at acceptable levels, ovulation is induced with a further hormone injection trigger, human chorionic gonadotrophin (hCG). 36 hours later your Fertility Specialist will collect the eggs while you are under a sedation, at the Capital Day Surgical Centre. This will take 20–30 minutes and you will visit the clinic before going home by lunch time. (Normally egg pick ups occur in the morning.)
  5. A sample of fresh semen (produced earlier that same day or thawed from a frozen sample) is prepared and placed together with an egg in growth media in a dish. The sperm enter the egg naturally in the case of normal IVF. Fertilisation may or may not occur depending on the quality of the egg and sperm and the maturity of the eggs. We may need to do ICSI on the day if our embryologists determine the sperm is unsuitable for IVF.
  6. Hopefully, a few embryos will develop well over a period of up to 5 days. Our laboratory monitors the development of the embryos and recommends the best embryo to transfer on day 5 or earlier after the egg collection. Sometimes if the embryos are not developing as planned, the ISIS lab manager will discuss with your Fertility Specialist the possibility of transferring embryos on day one, 2, 3 or 4.
  7. Embryo transfer is a painless procedure — similar to a PAP smear. This procedure takes about 20 minutes. The embryo is placed in a transfer catheter and using ultrasound it is guided into the thick lining of the uterus. You will be instructed to take progesterone support in the form of pessaries to support the embryo/s and to keep progesterone levels high. A blood test will be undertaken approximately two weeks later to establish if pregnancy has occurred.

Where can I find out more information?

See costs for more information.

Contact us on (02) 6175 9000 or email info@isisfertility.com.au.

© ISIS Fertility 2010
Canberra Australia

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