ivf cycle

A typical IVF treatment cycle consists of:

Information and discussion

In Vitro Fertilisation (IVF) is where the fertilisation of the egg by the sperm takes place outside the body, in our laboratory. Your Fertility Specialist will discuss their recommeded treatment program with you and if the decision has been made to proceed to IVF or a related procedure you will be given verbal information during the consultation about the procedure you will have, the likely effects and the success rates. You will then see a nurse coordinator.

Pre-treatment tests and preparation

Prior to starting treatment both partners will have a check for blood groups, Hepatitis B, Hepatitis C, HIV and Vitamin D. Rubella immunity, chlamydia and anticardiolipin antibodies will also be checked in women.

An up-to-date semen analysis will also be arranged with our laboratory. Its important to have a semen analysis in a fertility clinics laboratory as they are experts in carrying out this type of assessment.

Stimulation and monitoring of follicle growth

The first step of the IVF process is for the woman to use a combination of drugs to stimulate the ovaries so that you may develop a number of follicles. We can then recover eggs from these follicles for fertilisation and embryo development.

Your Fertility Specialist will select your drug regime based on your specific needs. Your Fertility Specialist will assess your age, infertility type and previous responses to IVF treatment (if applicable).

Injections usually span a 7-12 day period prior to an ultrasound scan which takes about 10 minutes depending on the number of follicles to be measured. It is important to remember that the ultrasound cannot determine if there is a healthy egg in the follicle, as these eggs are microscopic.

The average number of eggs we retrieve is 8-10 but this can vary.
A cycle may be cancelled if egg numbers are predicted to be greater than 20.

Following the ultrasound a blood sample may be collected for hormone assessment.

By using this information and the number of days of stimulation which you have had, we can best decide the most appropriate day for retrieving the eggs for fertilisation.

Oocyte (egg) retrieval

On the day of egg pick up you will arrive at Wagga Day Surgery half an hour before your procedure and would have fasted for the previous six hours. You will be admitted to hospital and prepared for theatre.

Arrangement will be made for the semen collection and the semen sample will be given to the scientists.

In theatre the Specialist will guide a needle through the vagina into the ovaries and proceed to empty the fluid from the follicles. This fluid is then passed through to the scientist who, using a microscope, will search for the eggs. The procedure lasts about 20-30 minutes and is normally conducted under General Anaesthetic.

The woman is then taken back to the recovery area and typically is able to leave hospital 1-2 hours later.

Semen collection

A semen sample is required, or in some cases, more than one sample is necessary on the day of the egg collection.

It is important to re-emphasise here that if the man anticipates having any problems with collecting the specimen he should speak to the coordinator well before the day of egg retrieval so that alternative arrangements can be made. If necessary, a special condom can be used which does not harm the sperm, or semen can be frozen and stored as a backup.

Insemination, fertilisation and embryo culture

Once the eggs have been collected, they are placed in culture dishes in the incubator in the laboratory. When the sperm sample has been collected, the scientists separate the normal and motile (moving) sperm. These sperm are used for the insemination.

The day after insemination, the eggs are checked to confirm that fertilisation has occurred. 70% of eggs will usually fertilise. Most of these fertilised eggs will divide to form embryos. A small proportion will not develop into embryos.

An IVF scientist will phone you the day after the egg retrieval to give you the fertilisation details and arrangements for the embryo transfer.

Embryo transfer (ET)

This simple procedure is performed at Wagga Day Surgery. The embryos are transferred into the cavity of the uterus using a very fine catheter which is passed through the cervix (neck of the uterus). This procedure is normally no more uncomfortable than a pap smear test and no anaesthetic is required. It helps if you empty your bladder just before the embryo transfer is performed. Your partner is more than welcome to attend the procedure with you.

You should be able to leave Wagga Day Surgery 10-15 minutes after this procedure is performed and you should be able to return to your normal daily routine.

There are no special precautions you need to take over the next two weeks.

Pregnancy testing

Arrangements will be made for you to have a pregnancy test performed on the appropriate day after embryo transfer. This test should be done even if bleeding has occurred because some pregnancies can continue despite vaginal bleeding. Importantly, some women can have an ectopic pregnancy following IVF and embryo transfer and have what seems to be a normal period. If you do not have the pregnancy test we will not be alerted to the possibility of an ectopic pregnancy.

If you are using Crinone, progesterone pessaries and/or hCG injections post embryo transfer, you may not have had a period by the time your pregnancy test is done. This is because the function of these drugs is to support the lining of the uterus thus sometimes preventing a menstrual period from occurring.

Positive pregnancy test

For those who become pregnant, ultrasound examination will be arranged for a day three weeks after the positive pregnancy test.

This ultrasound scan is to determine that there is a viable (living) pregnancy inside the uterus. About 18-20% of all pregnancies diagnosed on a blood test will be found to be non viable.

Negative pregnancy test

Should you not be pregnant you may wish to wait a while before undertaking further treatment. We understand that this can be a very difficult time for couples and our nurse coordinators and counsellors are always available to speak to.

It is important that you have a realistic view of your chances of success with treatment and if you still have questions around this then please speak to your Fertility Specialist.