The IVF process is where eggs are collected from the ovary, fertilised with sperm in the laboratory and replaced back into the uterus, hopefully generating a successful pregnancy.
At Monash IVF the majority of our patients undertake a short IVF cycle known as an Antagonist Cycle. On average the Antagonist Cycle time frame from a patient telephoning with their period to pregnancy test is approximately 4 weeks. This treatment is better for women because it is less stressful, it has fewer side effects and is much quicker, so couples see results earlier.
What happens during the IVF Process:
Step 1 – Egg Collection
The starting point of the IVF process is obtaining eggs from the ovaries. This is done by administering injections of FSH (Follicle Stimulating Hormone), which encourages the development of several follicles (sacs on the ovaries that contain eggs). There are usually 5 – 10 sacs, however the number can vary immensely. This process normally takes about two weeks. Once enough follicles have developed, the eggs are removed from the ovaries by passing a needle into the fluid filled sacs that contain the eggs (follicles) and aspirating them out. This is a simple procedure that is performed in theatre by a doctor under a light anaesthetic.
Step 2 – Sperm Preparation
While the eggs are being collected in theatre, the semen sample is also being prepared. Depending on the quality of the semen sample there are different preparation methods that can be performed, however the most common method is called a density gradient preparation. The semen is added to a test-tube that contains a special media, which filters out sperm that have poor motility. If the sperm count isn’t ideal, or if the man has had a surgical sperm collection, the sperm sample will be spun to concentrate as many sperm together as possible. These samples are then used to inseminate the eggs.
Step 3 – Insemination
There are two different types of insemination techniques. IVF standard insemination or ICSI (Intracytoplasmic Sperm Injection). IVF standard insemination is used in patients that have normal sperm parameters and this involves the scientist in the laboratory placing the eggs and the sperm into a dish and leaving them overnight so that fertilisation can occur. If there are severe problems with the sperm, or if IVF standard insemination has failed previously, IVF is combined with ICSI, where scientists inject a single sperm into each egg. These are then also left overnight in the hope that fertilisation will occur.
Step 4 – Fertilisation
The morning after the egg retrieval, the scientists check the eggs for signs of fertilisation. If normal fertilisation has occurred the fertilised eggs are now called ‘embryos’ and are grown in the laboratory until they are ready to be placed back into the uterus.
Step 5 – Embryo Culture
Embryos can be grown in the laboratory for up to six days after egg retrieval. They can be replaced back into the uterus at a variety of stages depending on what you have decided with your doctor. At Monash IVF, we offer two different stages of embryo culture and transfer, either ‘cleavage stage’ or ‘extended/ blastocyst stage’. Cleavage stage is the term used for either day two or day three embryo culture and transfer. This is beneficial for couples that have low numbers of embryos (usually one or two) available for transfer. Extended/ blastocyst stage is the term used for either day four or day five embryo culture and transfer. This is beneficial as it allows the scientists to further monitor your embryos and choose the most advanced embryo for transfer. This option is used in patients who have more embryos than they wish transferred and is mainly used to increase selection ability.
Step 6 – Embryo Transfer
On the day of your embryo transfer, the scientists will assess your embryos and pick the most advanced one for transfer. The embryo will then be loaded into a very soft thin plastic tube and placed back into the uterus. This procedure is very simple, much like a pap smear, and does not require an anaesthetic. The embryos will then continue to grow in the uterus until they implant.