Your doctor may suggest that you need either IVF (in vitro fertilisation) or ICSI (intracytoplasmic sperm injection) treatment. Both treatments allow us to transfer embryo(s) directly in to the womb.
This involves the fertilisation of eggs with sperm in an incubator in the laboratory.
IVF treatment requires more eggs than in a natural cycle so the ovaries are stimulated to increase the number of mature eggs available for fertilisation. The eggs are collected from the ovaries using ultrasound guidance. The sperm from the partner or a donor are specially prepared and mixed with the eggs in the laboratory to allow fertilisation to occur.
After three to five days in the incubator, one or two of the resulting embryos are transferred to the woman’s uterus through the cervix and hopefully they will then develop as they would in a normal pregnancy.
This is particularly applicable to women whose fallopian tubes are absent or damaged. IVF is also appropriate for other fertility problems such as endometriosis, unexplained infertility and male infertility, as well as the egg donation programme.
For a detailed overview of this treatment, follow a typical IVF Journey here.
In conventional IVF at least 100,000 sperm must be placed with each egg to have a realistic chance of achieving fertilisation.
ICSI treatment involves the injection of a single sperm directly into each egg. The treatment leading up to and after ICSI is identical to the conventional IVF cycle.
As only a small number of sperm are required for ICSI, this treatment is appropriate for couples where the man has low numbers of normal, motile sperm and would be unsuitable for treatment with IVF unless donor sperm is used. In addition, because the sperm does not have to penetrate the egg membrane itself, it is also suitable for couples who have had unexplained failure of fertilisation in previous IVF treatment. ICSI is only recommended in cases of proven male factor infertility or when there has been failure to fertilise eggs with IVF.
Patients may have long or antagonist protocol IVF depending upon the results of their investigation tests and past history. A long cycle starts with suppressing your hormones (usually with a drug called buserelin starting around day 21 of your cycle) so we can take control of when you ovulate. This is called down-regulation, and at this clinic it’s done with daily injections. After approximately 2 weeks of these injections (sometimes longer) you take injections to stimulate your ovaries to produce follicles that will contain the mature eggs.
Some patients have an antagonist protocol in which the down-regulation phase is missed out and stimulation injections begin on day 2 or 3 of your cycle. To stop ovulation (egg release) from happening a second injection is introduced part way through the stimulation to prevent this from happening. This drug is usually orgalutran or cetrotide.
The most appropriate protocol for you will be discussed during your consultations.
Embryos are monitored carefully and graded as they develop, and usually transferred 2-5 days after egg collection. Blastocyst culture involves allowing embryos to mature further (beyond ‘day 3’) in laboratory conditions before attempting to transfer them. In natural conception, embryos would not normally reach the uterus until day 5; this is called the blastocyst stage of development.
Blastocyst culture is available in our laboratory, and each patient’s cycle is assessed to see whether blastocyst culture is recommended. Generally, if more good quality embryos are available on day 3 to transfer than the number required to transfer, blastocyst culture may be recommended. Blastocyst culture is available to all patients at an extra charge, please see our price list for details.