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What To Expect

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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 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 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’ll take medication for 8-14 days to encourage the follicles in your ovaries to produce more eggs.

Your specialist 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. Having a partner involved is a good idea, you can watch and learn together to get it right, you will be proficient in this before you know it.

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 specialist will schedule the egg retrieval appointment prior to ovulation.

Egg retrieval – Egg retrieval, or egg ‘pick up’, is a hospital day procedure where the eggs are collected from your ovaries. You will have a general anaesthetic administered by an anaesthetist. The egg retrieval procedure takes about 20-30 minutes and you will be asleep during that time.

Using the latest ultrasound technology, your fertility specialist 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 specialist then removes fluid from the follicles that look like they’ve 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’ll be able to walk out on your own. However, as with all general anaesthetics, you won’t be able to drive after the procedure, we recommend bringing a support person with you.

Sperm supply – If you’re planning on using fresh sperm, the male will need to produce a sample the morning of the 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 strong 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. It’s 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. Our scientists are looking for a two- to four-cell embryo on day 2 and a six- to eight-cell embryo on day 3.

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’ll be waiting on news, so we’ll keep you up to date as much as possible.

Embryo transfer – If your embryo develops successfully in the lab, you will be ready for it to be transferred into your uterus.
Your fertility nurse is available to explain the process. You will be required to drink water prior to the transfer so you have a full bladder. We use ultrasound technology to get the embryo in the best spot, and this is helped by seeing the lining of the uterus.

The embryo transfer is a very simple process, like a pap smear. It only takes about 5 minutes, you’ll be awake, there’s no anaesthetic, and you can get up straight away. You can continue with your day, the embryo can’t fall out if you stand up or go to the toilet.

A scientist prepares your embryo by placing it in a small tube called a catheter. It’s critical this is done by an expert to disturb the embryo as little as possible.

Your fertility specialist places the catheter through your cervix and into your uterus. They use ultrasound guidance to pinpoint exactly where to place the embryo. An embryo is only 0.1 millimetre, and the specialist has a target area of approximately 1 millimetre to play with. The embryo needs to be accurately placed, so that it ‘sticks’ if not, there is a risk it’ll find a home outside the uterus.

The final blood test – Two weeks after your embryo transfer, you’ll have a blood test to measure your levels of the hormone HCG (human chorionic gonadotropin). HCG in your bloodstream usually means a positive pregnancy test.

The time between the embryo transfer and the blood test is often called the ‘two-week wait’ (2WW). 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.

 

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