IVF – What to expect with an IVF Cycle
An IVF ‘cycle’ is what we describe as one round of IVF treatment beginning with the first day of your full period.
As part of your fertility plan, you might start medication or injections before the first day of the cycle, however the IVF ‘cycle’ begins on the first day of your period.
Day 1 of your period
The first official day of your IVF treatment cycle is day 1 of your full period. All human bodies are different, and your fertility nurse will help you to identify your day 1.
Stimulating your ovaries
The stimulation phase starts at day 1. In a natural monthly cycle, your ovaries would produce 1 egg. You will take medication for 8-14 days to encourage the follicles in your ovaries to produce more eggs, aiming for 8-12.
Your Doctor prescribes hormone medication specific to your individual body and treatment plan.
There are 2 common hormones used to stimulate the follicles:
- Follicle-Stimulating Hormone (FSH)
- Luteinizing Hormone (LH).
Hormone medication is usually in the form of injections, (which can vary from 1-2 for the cycle, or 1-2 per day). We know this sounds daunting, but your fertility nurse will be there to show you exactly how to give the injections.
We monitor your ovaries and check how the follicles are developing with blood tests and ultrasounds. Your medication may be adjusted if need be. You will have some transvaginal ultrasounds (where a probe is inserted internally). Our team will support you through these processes and make you as comfortable as possible.
You will be monitored more frequently towards the end of the stimulation phase to time the ‘trigger injection’ accurately. The trigger injection gets the eggs ready for ovulation and your fertility nurse tells you exactly when to do the trigger injection. Your fertility doctor will schedule the egg retrieval appointment prior to ovulation.
Egg collection
Egg collection, or egg ‘pick up’, is a hospital day procedure where the eggs are collected from your ovaries. You will have a sedation administered by an Anaesthetist. The egg collection procedure takes about 20-30 minutes and you will be asleep during that time. You can have your egg pick up under local anaesthetic upon request.
Using the latest ultrasound technology, a Repromed Fertility Doctor guides a needle into each ovary (eggs are contained in the fluid within the follicles in your ovaries and invisible to the naked eye). The doctor then removes fluid from the follicles that look like they have grown enough to have an egg inside. Prior to retrieval, your ultrasound gives a good indication of how many eggs are available to be collected, the average number of eggs collected is 8-15.
Recovery takes about 30 minutes and you will be able to walk out on your own. However, as with all sedations, you will not be able to drive after the procedure for 24 hours therefore we recommend bringing a support person with you.
Sperm supply
If you are planning on using fresh sperm, the male will need to produce his sample the morning of your egg retrieval. If you are planning on using frozen or donor sperm, our scientists will have it ready and waiting in the lab.
The sperm is washed in a special mixture to slow it down so that our scientists can identify the best ones under a microscope. Once selected, the best sperm wait in the lab to be introduced to the eggs.
Fertilisation
Your eggs that have been retrieved, still in the fluid from the follicles of the ovaries are passed on to our scientists. The scientists use high power microscopes to find the eggs hiding in the fluid and remove them.
The eggs and some sperm are then placed in a dish and they have the chance to find each other and fertilise as they would naturally. Another option is the use of Intra Cytoplasmic Sperm Injection (or ICSI). ICSI is a technique where a single sperm is placed inside of the egg to try and increase the rate of fertilisation. Regardless of which technique is used, it is important the eggs are fertilised quickly.
Embryo development
Once the sperm fertilises the egg, it becomes an embryo. Our scientists put the embryo into a special incubator with perfect conditions for growth and development. Perfect conditions are created using a mix of amino acids, similar to how your body would nurture the embryo.
Our scientists keep an eye on the embryos over 5-6 days.
Unfortunately, not all eggs will fertilise and reach embryo stage. The eggs might not be the right maturity and the sperm might not be strong enough. We know you will be waiting on news, so we will keep you up to date as much as possible via your Patient Portal. A picture of the embryo that has been transferred will also uploaded to your Patient Portal as well as information on freezing outcomes of your remaining embryos.
Embryo transfer
If your embryo develops successfully in the lab, you will be ready for it to be transferred into your uterus.
The embryo transfer is a very simple process, like a pap smear. It only takes about 5 minutes, you will be awake, there is no anaesthetic, and you can get up straight away. You can continue with your day, the embryo can not fall out if you stand up or go to the toilet.
An Embryologist will assess and pick the most suitable embryo for transfer. The Embryologist will then prepare your embryo by placing it in a small tube called a catheter. It is critical this is done by an expert to disturb the embryo as little as possible.
A Repromed Fertility Doctor then places the catheter through your cervix and into your uterus. Transfers are done under ultrasound guidance so you will need a half full bladder.
The final blood test
Approximately two weeks after your embryo transfer, you will have a blood test to measure your levels of Human Chorionic Gonadotropin hormone (HCG). HCG in your bloodstream usually means a positive pregnancy test. A Repromed Fertility Nurse will let you know exactly when you need to have your blood test.
The time between the embryo transfer and the blood test is often called the ‘2-week wait’. It can be tough not to be anxious about the result. If you need some help to cope or someone to talk to, our counsellors are ready to help you.