“Don’t think of IVF as a treatment,” says Dr David Walsh of SIMS clinic. “It’s really more of a test. It examines how well a man’s cell – the sperm – and the woman’s cell – the egg – can work together.
It’s really an incidental by-product that when you put those embryos into a uterus it results in a pregnancy.” IVF is the process where a woman’s eggs are fertilised outside of her body in the laboratory. The resulting embryos are then transferred back into the uterus a few days later.
According to Walsh, IVF is recommended for women with absent, blocked or damaged fallopian tubes. It is also often used in cases of unexplained infertility, in some cases of male factor infertility and can be used in combination with ICSI (intracytoplasmic sperm injection).
Timeframe
Walsh says that, while every patient is different, there is a time frame to follow before considering the IVF route. “Couples generally turn to IVF after two years of trying.
Usually, in the first six months the couple will be trying themselves and then they may turn to their doctor for some advice. He/she may offer some options or advise taking supplements for the next six months.
“After that it is normal for the couple to look for some fertility treatment options.
IUI (intrauterine insemination) is one example. This involves taking the sperm and planting them high up in the womb to double the couple’s chances of getting pregnant. If this is unsuccessful IVF is usually the next option.”
There is an exception to this time frame– the woman’s age. “If the woman is coming close to her 40th birthday it may be important to consider IVF at an earlier stage.
Remember, often couples will want to have more than one child. They can sometimes focus too much on the first and, by unnecessarily delaying the process, they push back the second baby – this can create a problem.
It’s often about creating a family and not just one child.”
Two months
Walsh says that the IVF process takes, on average, two months.
“If I see somebody in mid November, generally speaking you would be looking at treatment in mid January,” he says.
“You need time to check the egg count and get them prepared for the cycle.”
The chances of success from IVF vary between patients, particularly according to the age of the woman. However, on average, about 28 per cent of patients will have a baby after one attempt at standard IVF.
“We are simulating what Mother Nature does. Mother Nature gives you a one in five chance of getting pregnant every time you try. We are doing something similar.
“With each failed cycle however the chances of success do decrease. Interestingly, if the man has a fertility problem, it’s not necessarily a bad thing. You can do something about it. Often men can be sensitive if their sperm count is low. But I tell them it is also a good thing because it means the treatment is more likely to work - because we know where some of the problems are arising from – and how to eradicate those problems.”
According to Walsh, it is crucial that couples lean on each other for support.
Eager to not sugar-coat the process, he admits IVF is a hard route to take.
“There will always be challenges along the way. How you cope with those challenges together is very important. Failing to get pregnant is just one of the problems that couples can face, there is also the possibility of not staying pregnant or having an ectopic pregnancy. The couple must be there for each other through the whole process. If they do that then I believe they have a great chance to succeed.
It’s a shared journey. And that’s the critical thing. In fact, I find that most couples are brought closer together by the process.”
What does IVF entail?
There are four general steps involved in an IVF cycle:
Stimulation
Under the care of a consultant gynaecologist, the woman is given fertility medications to stimulate her ovaries to produce many follicles. Follicles are the small fluid filled structures which develop on the ovaries, each of which will hopefully contain an egg.
The number and size of the developing follicles are measured by trans-vaginal ultrasound scans. The exact number of follicles, which develop varies between patients, but the average is about 10. The final preparation for egg retrieval involves a hormone injection, which mimics the natural trigger for ovulation. Egg retrieval will take place 36-38 hours after this injection.
Retrieval
Egg retrieval is a minor operating theatre procedure which is carried out on an outpatient basis under local anaesthesia. The trans-vaginal ultrasound probe is used to visualise the ovaries and a needle attached to the probe is passed through the vaginal wall into the follicles. The fluid within each follicle is aspirated and then examined in the IVF laboratory for the presence of an egg.
After identification, the eggs are washed and transferred into a special culture medium in Petri dishes in an incubator.
Fertilisation
While the egg retrieval is proceeding, the sperm is also prepared. A semen sample is provided by the male partner and, in the laboratory, a concentrated preparation of the best motile sperm is extracted from the semen sample. This sperm preparation (containing approximately 150,000 sperm) is added to the dishes containing the eggs, and they are incubated together overnight.
Transfer
Embryo transfer is a simple theatre procedure that does not routinely require anaesthesia. The embryos are placed into the uterine cavity by the doctor/IVF nurse by means of a fine catheter inserted through the cervix. The correct positioning of the embryos is confirmed by abdominal ultrasound, so the woman is required to have a full bladder for the procedure.
((http://www.independent.ie/))
Thank you for sharing this. I remember the day of ER this way. My husband and I arrived at the clinic early in the morning. Both had a restless night of sleep. Both of us were on edge. Were unsure of what to expect, despite all of our research. I was too nervous! My doc reiterated what was about to happen.~
ReplyDeleteUsing a needle attached to a catheter, she would suction the mature eggs out of each follicle. Then store them in tubes. They’d await fertilization by my husband’s sperm there. I was hooked up to an IV, which was used to deliver a local anaesthetic. 30 mins later I was wheeled into the operating room. It took about 15 minutes for the eggs I had to be retrieved. Afterward, I recovered in my room. Too weak after meds. We stayed at the clinic for about an hour. Then were discharged. Still groggy from the medication. I remember I spent the rest of the day sleeping.