IVF process

How does an IVF treatment cycle work?

An IVF cycle can be broken down into seven main stages which are outlined below. The most successful IVF treatments are designed around specific patient needs so individual treatment plans may be slightly different. All of our patients have unique needs and we take great care in providing everyone with tailored treatments. We will give you advice based on your individual circumstances so your treatment plan may vary slightly from this guide. We will always explain everything clearly to ensure you understand and are happy with your treatment plan.
We are always happy to answer any questions you may have, this helps you to take an active role in your treatment.

Your IVF Journey - First Steps

Consultation and tests

At the consultation your medical history, your current health and the available opportunities for progressing your treatment will be discussed. At CARE your consultation will be with an experienced and dedicated Specialist who will provide the most appropriate advice. We may need to perform certain screening tests before treatment can be started. The tests are important and will provide us with crucial insights into the most appropriate treatment plan for you.

Ovarian stimulation

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.

Monitoring

During the stimulation phase of your treatment, 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 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 for 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 and sperm collection

Egg collection
This is a straightforward procedure which takes around 30 minutes, and is performed with sedation or local anaesthetic and pain relief. 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 of the larger follicles. It’s normal to feel a few twinges during collection, but it isn’t painful. 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 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 functionally competent they can only swim very weakly, if at all. However, they can be injected into and successfully fertilise eggs using the ICSI technique. The only difference between IVF and ICSI is that with ICSI the sperm are injected directly into the egg.

Your IVF Journey - Egg Collection

Fertilisation and embryo development

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.

Embryo transfer

This 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.

Your IVF Journey - Embryo Transfer

The 'Two Week Wait'

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.

Pregnancy test

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, we’ll advise you.
If your pregnancy test is negative or we don't find an ongoing pregnancy during your scan we know you’ll feel upset. When you feel ready, we'll book you a follow up appointment with your consultant to discuss your next steps.
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.

Your IVF Journey - Post Embryo Transfer

Reassurance testing in early pregnancy

A Non-Invasive Pre-Natal test (NIPT) is designed to check your pregnancy for chromosome abnormalities and can be performed at CARE as early as 10 weeks, accurately detecting Downs Syndrome (trisomy 21), Edwards Syndrome (trisomy 18) and Patau Syndrome (trisomy 13). Your nurse will discuss this with you.