Talking to CARE is the very first step on any IVF journey. It’s not always easy to talk about your fertility, but once you’ve been in touch we can help you to get started.
To book your first consultation, call your local clinic directly or fill out our contact form. You don’t need a referral letter from your doctor to arrange a consultation, but if you’ve had treatment before a copy of your medical history will ensure you have a fully informed initial consultation.
At your consultation, we’ll talk through your medical and surgical history and discuss your options. If we think you need further tests or examination, we’ll try to do them there and then.
We want to keep your waiting time short, so we won’t ask you to do any unnecessary tests and we’ll use any up-to-date information you have to inform your consultation. To help us form an early view of the kind of treatment you might need, we’ll make arrangements to check a semen sample and do a pelvic ultrasound scan.
We’ll then use the results of all your tests, and anything discussed in your consultation, to develop your personalised treatment plan.
When you start treatment we’ll use drugs to stimulate your ovaries and increase the number of eggs you produce; this helps to improve your chances of success. There are different regimes you can follow, and we’ll tailor yours to your specific needs. In general, you’ll need to administer the stimulation drugs daily by injection - we’ll teach you how to do this properly.
Towards the end of your course of drugs, we’ll monitor your progress closely to see when your eggs are ready. When they’re ready we’ll give you another injection to help the eggs mature before collection, and approximately 36 hours later your eggs will be ready and we’ll give you a time for your egg collection appointment.
“It's been well worth everything we went through to get the positive result.”
Egg collection: During egg collection, we’ll recover your eggs using a vaginal ultrasound procedure. This is a straightforward process that takes about 30 minutes under sedation or local anaesthesia, and it’s considered an outpatient procedure. The number of eggs collected varies between patients, and once collected the eggs are prepared for the next stage by the embryologist. You should be able to go home within a couple of hours.
Collection of sperm: We’ll usually ask your partner to produce a sperm sample around the time of egg collection. Some patients may have sperm frozen while others might require surgical sperm recovery, either under sedation or local anaesthesia.
We’ll inseminate the eggs on the same day as collection. This can be done in two ways:
Fertilisation: Fertilisation is when a sperm fuses with an egg; we’ll check this the day after insemination, which we call day one. Successful fertilisation is indicated by the fertilised egg (zygote) having two pro-nuclei – this means it contains two nuclei, one containing the maternal DNA and the other containing the paternal DNA. Zygotes at this stage are known as 2 PNs. Once observed, we return the 2 PNs to the incubator for further monitoring.
Cleavage: Once the zygote divides into two cells – this is usually by the day following fertilisation, known as day two - embryo development begins. Cleavage is the usual term used to describe the division of cells within the embryo. This is because for the first five days, although the embryo increases in cell number it does not change its mass, and the cells, which get smaller and smaller, are cleaved from the original egg mass.
Each cell of the embryo has its own developmental programme, so the embryo might have two, three, four, five, or six cells on day two. Therefore, the number of cells on day two is not critical to success. We’ll assess the quality of these embryos and grade them from 1 to 4 (1 being the highest grade). This is particularly important when considering the freezing of embryos, as only 1 or 2-graded embryos are suitable for freezing.
We transfer your embryos between days three and six. If you have had pre-implantation genetic diagnosis (PGD) or pre-implantation genetic screening (PGS), we’ll freeze your embryos while we wait for the results. The embryo transfer procedure is straightforward and is usually performed without the need for sedation or anaesthesia.
The Human Fertilisation and Embryology Authority (HFEA) only allows the transfer of two embryos except in exceptional circumstances. If three embryos are to be considered for transfer we’ll need to discuss this very carefully with you and document our reasons for the HFEA.
Following transfer a nurse will visit you and explain the next steps, but you’ll be able to go home soon after.
We’ll assess the outcome of your treatment in two ways; first we’ll need to do a pregnancy test, which we might need to do a couple of times, and then we’ll do a pregnancy scan.
If the pregnancy test is negative, or we don’t find an on-going pregnancy during your scan, we’ll book you a follow up appointment with your consultant to discuss your next steps. If you need it, we’ll also offer you support counselling to talk things through.
Pregnancy test: We’ll ask you to do a pregnancy test 14 to 16 days after embryo transfer. The test detects hormones which indicate an early pregnancy.
Pregnancy scan: If the pregnancy test is positive we’ll book you an appointment for an ultrasound scan to see if a heartbeat is visible. Once this is confirmed, you’ll then be discharged into the care of your GP for antenatal care.