In Vitro Fertilisation is commonly referred to as IVF. IVF is the process of fertilisation by manually combining an egg and sperm in a laboratory dish. When the IVF procedure is successful, the process is combined with a procedure known as embryo transfer, which is used to physically place the embryo in the uterus.
What is involved with in vitro fertilisation?
There are basically five steps in the IVF and embryo transfer process which include the following:
�2 Monitor and stimulate the development of healthy egg(s) in the ovaries.
�2 Collect the eggs.
�2 Secure the sperm.
�2 Combine the eggs and sperm together in the laboratory and provide the appropriate environment for fertilisation and early embryo growth.
Transfer embryos into the uterus
Step 1: Fertility medications are prescribed to control the timing of the egg ripening and to increase the chance of collecting multiple eggs during one of the woman's cycles. This is often referred to as ovulation induction. Multiple eggs are desired because some eggs will not develop or fertilise after retrieval. Egg development is monitored using ultrasound to examine the ovaries and urine or blood test samples to check hormone levels.
Step 2:Your eggs are retrieved through a minor surgical procedure, which uses ultrasound imaging to guide a hollow needle through the pelvic cavity. Sedation and local anesthesia are provided to remove any discomfort that you may experience. The eggs are removed from the ovaries using the hollow needle, which is called follicular aspiration. Some women may experience cramping on the day of retrieval, which usually subsides the following day. However, a feeling of fullness or pressure may last for several weeks following the procedure.
Step 3: Sperm, usually obtained by ejaculation, is prepared for combining with the eggs.
Step 4: In a process called insemination, the sperm and eggs are placed in incubators located in the laboratory, which enables fertilisation to occur. In some cases where fertilisation is suspected to be low, intracytoplasmic sperm injection (ICSI) may be used. Through this procedure, a single sperm is injected directly into the egg in an attempt to achieve fertilisation. The eggs are monitored to confirm that fertilisation and cell division are taking place. Once this occurs, the fertilised eggs are considered embryos.
Step 5: The embryos are usually transferred into the woman's uterus anywhere from one to six days later, but most commonly it occurs between two to three days following egg retrieval. At this point, the fertilised egg has divided to become a two-to-four cell embryo. The transfer process involves a speculum which is inserted into the vagina to expose the cervix. A predetermined number of embryos are suspended in fluid and gently placed through a catheter into the womb. This process is often guided by ultrasound. The procedure is usually painless, but some women experience mild cramping.
These steps are followed by rest and watching for early pregnancy symptoms. A blood test and potentially an ultrasound will be used to determine if implantation and pregnancy has occurred.
How successful is in vitro fertilisation?
The success rate of IVF clinics depends on a number of factors, including patient characteristics and treatment approaches. It is also important to remember that pregnancy rates do not equate to live birth rates.
Risks associated with in vitro fertilisation
Ovary stimulation carries the risk of hyperstimulation, where the ovaries become swollen and painful. This condition–ovarian Hyper stimulation Syndrome– is usually rare, mild, and involves the following potential side affects: nausea, vomiting, lack of appetite, or a feeling of being bloated. More severe symptoms, which occur in one per cent of cases, include severe abdominal pain; severe nausea or vomiting; decreased urinary frequency; and ten pound weight gain within three to five days.
- American Pregnancy Association