In vitro fertilisation (IVF)
In vitro fertilisation (IVF) helps to achieve conception by treating the existing infertility or genetic problems. IVF takes around 2 weeks for the completion of a single fertilisation cycle. The process involves collection of matured eggs from the ovaries. Conventional IVF involves placing the eggs and sperm and allowing fertilisation to take place over a few hours in a culture dish. The fertilised embryos are then grown in the laboratory for a period of 2 – 5 days.
After this the embryo is transferred into the woman’s uterus.
Indications for IVF
The most common indications for IVF include:
- Damaged or blocked fallopian tubes
- Ovulation problems
- Premature ovarian failure (loss of normal function of your ovaries before the age of 40)
- Severe Endometriosis (presence of endometrial tissue outside the uterus)
- Presence of uterine fibroids (benign tumours in the wall of the uterus)
- Male factor infertility, including low sperm count and low sperm motility
- Presence of a genetic disorder
- To preserve fertility for patients with cancer or other health conditions
- Unexplained infertility
The steps involved in an IVF treatment are:
- Ovulation Induction: Dr Joseph Sgroi will administer fertility drugs to boost the production of your eggs. Transvaginal ultrasounds will be conducted to monitor the development of the eggs and blood tests obtained to check hormone levels.
- Egg retrieval: Dr Sgroi will perform a follicular aspiration, a minor surgical procedure to remove the eggs from your ovaries. An ultrasound probe is inserted through the vagina and into the follicles under ultrasound guidance. The fluid from each follicle in the ovary is drained to retrieve an egg.
- Insemination and fertilisation: The eggs are mixed with the sperm in an environmentally controlled chamber to facilitate the process of insemination. The egg is fertilised a few hours after insemination. If the chance of fertilisation is low, intracytoplasmic sperm injection (ICSI) may be used where the sperm is directly injected into the egg.
- Embryo Culture: Division of the fertilised egg forms an embryo. The development of the embryo is monitored and within 5 days, a normal embryo has several actively dividing cells.
- Embryo Transfer: Embryo transfer is performed 2 to 5 days after egg retrieval and fertilisation. A thin tube containing one or more embryos is inserted into the vagina through the cervix and into the uterus. After transfer, if an embryo attaches or sticks to the womb lining, pregnancy is the result.
After the procedure
For the first two days after an embryo transfer you should refrain from heavy lifting, physical activity like running or aerobics, swimming, alcohol, smoking and intercourse.
Dr Sgroi’s fertility nurses will organise for you to do a pregnancy test 10-14 days after embryo transfer to confirm pregnancy.
Risks and Complications
As with any surgical procedure risks and complications can occur. The possible complications associated with specific steps of an IVF include:
- Risk of multiple births
- Risk of premature and low birth weight
- Ovarian hyper stimulation syndrome (OHSS) (a condition of ovarian enlargement accompanied by fluid accumulation in the abdominal cavity)
- Risks of egg retrieval include bleeding, infection, and damage to the bowel, bladder, or blood vessels.
- Possibility of ectopic or tubal pregnancy