Infertility can affect 1 in every 6 couples, so if you are having difficulty conceiving, it is important to know that you are not alone and there are many treatments available that can help you achieve your dream of having a baby. With many different causes of infertility, these treatments may vary.
Repromed offers a complete range of fertility services to our patients. So while we specialise in In Vitro Fertilisation (IVF), we also offer treatments such as Ovulation Induction (OI), Intra Uterine Insemination (IUI), Tracking, Donor or Third Party Reproduction Program, Surrogacy, and surgical management of infertility (eg. sperm recovery and the removal of fibroids and endometriosis).
In Vitro Fertilisation (IVF) is the process where eggs are collected from the ovary, fertilised in the laboratory and placed back into the uterus, hopefully generating a successful pregnancy.
IVF is the preferred fertility treatment method if the women has tubal infertility (also known as blocked or damaged tubes), the male partner has very low sperm quality, or genetic testing of embryos is required (ie. Preimplantation Genetic Screening or Preimplantation Genetic Diagnosis). IVF is also preferred if someone has had a long period of infertility from unknown causes, as it allows doctors to pick up on cryptic causes of their infertility (for example failed fertilisation, poor egg or embryo quality) which are not seen on routine testing. IVF also generally has the highest chance of success on a per month basis of all treatments.
Repromed was one of the first fertility clinics in Australia to offer patient friendly short-cycle (antagonist) IVF treatment for couples. On average the Antagonist Cycle timeframe from a patient telephoning with their period to pregnancy test is approximately 4 weeks. This treatment is better for women because it is less stressful, has fewer side effects and is much quicker, so couples see results earlier.
Below is a step by step guide as to what happens during an IVF cycle at Repromed:
1. Egg Collection
The starting point for IVF treatment is obtaining eggs from the ovaries. This is done by administering injections of FSH (Follicle Stimulating Hormone), which encourages the development of several eggs (usually aiming for 8-12 however, the number can vary immensely). This process normally takes about two weeks. Once enough eggs have developed, they are removed from the ovaries by passing a needle into the fluid filled sacs that contain the eggs (follicles) and aspirating them out. This is a simple procedure that is performed in theatre by a Doctor under a sedation, although we do offer the procedure being done under local anaesthetic upon request.
2. Sperm Preparation
While the eggs are being collected in theatre, the sperm sample is also being prepared. Depending on the quality of the sperm sample there are different preparation methods, however the most common method is called a density gradient preparation. The sperm is added to a test tube that contains a special media, which filters out sperm that have poor motility. If the sperm count is very poor, or if the man has had a surgical sperm collection, the sperm sample will be spun to concentrate as many sperm together as possible. These samples are then used to inseminate the eggs.
There are two different types of insemination techniques. IVF standard insemination or ICSI (Intracytoplasmic Sperm Injection). IVF standard insemination is used in patients that have normal sperm parameters and this involves the scientist in the laboratory placing the eggs and the sperm into a dish and leaving them overnight so that fertilisation can occur. If there are severe problems with the sperm, or if IVF standard insemination has failed previously, IVF is combined with ICSI, where scientists inject a single sperm into each egg. These are then also left overnight in the hope that fertilisation will occur.
The morning after the egg retrieval, the scientists check the eggs for signs of fertilisation. If normal fertilisation has occurred the fertilised eggs are now called ‘embryos’ and are grown in the laboratory until they are ready to be placed back into the uterus.
5. Embryo Culture
Embryos can be grown in the laboratory for up to 6 days after egg retrieval. They can be placed back into the uterus at a variety of stages depending on what you have decided with your Doctor. Extended/ blastocyst stage is the term used for either day 4 or day 5 embryo culture and transfer. This is beneficial as it allows the scientists to further monitor your embryos and choose the most advanced embryo for transfer. This option is used in patients who have more embryos than they wish transferred and is mainly used to increase selection ability.
6. Embryo Transfer
On the day of your embryo transfer, the Embryologist will assess your embryos and pick the most suitable one for transfer. The embryo will then be loaded into a very soft thin plastic tube and placed back into your uterus. Transfers are done under ultrasound guidance so you will need a half full bladder. This procedure is very simple, much like a pap smear, and does not require an anaesthetic.