If you’re struggling with infertility, or are a part of a same-sex couple looking to add some mini members to your family, you’ve probably heard of IVF treatment. As one of the most common forms of fertility treatments in the UK, understanding its process is extremely important before you leap into its depths. We get it, navigating the artificial fertility pathways can be both daunting and stressful. And wrapping your head around the science terms whilst dealing with the mental stressors of infertility can seem near enough impossible. So we’re here to break down the what’s and how’s of IVF treatment.
A little IVF 101
In-vitro fertilisation (IVF) is a fertility treatment developed for those who do not wish to or cannot conceive naturally. Whilst it is common and fairly popular, it is also expensive and invasive. Luckily, the NHS provides full funding for women who have tried to conceive for 2 years naturally or have had 12 or more cycles of artificial insemination and still could not get pregnant. Some other women are also eligible for IVF, for example, women who are carriers of certain genetic conditions can have the option to go through IVF so that their child does not inherit their disease.
Whether or not you are eligible for IVF under the NHS depends strictly on everyone’s circumstances. You must discuss thoroughly with your gynaecologist or GP and if you are not eligible, there are many private clinics available for IVF treatments. The cost for 1 cycle of treatment roughly costs £5,000 and the price depends strictly on the clinic you choose, the treatment protocol you follow if you need to use a donor if you choose to freeze your eggs, sperm or embryos or have additional testing.
The IVF Treatment Process
Coming onto all the glorious scientific details, there are four key stages involved in an IVF cycle; ovulation stimulation, egg retrieval, egg fertilisation and embryo transfer. The entire process may take between 4 to 6 weeks but will vary and depend on you.
- Ovulation Stimulation
In this stage, your fertility specialist will plan and organise a timetable in which you must take hormone therapy to stimulate your ovaries to produce eggs by suppressing your menstrual cycle. As this is a highly time-dependent stage, you will be closely monitored regularly via ultrasounds and blood tests to analyse your progress. The simulation period generally lasts for roughly 10 days usually but can vary among our very unique bodies. Don’t be disappointed if there are fewer eggs retrieved compared to the number of follicles, which hold the eggs, because only roughly 75% of your follicles will produce mature eggs.
2. Egg Retrieval and Sperm Collection
Once your eggs are ready for retrieval, you will have the option to have the procedure done under complete or mild sedation. If you are having a fresh cycle, whilst your eggs are being retrieved, your partner or the sperm donor will be required to go into the clinic and produce sperm cells which will be used to fertilise your eggs. Egg retrieval is carried out under ultrasound guidance and a small transvaginal needle used to pierce into your ovaries to suck out the follicular fluid which contains the eggs.
3. Egg Fertilisation
During the fertilisation step, the goal is for the sperm cells to break into and enter your egg cells where an embryo will be formed. Your embryo will hopefully later grow into a baby. There are multiple techniques in which your eggs can be fertilised. One technique is called conventional IVF which involves placing the mature eggs in a petri dish full of sperm Another technique is called intracytoplasmic sperm injection, where one sperm cell is selected based on morphology and injected directly into your egg cell. The technique used depends on your sperm parameters, clinic and whether or not you have struggled with conceiving previously using conventional IVF.
4. Embryo Transfer
Depending on the clinic protocols, you will be able to have a transfer of day 3 or 5 if you have a fresh cycle. If you have a frozen cycle, you will be given medication to prepare the uterus lining and depending on your progress, your doctor will determine a transfer date. A few days after fertilisation, the embryo is now ready to be transferred into your womb. However, this does not mean that you are pregnant; a lot of factors need to be considered for your embryo to attach to your uterus and be developed into a baby. You will be given a pregnancy test to take at a given date roughly 2 weeks later, which would confirm whether or not the IVF process has been successful. The process for an embryo to grow into a healthy baby and undergo live birth is a very complicated and precise journey. A certain number of chromosomes, which is our genetic information in the form of our DNA, is required for an embryo to develop into a baby. The test that is used to understand and analyse the number of chromosomes in the embryo before implantation is called Pre-implantation Genetic Screening. However, many other screening techniques can be used too depending on your clinic.
Now, if during the fertilisation stage, there has been more than one egg fertilised, how does the doctor decide which one to transfer to ensure the maximum possibility of success? There are multiple criteria that the clinics use to determine this. Firstly, they use morphological grading, this is when the clinicians interpret how regions of the embryo appear. Secondly, how fast the particular embryo is dividing and how fast it has reached a certain stage of growth. Lastly, the final criteria using the pre-implantation technique to understand which embryo is euploid (has a “normal” number of chromosomes) Sometimes you will be given the option to transfer more than one embryo, however, don’t be mistaken, the odds that this will lead to a live birth will not be higher than when transferring only one embryo. However, if you do decide to transfer more than 1 embryo, then you will have a higher risk of multiple pregnancies which may create complications to you and your offspring.
Does IVF treatment work?
The question is, after all this talk about IVF, does it work? Do women get pregnant and give birth to healthy babies following an IVF treatment? The answer is yes, but the success rate strictly depends on the age of the mother as well as the actual cause of infertility and the success rates of your clinic. As younger women have a higher quantity and quality of eggs, the chances of a successful IVF are also higher for them. According to the Human Fertilisation and Embryo Authority (HFEA), roughly 30% of women under 35 who had IVF treatment resulted in live births and as your age increases the percentage decreases. Women who are over the age of 42 are not recommended to undergo IVF treatment as the success rate is far too insignificant. Exact success rates have been reported by HFEA.
Can anything go wrong?
Conceiving naturally is very demanding. Whether it is your egg release or your partner’s sperm count to whether or not you both have had sexual intercourse the right time at Hence artificially altering or getting involved in any of the steps of your pregnancy process has its risks. Firstly, there may be a chance of you developing ovarian hyperstimulation syndrome which is a severe effect of fertility medication as well as many other side effects. On the other hand, you may have multiple pregnancies which also have their complications. There may also be a chance of you having an ectopic pregnancy which means that the embryo will implant itself elsewhere in your uterus like in the fallopian tube rather than the womb. For example, an older woman may have a higher chance of facing these complications compared to a younger woman.
We are thankful for science and research that have developed many different techniques and treatments of conditions that were once untreatable. Infertility can be a very difficult and stressful experience, not being able to have children and build a family and possibly feeling guilty towards your partner may strain many relationships. If you want to know more about the mental effects of infertility and treatment click here.
IVF has helped many families fill their arms with children. Managing your lifestyle and daily choices may boost your success rates. Managing your weight, quitting smoking, decreasing your alcohol intake as well as exercising regularly and eating a healthy balanced diet all increase your chances. Despite there being many obstacles and risk of failure, IVF if still one of the most effective infertility treatments.
Are you thinking about IVF treatment? Why not start with a Hertility at-home test? We don’t believe in giving you results without the rest. Our team of experts include fertility specialists and counsellors who can create an actionable plan for your fertility future, and guide you through your journey.