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In vitro fertilization

The term IVF means conceived in glass. This is because the eggs or oocytes are fertilised with sperm in a dish in the laboratory. The embryo created is then transferred to the womb in order to achieve a healthy pregnancy.

In vitro fertilization | Birmingham Fertility CentreIVF is offered to couples with subfertility due to tubal damage, ovulation disorder not responding to medical treatment, male factor, and in unexplained subfertility. In addition it may be considered due to the age of the female partner, pelvic endometriosis, or reduced ovarian reserve or store of eggs.

The aim of treatment is to rescue eggs from the pool of eggs growing in the ovaries each menstrual cycle (see understanding your fertility). The standard long down regulation protocol is described below. The response will be monitored through the treatment cycle by transvaginal ultrasound scans. There will be between 4- 5 visits to the clinic including day of egg collection and transfer

The steps include:
1. The first stage is to switch off your hormones FSH and LH so they do not interfere with the treatment drugs. This is called down regulation. This is done by staring a drug called GnRH analogue from day 21 of your menstrual cycle. This takes between two to three weeks.
3. The next stage is to stimulate the ovaries with daily injections of hormone FSH. This will be self administered. You will therefore be taking two injections daily. The next scan is done to assess the response from the ovaries and should allow planning of egg collection.
4. Egg collection will be planned based on your response. When you are ready, we give you the third injection called hCG to allow the final maturation of the egg.
5. Egg collection is done between 34 to 38 hours after the hCG injection. This is done transvaginally under a light general anesthetic.
6. The sperm sample is collected around the time of egg collection and prepared . In the laboratory the egg and sperm sample are then mixed together under strict conditions.
7. The next day, the eggs will have fertilised to form fertilised eggs, and thereafter they form embryos .
8. Embryo transfer takes place between day 2 to day 5 (blastocyst transfer) depending on the number of embryos available, and the quality/ grade of embryos. We will transfer between one or two embrys depending on the grade of embryos, age of female partne;  in order to optimise your chances of success and to lower the risk of twin pregnancies.
9. Ultrasound guided embryo transfer is performed using very fine soft catheter, and the procedure should not cause any pain
10. You will then be asked to use a hormone progesterone pessary to support the lining of the womb unil the pregnancy test which is usually 16 days after egg collection.
11. If the test is positive we arrange to see you for a pregnancy scan in three weeks time.
12. If the test is negative we will carry out a review consultation when you are ready to discuss your current treatment and make plans for the future.

We may use alternative protocols called GnRH antagonist or Short or Flare protocols depending on your individual requirements.
There can be problems during your treatment which will be discussed on n individual basis. The most important risk of IVF treatment is the risk of over response leading to risk of ovarian hyperstimulation syndrome. We will discuss this in greater detail at your consultation, and during your treatment.