The IVF process can be broken down into seven main stages; this covers consultations, tests, and the treatment cycle, which we have outlined below. All treatment plans are designed to give each individual patient their best chance of having a baby.
We are always happy to answer any questions you may have, this helps you to take an active role in your 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.
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.