You might be returning for treatment using your own frozen embryos, from previous cycles, placed back into your womb. This does not need any of the stimulating drugs so is termed an un-stimulated cycle. Using donor eggs or sperm often falls into this un-stimulated cycle pattern so the journey is very similar.
Preliminary tests and screening
To make the best decision about your treatment in the consultation, your doctor needs the results of some tests. There may be a combination of blood tests and a vaginal ultrasound scan to assess your ovaries, and a semen assessment where appropriate. Your GP may do the tests and provide the results at the time of referral, or you can arrange an appointment yourself at the clinic.
At your first consultation with your fertility doctor, you discuss medical history and test results. The doctor will discuss with you their recommended programme of treatment, based on your personal results and circumstances.
Counselling is available at any stage of your treatment pathway. Fertility treatment is a significant emotional journey for all patients, and counselling provides extra emotional support. It is completely confidential. If you are going to be using donated eggs or sperm for your treatment, then you’ll be recommended to see the counsellor before starting treatment, to discuss the implications for both you and any children that may be born.
You need to attend an appointment with a nurse or doctor to sign consent forms, and talk through your particular treatment programme. They will explain all the consent forms that you need to sign, and also show you how to take any drugs you’ll be using during the treatment process. Once all the tests and consent forms are completed, you are ready to start your IVF cycle. If you are having treatment as a couple, both of you will need to attend this appointment to sign the consent forms. If you are funding your own treatment you will need to pay for your treatment programme at this point.
Your treatment will start on Day 1 of your period when you will need to call the clinic. We will then instruct you to start the treatment plan as explained in your Consents and Planning appointment. As you’re not undergoing ovarian stimulation, you may or may not have drugs to take in this cycle; this will be agreed with your doctor at your consultation. The drugs are there to help us control your endometrial development, so that we can replace your embryos in the best possible environment at the right time in a ‘medicated cycle’. If you have a regular menstrual cycle, we still monitor you, so we can transfer the embryo(s) at the best point in your ‘natural cycle’.
We’ll monitor your cycle through visits to the clinic for scans and possibly blood tests, or through home ovulation kits. The timings are different for everyone, because treatment is tailored to suit each patient individually.
If you’re using your own or donated frozen embryos, they will be carefully thawed for implantation. If you are using donated eggs or sperm, they will be used for insemination in the laboratory to create your new embryos.
We place your embryos, or the mixtures of sperm and eggs, in culture dishes in the incubator to allow development to take place
Shortly after egg collection, you may start taking drugs that help prepare your uterus lining to receive an embryo (this is known as Luteal Phase Support).
You clinic will be able to update you on embryo development.
Optional advanced treatment – Endometrial Scratch
A further procedure which may help with the implantation of an embryo. This is carried out before the egg collection phase.
During the few days after insemination, you’re effectively ‘on call’, to come in for the transfer appointment when your embryos are ready.
The embryos are carefully monitored in the period after insemination: first to check for fertilisation, then for signs for development which indicate the embryo is growing. The embryos are carefully monitored in the period after insemination: first to check for fertilisation, then for signs for development which indicate the embryo is growing.
Time-lapse monitoring provides more intensive observation of embryo development – Learn more.
Genetic screening (PGD/PGS) detects possible genetic diseases, and can assess embryos for probability of pregnancy success – Learn more.
Scheduling Embryo Transfer
The decision about when to complete the embryo transfer will depend on the number and quality of your embryos.
The procedure can feel like a smear test, but it takes longer: around 15 minutes. A tiny drop of culture medium containing one or two embryos is carefully deposited in the uterus using a thin catheter.
If you decided before treatment to store any further good quality embryos for further cycles, you’ll be consulted again, and it will happen at this stage.
We appreciate how difficult this ‘two-week’ wait can be. Please call us at anytime if you are concerned – no worry is too small. It’s a good idea to make plans for after embryo transfer, to help you feel more in control: try to live life as normally as possible.
The UK average success rate for an IVF treatment cycle is around 30%. The treatment journey can be made up of a number of cycles and frozen embryo transfers. The good news is that these will add up; the more cycles you go through, the greater your chances of success.
Around 17 days after egg collection you will need to take a pregnancy test.
If you’re pregnant, we schedule a scan in the clinic at around 6-8 weeks. If everything looks OK, you’re discharged to your GP.
If your period arrives before the test is due, or the test is negative, rest assured you are not alone.
We can meet to talk, review your treatment, and consider what the next step will be on your IVF journey. IVF conception often takes place over a number of cycles. You could be ready for a new cycle within a short time, even a couple of months if you have frozen embryos.