IVF treatment

When you arrange a consultation with Care, you will have access to your own Patient Portal where you will find all the information you need and your CarePals co-ordinator will contact you to check if you have any questions, and give you any additional information you need. You will then be ready for your first consultation.

At your consultation with one of our fertility specialists, we will discuss your medical history, your current health and the options for progressing your treatment. Your consultation will be with one of our team of experienced and dedicated specialists who will focus totally on you and on giving you the most appropriate advice. We may need to perform certain fertility tests before treatment can be started. The tests are important and will provide us with crucial insights into any causes of infertility, so that we can create the most appropriate treatment plan for you.

At this stage, fertility drugs are used to stimulate your ovaries, this maximises the number of eggs you will produce in your cycle. There are several different types of drugs and different ways that the drugs can be given. The specific type of regime for you will be your ‘Protocol’. One of the medical or nursing team will go through your Protocol in detail with you, we’ll give you a written outline of everything and any further advice or help will be available whenever you need it from our nursing team.

During the ovarian stimulation phase, we monitor your progress closely to establish exactly when is the best time for your eggs to be collected. The monitoring phase will last several days, the exact number of days will vary for each person and will depend on how many follicles have been stimulated and how fast they grow. A typical ovarian monitoring phase is 3-7 days.

You will be told when to take the drug which triggers ovulation. This will be at a very specific time and will determine when you attend the next step of the IVF Process -  egg collection. The ovulation drug is taken in the evening and around 36 hours later, in the morning, you will be ready for egg collection.

Egg collection (Egg Retrieval)

This is a straightforward procedure that takes around 30 minutes and is performed with sedation and pain relief at your fertility clinic. To collect the eggs, we pass a scan probe into the vagina and use ultrasound to guide a needle into one of the ovaries. We then extract eggs from the ovarian follicles; we can usually collect from nearly all the larger follicles. After collection, we recommend you have a short rest before going home.

Sperm collection

We'll usually ask for the sperm sample to be given at the time of the egg collection. Please remember that your semen sample is generally at optimum quality after 2 - 3 days abstinence from ejaculation, so we advise ejaculation 2 -3 days prior to the day of egg and sperm collection and then to abstain until you produce your semen sample.

In certain conditions, sperm are not present in the ejaculate due to the absence or blockage of the tube carrying the sperm from the testes.  Surgical Sperm retrieval can be performed to obtain sperm from the reproductive tract. Whilst these sperm are functionally competent they can only swim very weakly, if at all. However, they can be injected into and successfully fertilise eggs through ICSI treatment. The only difference between IVF and ICSI is that with ICSI the sperm is injected directly into the egg.

Once your eggs have been recovered, they will be put in to a special culture medium and safely transferred to an incubator to provide exactly the right environment and temperature conditions.

We spin the semen sample in a special media to isolate the dense, good quality sperm. We then wash the isolated sperm in another media to purify the sample.

Next, we fertilise the eggs with sperm to form embryos. We then grow the embryos in carefully controlled conditions until they’re ready to be transferred into the womb. The first signs of fertilisation are shown by the presence of two nuclei within the egg. If this has occurred, the fertilised egg should then divide in to two, and subsequently three, four or more cell embryos. At this stage, a Care nurse or embryologist will arrange a time to give you your fertilisation result and also when we need to see you again for embryo transfer.

This IVF procedure is straightforward and almost always performed without the need for sedation. Your transfer specialist will use a speculum (like the one used for smear tests) and the embryologist will load the embryos into a fine, soft catheter for the transfer specialist to place through the vagina and cervix and in to the womb. The embryo(s) will be injected in to a tiny drop of culture medium and the catheter will be removed and checked under the microscope to ensure they have been successfully transferred. The process should take about fifteen minutes.

During the period after embryo transfer, it is important that you take the hormone progesterone, this helps prepare the lining on the womb for the implanting embryo. It is important that the progesterone is taken until your first pregnancy test.

This period, often referred to as ‘The Two Week Wait’, can be challenging and it can seem like forever to pass because, of course, you’re anxious to learn the result of your treatment. Try to stay positive, you’ve done everything you can. If it helps, you could use our Bulletin Board to speak to other women at the same stage of their IVF treatment - there is a section called the two week waiting room. Remember - you are not alone. We understand that the ‘two week wait’ can be an extremely anxious time, and we are here to support you.

Assessing the outcome of your treatment is performed in two ways - the Pregnancy Test and the Pregnancy Scan. Your pregnancy test is usually taken 14 - 16 days after embryo transfer and indicates whether or not your embryo has implanted. It may sometimes be necessary to repeat this test, but we’ll advise you on what is needed.

If your test is positive, we’ll invite you to come into the clinic 2 to 4 weeks later for an ultrasound scan to check for a heartbeat to show an ongoing pregnancy. Once this is confirmed, we’ll discharge you into the care of your GP who will arrange your antenatal care.

If your pregnancy test is negative or we don't find an ongoing pregnancy during your scan we know you’ll feel upset. Support is always available to you - you may find comfort in speaking with a specialist fertility counsellor, who can help you to understand and process the emotions you may be feeling.

If you are experiencing recurrent miscarriage , there are many ways that we can investigate this further with you, and identify why implantation failure may be happening.

When you feel ready, we'll book you a follow up appointment with your consultant to discuss your next steps.

IVF was originally developed to overcome damage to the fallopian tubes. Blockage in a fallopian tube prevents sperm from reaching the egg to fertilise it. Fertilisation in the laboratory overcomes this problem. During IVF, your ovaries are stimulated to produce eggs, which are retrieved during a short procedure called egg collection. Your eggs are then fertilised with your partner’s or donor sperm in the laboratory, and your fertilised embryos are placed into your uterus through the cervix where they can implant and grow, so the fallopian tubes are bypassed all together.

Endometriosis is a condition where tissue that normally grows in the uterus implants and grows in other places in your body and can cause scarring, which may block your fallopian tubes. If you have mild endometriosis, a procedure known as a laparoscopy may improve your chances of a successful pregnancy. If your endometriosis is severe, you may still have a chance of getting pregnant naturally, however if you have damage to your fallopian tubes your doctor is likely to recommend IVF. You may end up choosing IVF because you prefer this to surgery, or you may already have had surgery but not conceived. If you endometriosis is not severe enough for surgery but you haven’t conceived after a few years of trying then you may also consider IVF.

A woman’s most effective reproductive years are in her 20s. Fertility gradually declines in the 30s, particularly after age 35. Even a healthy, fertile 30-year-old woman has only a 20 percent chance of getting pregnant naturally each month. The impact of age on your eggs is twofold. Firstly, as you get older, your eggs decrease in number. Age is the biggest factor affecting egg supply. The older you get, the fewer eggs you have. Women are born with their lifetime supply of eggs, your body does not produce more eggs. Secondly, egg quality deteriorates with age and this has a significant impact on the viability of embryos and chromosome disorders become more likely. For women, the ability to conceive is influenced by the quality of her eggs. Decreased egg quality means it becomes more difficult for the sperm to fertilise the egg naturally.

Ovulatory issues have a significant impact on fertility. The process of maturing and releasing an egg, is essential when you’re trying to conceive, and there are a number of things which can interfere with ovulation. These include Polycystic ovarian syndrome (PCOS) which can result in hormone imbalance and, among other symptoms, can cause irregular menstrual cycles. Women with PCOS may have difficulty getting pregnant because they do not ovulate in a regular pattern and if an egg is not being released it will be impossible for one to be fertilised naturally. In an IVF treatment cycle, the goal is to have the patient ovulate mature follicles.

With IVF we can develop a specific stimulation protocol for you to help optimise the number of eggs you produce in your cycle, monitoring you closely to establish the correct time to collect your eggs. We fertilise them in the lab with your partner’s sperm and monitor your embryos closely. When the time is right, we select for embryo transfer the one which we think has the highest chance of implanting successfully.

If you’re concerned that PCOS is going to make it difficult for you to have a baby, try not to worry. Most women who suffer from this condition go on to have successful pregnancies. IVF is a very successful treatment for women who have PCOS and the large majority of women who have not managed to become pregnant with other treatments will be able to get pregnant and have a baby with IVF if they are under 40.

Male infertility is the leading cause in failure to conceive in up to 40% of couples. Where sperm issues are a contributing factor in failure to get pregnant naturally, we can achieve a high success with fertility treatment.

The most common cause of infertility in men involves abnormal or insufficient sperm. Problems can arise when either not enough sperm is being produced, or the sperm is of poor quality. In this case we mean that the motility can be low, which affects the sperm's ability to ‘swim’ as vigorously as it needs to, or the sperm can be abnormally shaped. A normal sample will show 20 million sperm per millilitre at least half of which will be active.

Another issue is when sperm are not present in the ejaculate due to absence or blockage of the tube carrying the sperm from the testes. Minor surgery can be performed to obtain sperm from the reproductive tract. Whilst these sperm are capable of fertilising an egg, they can only swim very weakly, if at all.  

According to the HFEA, birth rates from IVF in the UK have steadily increased over time with the average birth rate per embryo transferred standing at 24% in 2018, compared with just 7% in 1991.

In 2019, the years of study in HFEA Statistical release published in 2021, they found:

• Birth rates for patients under 35 were 32% per embryo transferred
• Birth rates for patients aged 35-37 were 25% 
• Birth rates for patients aged 38-39 were 19%
• For women 43+ birth rates were below 5% 

Of course, the likelihood of success with IVF varies person to person as everyone’s needs are individual. One thing you can be sure of is that our teams at Care Fertility will do everything we can to give your best chance of having a baby. You can find out more about IVF success rates at CARE here.

As with any medical procedure, there is an element of risk with IVF. These risks include:

• Ovarian hyperstimulation syndrome (when ovaries become swollen and painful)
• Stress
• Egg-retrieval procedure complications
• Multiple births (the likelihood of having twins is higher with IVF)

At CARE the health and comfort of our patients is of the utmost importance to us. We do everything we can to minimise risk during IVF, and we offer support throughout your fertility journey.

Patients undergoing IVF are required to take a few different medications throughout the treatment process; these drugs are associated with some potential side effects. However, for most, the chances of starting a family through IVF far outweigh the possible side effects. Some possible side effects include:

• Abdominal pain
• Mild bloating and/or cramping
• Breast tenderness
• Headaches
• Constipation
• Mood swings

IVF is available on the NHS, however criteria vary across different Clinical Commissioning Groups (CCGs). You can read more about the process of getting IVF on the NHS, and NHS Funding for IVF here.

For more detailed information on costs at CARE Fertility, visit our IVF and fertility treatment costs page, where you can find fee schedules for our different clinics. Or read understanding IVF costs for more information.

Your treatment plan and associated costs will be discussed at your consultation, book a consultation with one of our doctors here.

The first successful IVF procedure was carried out in 1978 andProfessor Simon Fishel, who founded CARE Fertility was part of the UK team who pioneered IVF, since then over 5 million babies have been born worldwide.

IVF science has advanced very rapidly in recent years and our teams at CARE Fertility have been at the forefront of these developments, helping to pioneer ever more effective treatments.

There are more than 50,000 CARE babies in the world today.