A typical IVF treatment cycle involves taking drugs that stimulate your ovaries to produce several eggs. The eggs are then collected and mixed with sperm in a laboratory. IVF is carried out when the sperm quality is considered to be ‘normal’ If there are issues with the sperm quality a procedure called intracytoplasmic sperm injection (ICSI) may instead be used – this is where a single sperm is injected into the egg by an embryologist.
At Boston Place Clinic we believe in making life as easy as possible. We do not insist on a letter of referral from your GP or Specialist to make an appointment although this may be helpful particularly if you have medical problems or a complicated history. We ask that you send or bring any copies of investigations that you have had performed elsewhere as this may prevent repeating some investigations.
You can make an appointment by speaking to someone directly, by fax or letter from your GP or specialist or if you prefer drop us an email with your contact details for an appointment.
Preliminary tests and screening
You may need some preliminary tests for the doctor to decide the most effective treatment for you. This could be a combination of blood tests, a pelvic vaginal ultrasound scan and a semen assessment (if applicable). If you have already had fertility investigations or have had treatment elsewhere, please bring any results that you have to your first consultation at the clinic.
At your first consultation with your consultant, the doctor will discuss your medical history, test results and recommend a personalised treatment plan, based on your clinical history, results and circumstances.
Counselling is available at any stage of your treatment pathway. Fertility treatment is a significant emotional journey for all patients, and counselling provides extra emotional support. It is completely confidential. If you are going to be using donated eggs or sperm for your treatment, then you’ll be recommended to see the counsellor before starting treatment, to discuss the implications for both you and any children that may be born.
Before starting treatment, you need to attend an appointment with a member of our nursing team to sign consent forms, and talk through your particular treatment programme. They will explain all the consent forms that you need to sign, and also show you how to take any drugs you will be using during the treatment process. The consent forms would be sent to you 24 hours prior to the coordination appointment. Once all the tests and consent forms are completed, you are ready to start your IVF cycle. If you are having treatment as a couple, both of you will need to attend this appointment to sign the consent forms. If you are funding your own treatment you will need to pay for your treatment programme at this point.
Your treatment starts with your period and will follow the treatment protocol given by the nurse at the coordination appointment.
Over a period of around 2 weeks of ovarian stimulation with medication, you are likely to have 1-3 scans, and possibly blood tests, to monitor the development of the egg-producing follicles. The results are available on the same day. The timings are different for everyone because treatment is tailored to suit each patient individually. Generally, scan appointments are for 20-30 minutes.
The stimulation period ends with an injection that matures the eggs in the follicles, ready for egg collection.
The egg collection will take place 36 hours after the trigger injection. The procedure is performed in theatre in the presence of an anaesthetist and takes about half an hour. You will be given deep sedation intravenously.
A fine needle attached to a scanning probe will be passed through your vagina into each ovary to collect the eggs. On the same day, your male partner will need to produce a semen sample, or if you’re using donor sperm, this will be thawed ready to be used.
You can go home the same day, after a short period of monitoring. You will need someone to pick you up; you must not drive for the rest of the day, because of the anaesthetic.
If your treatment requires a fresh sperm sample, your partner will provide the sample around the same time of your egg collection. The sample is usually produced in one of our andrology (men’s) rooms. If a surgical procedure is required to retrieve the sperm, this will take place before the day of egg collection and the sample will be be frozen.
If sperm is already in storage or have been matched to a sperm donor, the sample will be thawed on the same day that the eggs are collected and used for treatment.
The sperm sample provided is prepared to ensure that the very best sperms are being used for treatment.
In Vitro Fertilisation Cycle – prepared sperm will be added to the eggs in a culture dish.
Intra-Cytoplasmic Sperm Injection (ICSI) Cycle – a single sperm will be selected and injected into each egg, then placed in a culture dish.
The culture dishes are placed in the incubator to allow fertilisation to take place.
Shortly after egg collection, you will start the medication to prepare the lining of the womb to receive your embryo. This is called luteal phase support. The medication is usually taken as a pessary which you can insert into the vagina or rectum yourself or in combination with injections which can also be easily administered by yourself.
The embryos are carefully monitored in the period after insemination.
The day after egg collection, an embryologist will call you to discuss the fertilisation of your eggs. In most circumstances, embryos are cultured in the lab for five to six days after egg collection until they reach the blastocyst stage. Depending on your treatment plan, the embryologist will either freeze all your embryos for a Frozen Embryo Transfer in a later cycle or advise you when your fresh embryo transfer will take place.
Scheduling Embryo Transfer
The decision about when to complete the embryo transfer will depend on the number and quality of your embryos.
The procedure can feel like a smear test, but it takes longer: around 15 minutes. A tiny drop of culture medium containing one or two embryos is carefully deposited in the uterus using a thin catheter under scan guidance.
Any good quality surplus embryos can be frozen and stored for future use if you decided before treatment.
Following the embryo transfer, you will need to wait between 12 to 14 days to find out if your treatment has been successful. We appreciate how difficult this ‘two-week’ wait can be Please call us at any time if you are concerned. A member of the nursing team will call you during this wait. Counselling is also available to provide any additional support you need.
On the day of your embryo transfer, you will be given a date for the pregnancy test which is usually a home urine test.
If you are pregnant, we schedule a scan in the clinic at around 6-8 weeks. If the scan is reassuring you will be discharged to your GP for routine antenatal care.
If your period arrives before the test is due, or the test is negative, rest assured you are not alone.
We can meet to talk, review your treatment, and consider what the next step will be on your IVF journey. IVF conception often takes place over a number of cycles. You could be ready for a new cycle within a short time, even a couple of months if you have frozen embryos.
During this time counselling and support will be available should you need it.