Before I began IVF more than 5 years ago now I had absolutely no idea what it entailed.
And since going through the experience, I’ve come to realise there are a great many misconceptions out there when it comes to IVF and the process involved.
I’ve had some bizarre questions thrown my way and I believe that’s mostly because of the media’s tendency to focus on the most extreme cases, often only loosely associated with IVF.
While the experience is indeed emotionally taxing and the procedures can also be physically uncomfortable, the process itself is a fairly straight forward one.
The psychological and emotional impact of IVF is a personal one and every individual experience is unique.
There can also be variations to the process and outcomes of each step, depending on how your body responds to medication and procedures.
However we’ve put together a list of frequently asked questions, outlining the ins and outs of the standard process, thanks to the specialists at BUMP IVF.
In Vitro Fertilisation (IVF) is a relatively straightforward and standardised process of fertilising eggs with sperm outside of the body. However, in a recent survey by BUMP, 45 per cent of women between the ages of 25-44 cited general ignorance around IVF, fertility and different treatments as a cause of social stigma in Australia.
Even though there is a lot of confusion surrounding IVF treatment there are actually three standard procedure options available- standard IVF, IVF with Intra-Cytoplasmic Sperm Injection (ICSI) and Frozen Embryo Transfer (FET).
Standard IVF is when fertilisation of the eggs by the sperm occurs in a dish (‘in vitro’ means in glass in Latin). The resulting embryo(s) are either transferred back into the uterus or frozen for use in a future cycle.
ICSI is a similar procedure but it involves injecting a single sperm into a single egg with the resulting embryos either being transferred back into the uterus or frozen for use in a future cycle.
Finally, FET is when hormones are given to prepare the uterine lining. A frozen embryo is then thawed and transferred into the woman’s uterus.
What tests do I need before receiving treatment?
According to BUMP’s research, 89% of women believe the process of having IVF is complex. But actually, standard IVF treatment is quite straightforward. At the start, you usually need to carry out a few basic tests to determine if IVF is right for you.
You will need a basic blood test to measure your hormone levels including: FSH (follicle stimulating hormone), Estrogen and Prolactin. As part of this test you will also be screened for Rubella as well as HIV and Hepatitis B and C.
Women will also have an AMH blood test. This measures the hormone associated with a woman’s ovarian reserve levels –the lower the number of eggs, the lower the level of Anti-Mullerian Hormone (AMH). Women with a lower ovarian reserve have reduced fertility and an increased risk of miscarriage. Doctors use this test to get an early snapshot so a decision can be made on when to start trying for a baby and when to access fertility treatment. This test can be done at any time during a normal menstrual cycle.
Women will also require a pelvic ultrasound, this involves a single transvaginal pelvic ultrasound scan between days 2 to 6 of the menstrual cycle and is used to look at the health of fallopian tubes, uterus and ovaries. It will also alert your clinic to any fibroids, polyps or cysts, which could affect your cycle.
Men’s semen will also be tested to measure the number and quality of sperm. Your doctor will look at the sperm movement and other characteristics that could affect conception.
Once your doctor has carried out these basic tests you can begin IVF treatment. Egg collection and fertilisation is the first stage of treatment. Drugs are used to stimulate a woman’s ovaries to produce a number of mature eggs, often via self-administered daily injections. These are then collected with a simple surgical procedure and fertilised by the sperm in our lab.
Fertilisation occurs where the sperm and eggs meet in a dish. One of the resulting embryos can then be transferred back into the uterus. Excess embryos can be frozen, or vitrified, for later use. In a little over 10 days after the embryo is transferred, your IVF clinic can confirm if the treatment has resulted in a pregnancy.
Each person’s case is unique. Your type of infertility, age and type of treatment all affect the chances of becoming pregnant but your doctor will explain your chances of success. Leading IVF clinics which use world’s best practice in the provision of IVF increases the chance of success. This includes the transfer of single 4 or 5-day-old embryos and the use of vitrification technology to freeze your excess embryos for later use.
Studies over the years have found no increase in risks to children born following standard IVF treatment.
There is a very small (around 2%) increase in risk in some congenital abnormalities using ICSI or the microinjection technique, the cause of which is not yet known. Although ICSI is quite a common procedure to improve egg fertilisation, the treatment is not used unless medically warranted.
No, there is no evidence to suggest there is an increased risk to children conceived from FET.
A Folate supplement is recommended (at least 600 micrograms per day either alone or in combination with other pre-pregnancy supplements) for at least one month before you fall pregnant and three months after conception. This reduces the chances of neural tube defects such as Spina Bifida.
Age is an important factor here. If you’re under 35 and have been trying to get pregnant for the past twelve months or so, it’s probably a good idea to get some fertility advice. Similarly, you should seek advice if you’re over 35 and have been trying for around six months.
You should also seek advice if you are concerned about recurrent miscarriages, have a history of endometriosis, irregular cycles, chlamydia/pelvic inflammatory disease or have a family history of early menopause.