What is In Vitro Fertilisation?

IVF gets its name from the Latin for ‘in glass’, as the fertilisation of the egg takes place outside the body. It is an ideal treatment for couples who are struggling to conceive in the normal way. Once considered a medical miracle, it is now a commonplace treatment for infertility.

During IVF, eggs are removed directly from the ovaries and mixed with sperm outside the body. Following fertilisation, embryos are implanted back into the woman’s uterus, where the rest of the pregnancy proceeds as normal.   

This article is written by Jackie Griffiths, a freelance journalist who writes health, medical, biological, and pharmaceutical articles for national and international journals, newsletters and web sites. 

Who can benefit from IVF?

IVF can help overcome many of the common problems of infertility, including:

• Damaged or removed fallopian tubes
• Low sperm mobility or low sperm count
• Hostile cervical mucus
• Age related issues
• Other problems with traditional conception such as physical disability

The success rate for the procedure will depend on the nature of the original issue, but is generally around 20-30% per cycle. Other factors relating to the skill and techniques of the clinic involved will also affect the success rate, with some clinics boasting up to 50% success.

In cases of low sperm count or poor sperm quality, IVF can be used in conjunction with Intracytoplasmic Sperm Injection (ICSI) to improve the chances of a successful conception. In this case, a single sperm is injected directly into the egg to guarantee fertilisation.

IVF can also be used in conjunction with frozen eggs and/or sperm, as well as with donor eggs or sperm, giving many more women the opportunity to conceive.

The IVF Procedure

A complete cycle of IVF treatment takes around 20-25 days, typically starting on the third day of menstruation.

Stage 1 – Ovary Stimulation

The ovaries usually produce just one egg per cycle, so medication is used to stimulate multiple eggs. Ovary growth is monitored using ultrasound for around ten – fourteen days of injections, and hormone levels are checked.

Stage 2 – Egg Collection

When the ovary and eggs are mature the eggs are collected. This is done through the vagina, using a needle guided by ultrasound, and takes around twenty minutes. The process is usually conducted under local anaesthetic.

Stage 3 – Egg and Sperm Combination

Under lab conditions, the eggs and sperm are carefully prepared, combined at a ratio of around 75,000:1 and incubated for around eighteen hours to allow fertilisation to take place.

Successfully fertilised eggs are then transferred to a growth medium for around four – five days until they have reached the 6-8 cell or blastocyst stage. The best of these embryos are then selected for transfer back into the uterus.

At this stage, unused embryos can be frozen for use in future treatments, to avoid having to go through the early stages every time.

Stage 4 – Embryo Transfer

Between one and three embryos are transferred to the uterus, using a thin catheter that passes through the vagina and cervix. The actual number of embryos used will depend on age, health, and other factors, including the legislation that applies in the country of treatment.

An additional dose of progesterone may be given to stimulate thickening of the uterus wall to assist embryo implantation.

Stage 5 – Pregnancy test

After two weeks, a standard pregnancy test can be conducted to assess the result of the procedure.

Possible Complications

There are many reasons why a cycle of treatment may be unsuccessful, including the age of both the man and the woman, the quantity and quality of sperm and eggs, and the failure of the embryos to implant. The clinic may also be unsuccessful in collecting and combining the eggs and sperm to create embryos.

With success rates of between 20% and 30%, it is important to have realistic expectations. Just like traditional conception, it can take time and patience to reach a successful outcome.

Successful treatments can also have complications, including an increased risk of multiple births, problems arising from over-stimulation of the ovaries, and an increased risk of an ectopic pregnancy (where the embryo lodges in the fallopian tube rather than the uterus).

Costs

Private IVF treatment costs between £1,000 and £4,000 per cycle, depending on the clinic involved.

While NICE recommends that every woman between 23 and 39 who has fertility problems should be offered three cycles of IVF on the NHS, in reality this varies widely between local health authorities and is ultimately a local, budget-dependant decision.

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