Frequently asked questions about IVF

As the most widely used assisted reproductive technology in the world for couples trying to have a baby, it’s not surprising that there are many, many questions about in vitro fertilisation (IVF)!

We have selected the TOP questions we receive:

• What is IVF treatment and how does it work?
• Is the IVF procedure painful?
• How long does it take to get pregnant with IVF?

1. What is IVF treatment and how does it work?

In vitro fertilisation is the most effective and widely practised infertility treatment in the world.

IVF is a sequence of procedures involving the fertilisation of an egg outside the woman’s body in a specialised laboratory. It is often carried out after other methods of attempting pregnancy have failed.

To begin with, fertility drugs are usually prescribed to help stimulate the development of the egg. Even if a woman does not have ovulation problems, the drugs help to produce more than a single egg, which improves the pregnancy rate. Generally, 10 to 20 eggs are retrieved from the ovaries using a small needle. Healthy, mature eggs are mixed with a special medium and spermatozoa in a specialised laboratory to fertilise the eggs. On average, around two-thirds of the eggs collected are mature enough to be fertilised.

There are two ways of fertilising an egg:

• Conventional insemination, where the egg and sperm are combined in a glass Petri dish and then incubated.
• The other option is intracytoplasmic sperm injection (ICSI), where sperm is injected into the egg using a needle and a sophisticated operating microscope. ICSI is used around 70% of the time when fertilisation is less likely due to factors such as poor sperm quality or previous IVF failure.

The IVF team (doctors and embryologists) will decide which approach to use based on multiple factors relating to the couple undergoing IVF. Both methods have approximately the same success rate.

Once the embryos have developed, they are examined and graded by an embryo specialist. A top-quality embryo is selected for transfer; the other good-quality embryos can be frozen for later use. Embryo transfer usually takes place 5 or 6 days after egg retrieval, but sometimes earlier, on the second or third day. A single embryo is usually transferred into the uterus to avoid a multiple pregnancy, which carries a higher risk of complications for babies and mothers. It is hoped that, within a day or two, the embryo will hatch and implant in the uterine lining, where it will continue to develop into a foetus.

Approximately 12 days after the embryo transfer, a blood pregnancy test will be carried out and if a pregnancy is confirmed, you will be followed by blood tests and possibly ultrasound scans, to confirm viability and whether there is a multiple pregnancy. If the pregnancy appears normal at 9-10 weeks, you will be referred back to your obstetrician!

To find out more about the whole process, please read our article: How does IVF work, step by step?

2. Is the IVF procedure painful?

No.

There are a few stages in the IVF process that may cause slight discomfort, as described below. It is very rare to experience more than minor pain.

Most fertility drugs are administered by injection. Nowadays, they use easy-to-administer technology – such as a pen – which is an improvement on those administered a few years ago

Egg retrieval is a surgical procedure that involves removing the eggs from your ovaries. A small needle is used, passing through the top of the vagina into one ovary and then the other. An anaesthetist will closely monitor your intravenous sedation and you should feel no pain or discomfort during the less than 30-minute process.

You may experience slight cramping on the day of the procedure, which usually disappears the next day. You may feel a sensation of fullness and/or pressure due to the expansion of the ovaries through ovarian stimulation, which may last for a few weeks.

Embryo transfer uses a soft, flexible, thin catheter to transfer the embryo into the uterus. An abdominal ultrasound ensures that the tip of the catheter places the embryo in the best place for implantation. Pain and discomfort are rare, and the experience has been compared to that of a vaginal smear.

3. How long does it take to get pregnant with IVF?

An IVF cycle lasts about two months. Women under 35 will get pregnant and have a baby with their first IVF egg retrieval and subsequent embryo transfer(s) about half the time.

Women who do not become pregnant after the first IVF cycle still have a very good chance of becoming pregnant during the second and third IVF cycles and even more. Many factors affect your ability to get pregnant and have a healthy baby with IVF. Your doctor can usually tell you why you’re not getting pregnant and explain your chances of having a baby with IVF.

Age is the factor that most affects the success rate of IVF. The average percentages of births by IVF according to age are :

• 10% for women under the age of 35
• 3% for women aged 35 to 37
• 1% for women aged 38 to 40
• 7% for women aged 40 to 42
• 10% for women over 42

In addition to these statistics, it is important to note that the cumulative success rate for a live birth increases with additional IVF cycles for all women. However, the success rate remains lower for older women. Furthermore, the Centres for Disease Control (CDC) have recently observed that the IVF success rate for each age category has increased in recent years, as techniques and experience improve,

You should also be able to ask any fertility clinic what their IVF success rate is. Remember that clinics’ success rates vary according to the characteristics of their patients and the individualisation of patient care, so this should not be the only factor to consider when choosing a fertility clinic.

Many couples are unsuccessful the first time and continuing with IVF cycles often involves purchasing a separate treatment cycle each time it doesn’t work. While most patients choose to fund their treatment one cycle at a time, choosing a multi-cycle plan offers a greater chance of IVF success and a lower cost per cycle.