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What Happens During IVF?

Initial Consultation

Before starting IVF you will need an initial consult which will confirm if IVF is a viable Fertility treatment option for you. It will involve various checks including blood tests and an ultrasound of your reproductive system as well as the partners or donors sperm.

Ovarian Stimulation

The IVF process typically begins with the stimulation of the ovaries. The goal is to produce multiple eggs for retrieval, as not all eggs will fertilize successfully. Hormonal medications, often in the form of daily injections, are administered to stimulate the ovaries to produce multiple follicles, each containing an egg. Monitoring of hormone levels and ultrasound scans are performed regularly to track follicle growth.  When the follicles are shown to have grown to a specific size commonly between 17 to 19mm then a drug is required to encourage the follicles to release the eggs.  You will then be scheduled to have your egg retrieval within a 24 hour window after administering the drug.

Egg Retrieval

Once you arrive for your egg retrieval you will be asked to change into sterile theatre garments and in the egg retrieval room will be asked to lie down on a bed which will position your legs apart to enable easier access by your Health Provider.  A  Speculum  will be inserted into the vagina making it stay in a widened position to allow the cervix to be more accessible.  Ultrasound will be used to help show your uterus clearly so that the egg can be guided carefully into the right place.  The egg will then be inserted into the end of the catheter and the catheter guided gently through to release the egg in the right place.

Sperm Collection

Around the same time as you are having your eggs retrieved then a sperm sample is collected from the male partner or sperm donor.   The sperm is then processed in the lab and prepared for fertilization.   In some cases if chosen the ICSI (Intracytoplasmic Sperm Injection) may be used where a single sperm is directly injected into the egg to help facilitate fertilization.

Fertilization of Egg & Sperm

The eggs retrieved and sperm are combined in a dish in a laboratory and they are incubated in controlled environment and temperature and monitored over the next few days.   If the fertilization is successful it will result in the formation of an embryo and then the next stage will be to monitor the development of the embryo.  If an ideal outcome there will be a number of embyros that fertilized to monitor but in some cases there may be just one or none that managed to fertilize.

Fertilization of Egg & Sperm

The resulting embryos are cultured in a special incubator, and their development is monitored closely by embryologists. Typically, they are allowed to grow for 3 to 5 days where they will undergo multiple cell divisions.  You may be recommended depending on the outcomes to freeze the eggs at 3 days or at 5 days.

Embryo Selection

Embryo quality is assessed, and the most viable embryos are selected for transfer. Depending on the individuals circumstances a transfer of the selected embryos will be transferred fresh or they will be frozen and transferred at a later date.

If you had a number of embryos which were found to be viable then if a fresh transfer happens the most viable will be transferred and the others frozen which can be used a a later date.   Or if it has been decided a fresh transfer is not best option then all embryos will be frozen and the most viable thawed when ready for doing the transfer.

In some cases, preimplantation genetic testing (PGT) may be performed to screen for genetic abnormalities before embryo transfer.  In this case a fresh transfer is not possible as the eggs need to be frozen to under PGT.

Fresh Embryo Transfer

If the decision is to do a fresh transfer then hormonal medications will take place to support the uterine lining and facilitate embryo implantation.  This support will continue for a specific amount of time after embryo transfer as suggested by your Health Provider.

Frozen Embryo Transfer

In order to do a frozen embryo transfer you will start medications on the 1st or 2nd day of menstruation which will help increase your hormone levels build your uterine lining ready for an embryo to be transferred.

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