In vitro fertilisation (IVF) is the process by which egg and sperm are brought together in the laboratory to form an embryo. This is later transferred to a woman’s uterus to develop into a baby in the normal way. For many people, that broad-brush description is as far as their knowledge needs to go.
But if you’re thinking of undergoing one of the 918,000 IVF cycles that take place annually in Europe, you’re sure to want more than a rough idea of the IVF process. This article aims to fill in the details and explain exactly what you can expect from a cycle of IVF treatment. We will take you through the IVF process one step at a time, set out the IVF timeline and explain when and why various additional associated techniques are used.
What are the steps of the IVF process?
During your first visit to one of our IVI clinics, our clinicians will carry out diagnostic testing to decide which fertility treatment is the most appropriate in your case. IVF is the fertility treatment likely to be recommended when previous simpler techniques such as artificial insemination have been unsuccessful, for women with various ovulatory problems or blocked fallopian tubes, and for couples where male infertility is a factor. These are the steps:
The stimulation of your ovaries to produce multiple eggs starts with a 11 to 14 day course of hormonal medication, usually self-administered. During this time, your gynaecologist will check how the process is developing with three or four ultrasound scans and blood tests. When the egg follicles have reached a suitable stage, you will receive a dose of hCG hormone to trigger maturation. The next step, oocyte retrieval, takes place 36 hours later.
Retrieval of the oocytes is a simple process which lasts a mere 15 to 20 minutes. It is carried out in an operating theatre with light sedation so there is no discomfort. Each follicle containing an egg is accessed through the vaginal cavity and the fluid containing the eggs is gently aspirated through a fine needle. You rest for a while after the procedure and then you are free to return home and resume your normal everyday routine.
Fertilisation and embryo culture
As soon as the eggs are collected, they are fertilised in the laboratory, using either your partner’s or donor sperm which has been prepared in advance. There follows a period of five to six days during which the embryos are cultured. Our embryologists observe and monitor their development. It is now possible, through time-lapse EmbryoScope technology and other devices, to monitor morphological development accurately in real time, assisting us with selection of the best embryo and rejecting those which are unlikely to result in pregnancy.
Transfer of the best embryo
The few days of waiting and observation also provide an opportunity to prepare your uterus for reception of the embryo, making sure it is the right thickness to be receptive to pregnancy. The transfer itself is simply a matter of inserting the selected embryo into your uterus with the help of a specially designed cannula. It’s quick and painless and does not require an anaesthetic.
Any remaining good quality embryos can be vitrified in case they are needed later, so you wouldn’t need to go through the whole cycle again.
The IVF timeline explained
The IVF process timeline is not so predictable that you can plan your diary around it, so it’s best to leave some flexibility in your plans. In general however you can expect the timeline to go something like this:
- Initial consultation and diagnostic testing: one to two weeks depending on circumstances.
- Ovarian stimulation phase: 11 to 14 days, total time three to five weeks
- Retrieval and embryo culture: five to six days, total time four to six weeks
- Two-week wait before blood test to confirm pregnancy: total time six to eight weeks.
As you can see, the initial full cycle can take anything up to a couple of months. In the event that pregnancy does not result from the first attempt, and you had enough good quality embryos for vitrification, any subsequent attempt would be significantly shorter. It could consist only of a few days of endometrium preparation followed by embryo transfer. The whole process therefore would take between two and three weeks before the pregnancy test.
What else do I need to know?
Some of the processes that may be involved in your IVF treatment are discretionary – that is, your fertility doctor will only recommend them if they are indicated in your particular case. Examples include:
Intracytoplasmic sperm injection (ICSI).
ICSI is used as an alternative to mixing egg and sperm in a petri dish, for a more precise method of fertilisation. In ICSI, a single sperm is selected and microinjected into the egg to facilitate fertilisation. This technique is becoming increasingly common as a standard procedure, but is particularly likely to be used in cases of male factor infertility when selection of a single healthy sperm is vital to optimise the chances of fertilisation.
Preimplantation Genetic Test (PGT)
PGT could be part of your IVF process if there is a medical need. For example, if either prospective parent has a hereditary condition which could be passed on to their children, PGT could provide a safeguard. Genetic testing can detect the presence of genetic diseases and chromosomal abnormalities in an embryo to ensure that only healthy embryos free from identifiable disease are selected for transfer.
The testing involved needs a certain amount of time to obtain reliable results. This may necessitate vitrification of all the embryos for a short time and so would add a few days to your IVF timeline.
If there’s anything else you need to know about what to expect from the IVF process, do get in touch with us through our online contact form. You could also prepare yourself by taking a look at our video about your first visit to IVI.
If you’re thinking of IVF treatment, who knows, your baby could add to the happy statistic of more than 200,000 already born with our help to loving families all over the world.