IVF stands for in vitro fertilisation – which literally means ‘in glass’, hence the term ‘test tube baby’. This article focuses on IVF treatment as a procedure that allows reproduction for couples who are both fertile, but who have problems conceiving naturally. IVF treatment can also be used in conjunction with donor eggs or sperm, to help couples where one or both are infertile; the underlying process is the same, but the arrangements can be more complex.
This article on IVF treatment is written by Kathryn Senior, a freelance journalist who writes health, medical, biological, and pharmaceutical articles for national and international journals, newsletters and web sites.
IVF treatment involves the removal of eggs from the female partner, the external fertilisation of these eggs using sperm from the male partner, and the implantation of the resulting embryo(s) back into the womb of the mother. If all goes well, this establishes a pregnancy that then progresses as any other.
The whole cycle of IVF treatment takes around 20-25 days, typically starting on the third day of menstruation. With an overall success rate of just 20-30%, it can often take several attempts to secure a viable pregnancy, and so the entire process can extend to six months or more. This can make IVF treatment a considerable emotional and financial strain on both partners.
IVF treatment is undertaken in several distinct stages, and you will need to return to your chosen clinic several times during each IVF treatment cycle, so it is worth considering travel times and costs when making your choice.
Stage 1 – Ovary Stimulation
In this first stage of IVF treatment, the female partner is given fertility drugs called gonadotrophins. These are used to stimulate the ovaries to produce multiple eggs to a set timetable. This process involves around ten days of injections, with the results carefully monitored via blood tests and ultrasound. Further drugs are used to prevent natural ovulation before the eggs are harvested.
Stage 2 – Egg Collection
When the eggs have reached the desired maturity, a final injection is given to prepare them for harvesting. The next stage of IVF treatment can then begin, with the eggs collected using an ultrasound-guided needle that reaches the ovaries via the vaginal wall. This part of the process takes less than 20 minutes and is usually conducted under local anaesthetic and sedation.
Stage 3 – Combining the eggs and sperm
The collected eggs are then cleaned, and the sperm cleared of inactive or damaged cells, before the two are brought together in a special culture at a ratio of around 75,000:1. This is then incubated for around 18 hours to allow fertilisation to take place before fertilised eggs are transferred to a growth medium until they have reached the 6-8 cell stage. The resulting embryos are then checked for quality and uniformity of development, and the best are chosen for implantation. If more quality embryos are produced than are needed for this cycle of IVF treatment, these can be frozen for future use, shortening the process for subsequent attempts.
Stage 4 – Embryo implantation
In the UK, just two of the chosen embryos are transferred back to the uterus. This is done using a fine catheter introduced via the vagina and cervix. Progesterone is often given to stimulate thickening of the uterus wall. This increases the chances of a successful embryo implantation.
Stage 5 – Pregnancy test
After two weeks, a standard pregnancy test can be conducted to assess the result of the procedure, or an ultrasound scan be used to detect the developing foetus.
If your current cycle of IVF treatment has been unsuccessful, most clinics would recommend a break of at least a month, and one normal menstrual cycle, before a further attempt is made. Studies show that while one in three women will be successful in getting pregnant via IVF treatment first time around, this increases to one in two by the end of a second treatment cycle. However, if you have been unsuccessful over three cycles, then the chances become slimmer, and you may wish to investigate other routes to starting a family, such as adoption or fostering.
Emotional and financial costs
Before you undergo any infertility treatment it is important to be aware of what is involved emotionally as well as physically. Most couples come into IVF treatment after a several years of trying to conceive naturally without success, which can mean they start the process with high expectations. The stress of then undergoing the ‘unnatural’ process of IVF treatment, with all its injections and invasive procedures, can become overwhelming. Repeating IVF two or three times only serves to magnify these feelings.
You should also consider what is involved financially. While every woman between 23 and 39 who has fertility problems should be offered three cycles of IVF treatment paid for by the NHS, this varies widely between local health authorities. This situation is not likely to improve as budgets look set to be cut back further. The alternative of private IVF treatment costs up to £8,000 per cycle, adding financial pressure and disappointment to the cocktail of emotions that are already running high.
There is a great deal involved in IVF treatment, physically, emotionally and financially, and the decision to undergo the treatment should not be taken lightly. However, if the process proves ultimately successful, most parents consider it a small price to pay to have the family that they would otherwise be denied.