A typical IVF journey, whether it is for the first time or trying again, can also be called a ‘stimulated cycle’. This is because your treatment will involve taking drugs that stimulate your body so we can collect a number of eggs for fertilisation.
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 member of our nursing team 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 Consenting appointment. Often you will take drugs to regulate your cycle; this gives the clinic the ability to manage when you ovulate.
In general, treatment starts with drugs that stimulate your ovaries. This enables us to collect a number of eggs for insemination, rather than the usual one. The drugs are injections that can be taken at home – you’ll be shown how to do this.
Over a period of around 2 weeks of stimulation, you’re likely to have 1-3 scans, and possibly blood tests, to monitor the development of the egg producing follicles. These are short appointments that last around 20mins, and the results are available later the same day. The timings are different for everyone, because treatment is tailored to suit each patient individually.
Once your follicles are ready, the stimulation period ends with an injection that matures the eggs in the follicles, ready for egg collection.
The appointment to collect the eggs will take place 36-40 hours after the trigger injection. The procedure takes about half an hour, and you will be given drugs to make you sleepy during the procedure. With the help of a scan probe, a very fine needle is passed through the vaginal wall and into the ovary to collect the eggs. Usually, around 80% of follicles contain an egg. You can go home the same day, after a short rest at the clinic. You’ll need someone to pick you up; you mustn’t drive for the rest of the day, because of the anaesthetic.
If your treatment uses a fresh sperm sample, it will be provided on the same day as the eggs. You provide the sample at the clinic, in one of our andrology (men’s) rooms. If you’re providing the sample via a surgical procedure, this will take place before the egg collection day, and the sample will be be frozen.
If you already have sperm in storage, or have been matched to a sperm donor, the sample will be thawed on the same day that the eggs are collected.
The sperm sample provided is prepared to ensure that the very best sperm are being used for insemination.
In Vitro Fertilisation Cycle – prepared sperm will be added to the eggs in a culture dish.
Intra-Cytoplasmic Sperm Injection Cycle – a single sperm will be selected and injected into each egg, then put into a culture dish.
The culture dishes are placed in the incubator to allow fertilisation 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.