IVF – Invitrofertilisation

What is IVF?

IVF was originally developed for women with blocked or missing fallopian tubes and it is still the procedure of choice for these situations. It is also used when other conditions are present, including endometriosis, male factor infertility and unexplained infertility in which no medical cause for infertility can be found. We will review your history, medical assessments and other factors which may impact on your fertility and help to guide you to the treatment and diagnostic procedures that are most appropriate for you.

IVF treatment cycles consist of a number of steps over 4-5 weeks. An IVF cycle starts when a woman begins taking drugs to stimulate her ovaries to produce eggs. The cycle involves collecting eggs, collecting sperm, fertilizing the eggs in a culture dish, and then transferring any resulting embryos into the woman’s womb. Progress is monitored through ultrasound scans and blood tests, and of course, a pregnancy test.

Are the injections painful?

With the advent of newer fertility medications (Puregon and Gonal F), many injections that were given intramuscularly can now be replaced by medications given as a little injection under the skin (subcutaneous). This method is similar to insulin injections to diabetic patients.

Additionally, one medication, which has been given as a subcutaneous injection (Lucrin), can be replaced by a medication administered as a nasal spray (Synarel). Both medications are equally effective.

Once the egg retrieval is performed, progesterone supplementation is used to prepare the lining of the uterus for the transfer of embryos. For most of our treatment cycles, we recommend using vaginal progesterone gel (Crinone) or progesterone pessaries.

Women on average, may have to inject only 8-10 days of FSH (follicle stimulating hormone) and one subcutaneous injection of hCG before the eggs are ready to retrieve.

Your comfort and peace of mind is vitally important and we will work through any issues you have, including pain expectation and tolerance to tailor a program that gives you the maximum chance of success.

Are the procedures painful?

The only procedure that could be considered minor surgery in the IVF process is the retrieval of the eggs from the ovary. During this procedure a needle attached to a vaginal ultrasound probe is passed through the wall of the vagina and into each ovary.

A light anaesthetic is administered intravenously prior to retrieving your eggs, which wears off quickly after the procedure. Without anaesthetic for this procedure, it could be quite painful. The procedure is relatively quick (approx 20-30 minutes). After the procedure the patient may feel some minor cramping in the ovaries that can also be treated with very safe medications.

Each patient at every egg retrieval procedure is closely monitored by a fully board certified anaesthetist. This allows us to safely provide as much anesthetic as may be necessary to provide complete pain relief for the procedure.

In pain or discomfort terms, an embryo transfer is often compared to a PAP smear. It is a rapid procedure (5 min) that is performed with no sedation unless medically required or requested. Partners are welcome to be present during the transfer procedure (provided sedation is not used).

As with every step of your fertility journey, we are dedicated to your comfort and peace of mind and we will work through any issues you have, including pain expectation and tolerance to tailor a program that gives you the maximum chance of success.

Will my baby suffer birth defects?

It is important to recognise that the rate of birth defects in humans in the general population is about 3% of all births for major malformations and 6% if minor defects are included. Fortunately, 30-plus years following Louise Brown’s birth (the first IVF baby), we now have ample data that children conceived through IVF have no increase in these rates of birth defects. Further follow-up on older children indicates that IVF children have done as well or better than their peers in academic achievement (probably a social bias) and have no higher rates of behavioural or psychological difficulties.

Will the hormones cause long-term health risks?

An ongoing National Institutes of Health funded study is specifically designed to address the question of whether fertility medications themselves may play a causal role in ovarian, breast or uterine cancer. While the study is still under way and needs another 5-10 years of follow-up to be conclusive, preliminary results suggest no association between fertility medications and risks for invasive cancers. At this time, we can say that there is no direct evidence that fertility drugs play a causal role in increasing a woman’s risk of invasive ovarian, breast or uterine cancer.

IVF success rates: what can I expect?

As with all fertility treatments, the success of IVF is dependent on individual factors. In IVF, a woman’s age has a number of effects on the success of treatment. The older a woman is, the more likely it is that she may have issues such as impaired egg quality and quantity, lower numbers of follicles when stimulated with fertility hormones for IVF, lower numbers of eggs retrieved with IVF, lower rates of implantation with IVF, and increased rates of miscarriage.

For this reason, the earlier you have IVF treatment in terms of age, the more likely you are to have a healthy baby.

Counselling

At Nurturing Your Fertility, we are committed to your health and wellbeing. We understand that infertility and its treatment can be stressful from an emotional, physical and financial point of view. We encourage our patients to develop a network of supportive friends and relatives.

In addition to our medical and nursing staff, a counselling session with our trained infertility counsellor is included in the cost of an IVF cycle in which you don’t conceive. We believe this is an essential part of any treatment program. We understand this can be one of the most challenging times in any person’s life and are committed to making your fertility journey as easy as possible.

TO FIND OUT WHETHER IVF COULD BE AN OPTION FOR YOU, PLEASE CONTACT US