In Vitro Fertilisation (IVF)
In IVF treatment we aim to stimulate the ovaries with fertility drugs so as to obtain as many eggs as possible. The eggs are then mixed with sperm to achieve fertilisation, and usually one, two or exceptionally three embryos are placed in the uterus to optimise the chances of pregnancy.
If you are advised that IVF is the course of treatment suitable for you, this information will help you to understand what is entailed. You should keep a note of your period dates and inform us which month is suitable for you to attend for treatment. We can usually adjust your period dates to suit your work schedule.
When you have decided when you wish to go ahead with treatment, you will be given an appointment to attend the Centre to discuss the sequence of events, and the dates involved. This is an important and necessary appointment. No fee is charged for this visit.
You will be prescribed a hormone drug to suppress the ovaries prior to stimulating them with fertility drugs. You may arrange to purchase these drugs with the help of The Harley Street Fertility Centre or your local chemist (compare prices carefully).
On the first day of your period please contact the Centre to arrange an appointment for an ultrasound scan. The scan is performed by inserting a slim probe into the vagina to check the uterus and the ovaries. There is no need to have a full bladder, and it is painless.
“We will give you instructions for daily injections to stimulate the ovaries”
Side effects like lethargy, lassitude, nausea or hot flushes may be experienced, but should not affect your normal activities at home or work.
Further injections are varied according to your ovarian response and this monitoring may be repeated after 3 to 4 days.
Sometimes the ovaries fail to respond excessively to drugs. If this happens we may have to stop the treatment and re-commence at a later date.
Egg recovery usually takes place 12 to 15 days after starting fertility drugs. Two days prior to egg recovery you will he asked to have a booster injection to "ripen" the eggs, Human Chorionic Gonadotrophin (HCG). This injection is timed approximaely for thirty four and a half hours prior to egg recovery so tends to be given between 2200 hours and 2400 hours two nights before eggs are collected.
On the day of egg recovery both partners are asked to attend, so that the male partner can provide a semen sample for IVF, and can also accompany the female partner home afterwards.
Egg recovery is performed by a minor surgical procedure with a general anaesthetic. This procedure is performed at the Harley Street Clinic.
During the egg recovery, a vaginal ultrasound probe is inserted so that egg follicles in the ovary can be seen. A thin needle is then directed into the ovary. through the vagina, so that the eggs can be aspirated (sucked) into a small test tube.
“The eggs are placed in labelled dishes in the incubator”, the sperm is prepared and mixed with the eggs 4 to 6 hours later, at the Harley Street Fertility Centre.
You should be ready to go home, accompanied by your partner or a relative, a couple of hours after the egg recovery.
The next afternoon you will need to phone the Centre to find out if the eggs have fertilised. If the eggs have fertilised we will give you an appointment time to attend for embryo replacement which is usually performed two or three days after egg recovery but it could be 5 days later in case of Blastocyst replacement.
Embryo replacement is a simple, quick and painless procedure. A maximum of two embryos are selected for replacement from the total obtained in the IVF treatment and the remainder are frozen for subsequent attempts. The implications of the number of embryos implanted will be discussed again prior to embryo replacement.
“The procedure is similar to having a cervical smear”, and after a short rest you may go home.You will have an opportunity to see your embryos under the microscope before your replacement.
In the two weeks after embryo replacement, you are advised to take things easy for the first four days, and can then return to non-stressful activity after that. You will receive medication – a vaginal gel or two injections, during this time to maintain the lining of the womb to maximise the chances of pregnancy.
Drink at least 2 litres of water each day.
You should not lift heavy articles. Light housework and cooking are acceptable. Do not have any x-rays or drugs unless prescribed. If you have any cramp-like pains, you can take aspirin or paracetamol.
Speak to us at the Centre for advice if you are unsure about anything.
On day 15 after embryo replacement, you will come into the centre for a pregnancy test, the results of which will be known later the same day.
If the test is positive we will arrange a scan three weeks later to confirm that all is progressing well with your pregnancy. We then liaise with your GP or gynaecologist in order for you to attend for ante-natal and obstetric care.
“If your pregnancy test is negative, a follow-up consultation will be arranged to discuss your treatment cycle and future treatments”
Your frozen embryos are stored at -196 degrees Celsius for transfer at a later date. These do not deteriorate with time and we are allowed by law to store them for up to five years. (with an extension of storage for a further period of up to five years in some cases). If you conceive with the first treatment cycle, you can return for frozen embryo replacement (FER) whenever you wish.
If you have not been successful with treatment, FER gives you another chance at a much reduced price, without the injections for ovarian stimulation and without having to undergo egg recovery. We replace embryos in "natural cycles" two or three days after ovulation occurs. Scans and/or urine/blood tests are performed to time ovulation accurately.
“A pregnancy test is performed 15 days after ovulation”
If the test is positive, we arrange a scan to check that all is progressing well with the pregnancy. If the test is negative, a follow- up consultation to asses and review your treatment cycle will be arranged.
It is a good idea to think about your own health and well-being prior to, and during IVF treatment. Pay close attention to diet and your lifestyle before conception to enable your body to cope with the demands of pregnancy, childbirth and hopefully ensure a healthy mother and baby.
Eat a healthy and balanced diet, including plenty of fresh fruit, vegetables and fibre. Drink at least 6 glasses of water daily. Cut down on sweet snacks like chocolate and fatty foods. Avoid unpasteurised dairy produce during pregnancy and aim to reduce the consumption of pre-cooked, prechilled foods to avoid food poisoning.
We suggest you take a good daily multi-vitamin tablet (one without ginseng) and a folic acid supplement of 5mg daily. This is to ensure that you have a good supply of vitamins as it has been shown that a lack of folic acid may be a cause for neural tube defects, such as spina bifida.
Exercise should form a vital part of a healthy lifestyle Exercise in some form, depending on your interest and ability, is beneficial and some exercises can he continued throughout the pregnancy However, always consult your doctor on what type of exercise is suitable for you. Try to stop smoking, and reduce alcohol consumption.
“Avoid unprescribed medication and inform your doctor/dentist that you are having fertility treatment”
Keep stress levels down and feel free to discuss any worries with the staff in the Centre.