IVF is undoubtedly the best-known fertility treatment and tends to be the “blanket” term, particularly in mainstream media, to describe all fertility interventions. There is a good reason for this: IVF was absolutely groundbreaking when it first resulted in the birth of a healthy baby girl in Manchester in 1978. 35 years and 5 million babies later we are making huge advancements in the field of fertility medicine, but IVF remains at the heart of successfully treating subfertility.
IVF stands for In Vitro Fertilisation and it actually describes the part of the procedure that occurs in the embryology lab, not in the clinic’s theatre.
In our IVF Clinics, treatment actually begins early in the menstrual cycle when the female patient takes fertility medication prescribed for her by one of our medical team to stimulate the growth of follicles on the ovaries.
Each of these follicles or sacs should contain an egg. We monitor the development of these follicles using transvaginal ultrasound scans and hormone blood tests over the course of approximately 8-10 days.
After each scan and blood test, we have the option to adjust medication to either further stimulate or to reduce the stimulation so that we can achieve the optimum number of eggs while making sure that our patient remains well.
When we believe that the follicles have developed to an appropriate size and number we instruct the patient to use an injection to trigger ovulation. The egg retrieval procedure then takes place 36 hours later.
This procedure is carried out by one of ReproMed’s doctors in our operating theatres in Dublin. It is carried out under local anaesthesia or sedation and is relatively quick: the average procedure lasting approximately 20 minutes depending on the number of follicles the patient has.
Using a needle and with the guidance of ultrasonography, the doctor retrieves the fluid from inside the follicles and passes to the embryologist who examines the fluid for the presence of eggs.
IVF or ICSI?
While the female partner is undergoing the egg retrieval procedure the sperm sample, donor or partner is being prepared for use in IVF.
Any mature eggs retrieved from the procedure are placed in a Petri dish in an incubator in the laboratory, to which the prepared sperm sample is added. These are allowed to culture overnight to allow fertilisation to occur.
In some cases, fertilisation needs to be assisted, for example where sperm quality is poor, so our embryology team will utilise a method known as ICSI, Intracytoplasmic Sperm Injection.
The embryologist will select an individual sperm cell and inject it directly into the egg, thus bypassing part of the challenge that sperm cells face to pass through the ‘shell’ of the egg.
The eggs are incubated overnight and 16 hours later our embryology team will check them to assess whether fertilisation has occurred.
Over the course of 5 days, we assess the progress of the embryos at specific periods to assess whether development is happening as it should.
On the fifth day, we select one or two of the best embryos and they are transferred into the patient’s uterus by one of our doctors, using a fine catheter.
Two to three weeks later, we ask the patient to return to us to have a pregnancy test at which stage we will be able to confirm by hormone levels in the blood whether the treatment has been successful or not.