Step 1: Egg collection
IVF treatment involves obtaining eggs from the ovaries. Ovaries are stimulated by administering injections of FSH (Follicle Stimulating Hormone), which encourages the development of several follicles (fluid filled sacs on the ovaries that contain eggs). This process normally takes about two weeks. At time of egg collection there are usually 5 – 7 follicles that have grown, however the number can vary immensely. Once enough follicles have developed the eggs are removed from the ovaries by passing a needle into the follicles and aspirating the fluid. The fluid is observed under a microscope where the eggs are removed and placed in a culture dish. This is a simple procedure that is performed in theatre by a doctor under light anaesthetic.
Step 2: Sperm preparation
Following egg collection the semen sample will be collected and prepared. Sperm parameters will determine which preparation method is used, the aim is to harvest a good concentration of highly motile, morphologically normal sperm. The prepared sample is viewed under a microscope and sperm counted.
Step 3: Insemination
Standard IVF insemination involves a calculated volume of sperm being inseminated into a each dish containing the collected eggs. For ICSI the procedure is quite different, it involves one of our scientists injecting a single sperm into each egg. After sperm has met egg the dishes are left in the incubator overnight in the hope fertilisation will occur.
Step 4: Fertilisation
The morning after the egg collection, our scientists check the eggs for signs of fertilisation. If normal fertilisation has occurred the fertilised eggs are now called ‘embryos’ and are grown in the laboratory until they are ready to be placed back into the uterus.
Step 5: Embryo Culture
We offer two different stages of embryo culture – ‘cleavage stage’ or ‘extended/ blastocyst stage’. Cleavage stage is the term used for either day two or day three embryo culture. This is beneficial for couples that have low numbers of embryos (usually one or two) available for transfer. Extended/ blastocyst stage is the term used for day five embryo culture. This is beneficial as it allows our scientists to further monitor your embryos and choose the most advanced embryo for transfer. This option is best in patients who have a larger group of embryos and is mainly used to increase selection ability.
Step 6: Embryo Transfer
This procedure is very simple, much like a smear test, and does not require an anaesthetic. The embryos will then continue to grow in the uterus until they implant.
Step 7: Remaining embryos
Following your transfer your remaining embryos will be either frozen or discarded as per our discussions .
Step 8: Pregnancy test
Fourteen days following your egg collection you will be asked to take your pregnancy test. This is done by a simple blood test.
What are success rates?
Below is the Australia and New Zealand Assisted Reproduction Database (ANZARD) success rates for 2011 (most recently available) as an indication of what to expect from your treatment and should only be used as a general guide.
Figure 1; Clinical Pregnancy Rate (CPR %) per Embryo Transfer
Data provided by National Perinatal Epidemiology and Statistics Unit (NPESU) for Australia New Zealand Assisted Reproduction Database (ANZARD) 2011 (http://www.preru.unsw.edu.au/PRERUWeb.nsf/page/ANZARD)