Introduction
In vitro fertilisation (IVF), also called "test tube baby treatment" is a treatment that has helped several thousand couples achieve the joys of parenthood. This information will tell you about the treatment that this Unit offers with regard to IVF. If you have had the treatment elsewhere some of what you read will be familiar but the techniques we use may not be the same as those you know about.

The first thing to mention is that it does not work every time. In every unit in the world, IVF fails more often than it succeeds. We know our techniques work and like every other IVF unit, we are constantly reviewing our methods to improve our success rates. Our staff keep in contact with those from other units and regularly attend medical and scientific meetings to share information and new ideas.

Your treatment will need the co-operation of your GP or family doctor and it is best if he or she refers you to the Unit. Usually your GP knows a lot about your medical background, which is a great help to the Unit staff. Also, if you do not become pregnant, your GP will still be able to help.

IVF is carried out by a team consisting of Gynaecologists, Nurses and Embryologists, Seminologists and Counsellors, with the help of an Andrologist (male specialist). Most of or all of these individuals will at some time be involved in your care.

Before starting treatment
The first step for most patients will be to come to the hospital to attend our informal Patient Information Evening, where several members of the Unit team will provide you with comprehensive details of your forthcomming treatment.

• Blood Tests


• Semen Analysis

Blood tests are carried out on the woman to check hormone levels and Rubella (German measles) immunity.

The semen analysis is important and is carried out by the seminologist and embryologists in the Unit. One advantage of IVF is that fewer sperm are needed than for normal conception, which makes IVF useful in some cases of male infertility. Although IVF does not need as many sperm to be successful, those sperm must be able to survive for several hours in fluid in which we grow embryos.

This means that the tests carried out in the other clinics are not necessarily relevant for us which is why we repeat them. Samples may be produced in the Unit but if you prefer, you can produce the sample at home or at your hotel and bring it to us within an hour of its production.

When we have received the results of your tests, you will be given an appointment to see a clinician to discuss your fertility problem and talk over anything you are concerned about. If it seems that IVF is not the most appropriate form of treatment, we can advise you about treatment that may be more suitable and make arrangements for you to receive it.

What is IVF?
IVF involves collecting eggs from the ovary, putting them together with sperm in a dish, and if they fertilise, putting the embryo or embryos that result back in the womb.

What does IVF involve?
Ovulation stimulation: - Every month women develop several eggs in their ovaries but usually only one is chosen by the body to be released into the fallopian tube. In IVF we make women produce more than one egg and in this way we have a greater chance of collecting at least one which is healthy.

There are several ways in which we stimulate egg production and we will choose the most suitable method when we meet you and have discussed your particular circumstances. For most women we use a combination of drugs some of which contain fertility hormones. The first drug switches off the pituitary gland and this has the effect of putting the woman through a temporary menopause (the change). When it is being used the body responds in a more controlled way to fertility hormones.

Drugs containing fertility hormones act on the ovary to make it produce more eggs than it normally would. The fertility drugs will need to be given every day for about 10-11 days. Many women ask their GP or Practice Nurse to give these injections, or come to the Unit. A few may prefer to give their own injections or ask their partners to do it for them and we offer a training session for this. These injections are given just under the skin or into the muscle of your buttock, rather than into a vein.

Once you have started treatment we will need to find out how well your body is responding. We do this by using a combination of blood tests and vaginal ultrasound scans.

The most important test is the ultrasound scan. We use a sophisticated ultrasound machine, which is probably unlike any you have seen before. For a start, you will need an empty bladder. The ultrasound probe is an internal one that fits into the vagina from where it measures the size of the ovarian follicle. Most women find having a scan with a machine like ours is simple and less uncomfortable than having a smear taken or an internal examination.

On the day after the last daily hormone injection, you will need an injection of the hormone Human Chorionic Gonadotrophin (hCG). This matures the eggs which should be ready for collection 36 hours later. Since we collect eggs in the morning, this means you will need the injection late at night, almost always some time between 9.30pm and 2.30am. If you need to, you come to the Emergency Room at the hospital where one of the Nursing Staff will give you this injection. If this is inconvenient then perhaps the injection can be given by your local hospital or your GP. If you are going to ask someone else to do this for you, you will need to ask in plenty of time and make sure that there is always back up available.

Egg recovery: - 36 hours after the hCG injection, we collect the eggs from your ovary. This is carried out using the same equipment used for the scan.

We pass a fine needle through the back of the vagina and into the ovary. The fluid from each follicle is sucked into tubes and examined by the embryologist who looks for eggs. Each portion of fluid is examined in turn and this is continued until every possible egg has been collected.

The whole procedure takes approximately 10-15 minutes. You may have your eggs collected either under sedation or under a general anaesthetic. Your doctor will discuss this with you before you start your treatment.

Embryology:- The next stage is to put the best of the sperm with the eggs. We normally ask for your partner’s semen to be produced in the morning before the eggs are collected. The sperm are washed, prepared and then put with the eggs. The day after egg collection we can usually tell if fertilisation has happened by examining the eggs. Not all eggs fertilise properly and only the healthy ones are used. The healthier the eggs are the greater the chance of fertilisation happening and of getting at least one healthy embryo.

Embryo Transfer:- Two days after the eggs have been taken out, if they fertilised and are developing normally, we put them into your womb. This procedure is quick and simple. A fine plastic tube containing the embryo(s) is passed through the cervix (the neck of the womb), and the embryo(s) are placed high into the womb.

Most embryos do not develop into babies but to give you the best chance of pregnancy, most IVF units place more than one embryo into the womb. The policy at our unit is to replace two embryos at one time. This is due to the risks associated with multiple pregnancies. We will talk this over with you before you start treatment.

After your embryo transfer, you will be given further advice about your aftercare from the staff before you go home.

After Transfer:- The fertility drugs that you have been given sometimes cause the ovary to be less effective than usual in preventing the start of your next period. We help it with a hormone called Progesterone which is given in the form of a tablet that you insert into the vagina. We will discuss this with you during your treatment.

Side Effects of Treatment
click here

Pregnancy testing
Two weeks after embryo transfer, we carry out a pregnancy test which will take a few minutes. We will supply you with a container to save the first urine you produce on the morning of the test. Remember that not every positive pregnancy test becomes a baby. More.

After the result of the pregnancy test, we will spend time talking things over with you. If you are pregnant, we will be able to offer pregnancy advice and support. If the treatment has not worked, then there are always things we learn from the results of the tests we carry out during IVF. We can use this information to plan another course of treatment should you want this. The way your body has responded to the drugs will often give us clues about the problems that might have stopped you from becoming pregnant naturally. Sometimes we can also find out more about the ability of your partner’s sperm to fertilise eggs.

If at any time you have any questions or queries please do not hesitate to contact the Unit. If at any stage you wish to see one of our counsellors, this can be arranged for you.