What Is IVF and How Does It Work?
In vitro ('in glass') fertilisation is a technique that helps couples who have struggled to conceive naturally.
An embryo is created in a laboratory and then transplanted into the womb.
The simple answer is that the process of fertilisation is the same, it just happens outside the woman’s body.
Eggs are collected and mixed with a sperm sample. When a sperm makes it into the egg, you get an embryo. This is then surgically implanted back into the woman’s womb.
Before eggs are removed, a lot of effort is put in to help the woman produce a healthy supply.
What happens during IVF can differ depending on the clinic, but typically the treatment stages are as follows;
1. Suppressing the usual menstrual cycle
Medication is given to suppress your natural menstrual cycle to help make medicines used in the next stage of treatment more effective.
This medication is usually taken for about 2 weeks and can come in the form of daily injections or a nasal spray.
2. Increasing the egg supply
At this stage of the treatment you are given a fertility hormone called follicle stimulating hormone, or ‘FSH’ for short.
This is usually taken for up to 12 days and comes in the form of a daily injection.
FSH is taken to help increase the number of eggs your ovaries produce, giving a greater choice of embryos to use during your treatment.
3. Ultrasound checks
During the treatment process your clinic will administer vaginal ultrasound scans to monitor your ovaries and help check progress.
4. Collecting the eggs
At this stage you will be sedated, and your eggs collected.
This procedure is performed using a needle that passes through the vagina, guided by ultrasound.
It’s a minor procedure and usually doesn’t take longer than 20 minutes.
Some women experience cramps or some vaginal bleeding afterwards.
5. Fertilising the eggs
Your eggs are now mixed with your partner’s (or sperm donor’s) sperm in a laboratory.
At around 20 hours, they’re checked to see if any have been fertilised.
A fertilised egg is then left to grow in the lab for up to 6 days before being transferred into the womb.
Sometimes, each egg will be injected with a single sperm.
This technique is called intracytoplasmic sperm injection (ICSI) and is used to help when male fertility is an issue.
ICSI might be recommended for some the following reasons;
6. Transferring the embryo's
When the eggs are ready, they are transferred into the womb using a catheter that’s passed into the vagina.
This procedure is similar to a cervical screening test, so sedation isn’t normally needed.
It's possible to get IVF treatment on the NHS, but because of the wait and rigorous selection criteria, many go private.
How much is IVF in a private clinic? Costs vary but one round of treatment is usually about £5,000.
When thinking about how much IVF costs, it's a good idea to also consider the emotional and physical effects.
Bear in mind that just 20-25% of treatment cycles result in a birth.
The younger you are, the more chance you have of getting pregnant using IVF treatment. The drugs used to stimulate the ovaries can sometimes lead to OHSS.
IVF often ends up with multiple births, because more than one embryo is implanted in the womb.
A single embryo can also split to create identical twins.
In fact, one in six IVF pregnancies are multiples, compared to one in 80 from natural conceptions.
The fertility drugs used to increase the chance of getting pregnant also add to the chance of a multiple birth.
As there are some extra risks associated with having twins or triplets, certain clinics now recommend freezing additional viable embryos.
The first 'test tube' baby, Louise Brown, was born in England in 1978.
The first born from IVF with a frozen embryo was in Australia in 1984
Babies born from frozen embryos have higher birth weights, and another advantage of freezing is that it cuts down the need for artificial hormones.
A new process of fast freezing, vitrification, is another advance.
Some reckon that in future, all embryos might be frozen and transplanted at the right point in the natural cycle.
Find out more here – hfea.gov.uk
. IVF, NHS, June 2018