In Vitro Fertilization (IVF)
IVF stands for ‘In Vitro Fertilisation’ where eggs and sperm are taken and put together outside of the body to fertilise. The fertilised egg is then grown in the laboratory for five days until it develops into an embryo.
IVF is recommended to patients for a wide variety of reasons, including unexplained infertility, endometriosis, tubal factors, sperm factors, and for same-sex couple or single women seeking donor sperm.
To undergo IVF, the ovaries must first be stimulated with medications. There are many different types of stimulation protocols, and your No.1 Fertility Specialist will determine which is right for you, taking into consideration the results of your investigations, why you need IVF and how you have responded in previous cycles (if applicable). The aim is to get a good number of quality eggs.
During the stimulation portion of the IVF cycle, the growth of the follicles on the ovaries is monitored through blood tests and ultrasound. When the follicles are an appropriate size to indicate there are a good number of potentially mature eggs, a final injection is given to mature the eggs.
After this final injection the egg collection can be arranged. The egg collection is a minimally invasive procedure done under light anaesthetic. It involves a small needle being guided by ultrasound through the vaginal wall and into the ovary.
On the day of egg collection, if a fresh sperm sample is being used this will need to be provided so the scientists can inseminate the eggs.
There are two fertilisation techniques that can be used:
Natural IVF is when the egg is put in a dish together with thousands of sperm that have been prepared by the laboratory. The sperm then need to go through all the stages in the fertilisation process, so a form of natural sperm selection occurs with only the fittest sperm able to fertilise the egg.
Intracytoplasmic Sperm Injection (ICSI)
ICSI (Intracytoplasmic Sperm Injection) involves selecting and immobilising a single sperm and then injecting it directly into the egg. Even though a sperm is deposited directly into the egg, this does not mean that fertilisation is guaranteed. ICSI bypasses the physical barriers between the sperm and the egg, however the sperm still needs to initiate fertilisation when placed in the egg.
Once fertilisation occurs, the now fertilised egg grows and develops over the next five days where the cells in the egg continue to divide until a blastocyst is formed.
Once the blastocyst stage of development is reached, the embryo can be transferred back into the uterus, frozen or PGT-A tested.