What is IVF?
The term In vitro fertilisation, IVF, literally means fertilisation “in glass” and refers to the process where a woman’s eggs are fertilised outside of her body in the laboratory. The resulting embryos are then transferred back into the uterus a few days later.
Who is IVF suitable for?
IVF is specifically recommended for women with absent, blocked or damaged fallopian tubes. It is also often used in cases of unexplained infertility, in some cases of male factor infertility and can be used in combination with ICSI (intracytoplasmic sperm injection) in cases of severe male factor infertility.
What does IVF involve?
There are four general steps involved in an IVF cycle:
- Stimulation of the ovaries to encourage development and maturation of the eggs.
- Retrieval of the eggs
- Fertilisation of the eggs and culture of the embryos
- Transfer of the embryos back into the uterus These steps are described more fully below:
- Stimulation of the ovaries to encourage development and maturation of the eggs Under the care of a consultant gynaecologist, the woman is given fertility medications to stimulate her ovaries to produce many follicles. Follicles are the small fluid-filled structures which develop on the ovaries, each of which will hopefully contain an egg. The number and size of the developing follicles are measured by transvaginal ultrasound scans. The exact number of follicles which develop varies among patients, but the average is about 10. The final preparation for egg retrieval involves a hormone injection which mimics the natural trigger for ovulation. Egg retrieval will take place 36-38 hours after this injection.
- Retrieval of the Eggs Egg retrieval is a minor theatre procedure which is carried out on an outpatient basis under local anaesthesia. The transvaginal ultrasound probe is used to visualise the ovaries and a needle attached to the probe is passed through the vaginal wall into the follicles. The fluid within each follicle is aspirated and then examined in the IVF laboratory for the presence of an egg. After identification, the eggs are washed and transferred into the special culture medium in Petri dishes in an incubator.
- Fertilisation of the eggs and culture of the embryos While the egg retrieval is proceeding, the sperm is also prepared. A semen sample is provided by the male partner and, in the laboratory, a concentrated preparation of the best motile sperm is extracted from the semen sample. This sperm preparation (containing approximately 150,000 sperm) is added to the prepared egg and then is left for fertilization and then is placed into the patient.
What are the symptoms of male infertility?
In most cases, there are no obvious signs of infertility. Intercourse, erections and ejaculation will usually happen without difficulty. The quantity and appearance of the ejaculated semen generally appears normal to the naked eye.
On the day of the planned insemination, the husband/ partner provides a semen sample. A concentrated preparation of motile sperm is extracted from the semen sample in the laboratory. The sperm preparation is placed into the uterine cavity by the doctor/IVF nurse by means of a fine catheter inserted through the cervix. In general, IUI is a painless procedure, which takes only a few minutes.
IUI using donor sperm?
IUI is also sometimes carried out using the sperm of an anonymous donor (IUI-D) in couples where there is a significant male factor involved.
Is IUI successful?
Yes, for some couples, IUI is a very effective form of treatment provided that the man’s sperm and the woman’s tubes are healthy. The success rates for IUI are generally around 10-15% per cycle.
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