Approximately 1 out of every 6 couples struggle with infertility. Many times the root cause of infertility is difficult to pinpoint, and this can be a very traumatic truth for couples who desperately want a baby and who simply cannot conceive naturally.
There are many causes of infertility. Research has shown that 30% the cause of infertility is found to be the woman, equally 30% the cause of infertility is found to be the man. Over and above that, 30% of infertility is found to be both male and female, with the final 10% believed to be an underlying cause that cannot be determined by diagnostic methods used today.
To determine the cause of infertility you will need to undergo an infertility assessment. Thankfully, many problems can be rectified through fertility treatment, which can increase your chances of successfully conceiving a child.
There are many levels of fertility treatment out there and fertility clinics will diagnose and advise couples (or individuals) on what journey would be best for them, depending on the severity of their infertility. One of the most common solutions out there for couples struggling with infertility is referred to by in vitro fertilisation (IVF).
So, what Exactly is IVF?
IVF is a procedure used to overcome a range of fertility issues. It sees the egg and sperm joined together outside the body, in our specialised laboratory.
The fertilised egg, or embryo, is allowed to grow in a protected environment for three to five days, after which it is transferred into the woman’s uterus, increasing the odds that a pregnancy will result.
The procedure, first utilised in 1978, requires the woman’s ovaries to first be stimulated with fertility drugs to produce multiple mature eggs. For many couples battling infertility issues, this gives them the best possible chance of having a baby.
For women who are uncomfortable with fertility drugs, our natural cycle IVF option is a no- or low-stimulation approach. Patients are monitored closely as they approach ovulation, and they may require a so-called “trigger” shot to induce ovulation and “ripen” the egg or eggs. The egg is then retrieved in the same way as for conventional IVF.
IVF is performed in cases where there is a pelvic or tubal problem, where there is unexplained infertility, or following unsuccessful ovulation induction or artificial insemination. Egg retrieval is performed under anaesthetic in our on-site theatre, and once fertilised, the egg (now an embryo) is reintroduced to the uterus via a small catheter. A pregnancy test can be performed 10 to 12 days later. If it is positive, the foetus will be visible on an ultrasound two weeks later.
Candidates for IVF are:
Couples who have failed to conceive via less complicated medical procedures, such as Timed Intercourse and IUI
Women with tubal problems
Couples affected by male infertility
LGBTQ couples using donor eggs and/or sperm
Women with unexplained infertility
Women with severe endometriosis
When one or both partners are HIV positive
If you are struggling with infertility, and are considering IVF, you will need to understand the process well before beginning.
What is the Process of IVF?
The first step will be to book an appointment at HART fertility clinic, and to see one of our expert IVF specialists. They will be able to discuss everything you need to know and will help you understand the process that you will need to go through for IVF. This is also when you will be able to learn about the costs of IVF.
IVF is expensive, so do discuss this with the clinic on your initial visit to understand the process, step by step.
Preparing for IVF
Before you begin the IVF treatment process, you will be instructed to begin taking a prenatal vitamin and other supplements as well. You will be expected to adopt a healthier lifestyle as this will assist in preparing you for the treatment, and in turn for a pregnancy.
To start the process of IVF, you will receive hormone injections that you will need to administer yourself. These will be daily injections. If you are uncomfortable administering these on your own, you can get your partner to assist you, or you are welcome to come to the clinic where one of our nurses will administer these for you.
The purpose of these hormone injections is to stimulate your ovaries to produce more eggs than what is produced in your natural cycle. By producing more eggs, the embryologist will be able to collect more eggs, which will give you a higher chance of successfully creating and implanting an embryo.
During this period you will be closely monitored using blood tests and ultrasounds. This will give the IVF coordinator looking after you a better understanding of how your hormone levels are doing, as well as when your eggs are mature enough to be harvested.
Collection of the Eggs
Once your eggs are ready for collection, you will be given another injection to trigger the ovulation of the matured eggs so they are able to be collected.
Approximately 36 hours after receiving this injection that triggers your ovulation, the eggs should be collected. For the eggs to be collected, you will need to be given a mild sedative in addition to a local anaesthetic in your vagina. The embryologist will insert a needle through your vagina into your ovary to collect your eggs.
Once the eggs are collected, they will be evaluated for maturity and quality in order to decide which are the best choices to fertilise.
If the quality of your eggs are not suitable for fertilisation, there is an option for IVF with Egg Donors which we would be most happy to discuss with you should this need to be considered.
At the same time that you are undergoing the above procedure to collect your eggs, your partner (or a sperm donor) will be asked to give a sperm sample.
The sperm will need to be evaluated to make sure that they are suitable for fertilisation. Again, should your partner’s sperm not be suitable for fertilisation (or if you are a same sex couple, or a single woman), there is an option for IVF with donor sperm. The egg and sperm are placed in an incubator where they will (hopefully) fertilise.
Transfer of Embryo
The procedure of transferring the embryo into your uterus is painless and a simple procedure that doesn’t take long. You won’t need to receive any type of anaesthesia for this procedure and in some cases may be mildly uncomfortable.
About 5 or so days after fertilisation, the embryo is inserted through your vagina, through your cervix, and up into your uterus.
You will continue to receive hormone treatments to ensure the best possible conditions for your embryo to implant and begin developing.
Freezing Your Embryos
Because only one embryo is usually implanted at any given time, you may have more than one quality embryo that has been collected. You can at this point, choose to have your additional embryos or sperm frozen for future use should you need them.
This is possibly the most difficult part of this process because it is a waiting game from here. The initial wait is just over two weeks before returning to the IVF clinic to undergo a pregnancy test and to find out the news. This can be a very anxious, terrifying and exciting time.
Although we always hope and pray that our patients receive the news they have so eagerly anticipated, a positive outcome is not always the case. Some couples may choose to continue trying with subsequent rounds of the IVF treatment if the first is not successful, yet others may feel that they cannot continue for whatever reason.
It is important to do what is best for you at the end of the day. IVF can be a very long and exhausting process for some. It can be uncomfortable, stressful, expensive, and sometimes, very disappointing as there really is no guarantee of a successful pregnancy or birth.
HOWEVER, do not give up! And know that we are always here to discuss any of your concerns from beginning to end.
We also work closely with Amanda Dunsby, from Fertile Beings. Amanda is a Fertility Coach and would guide you through the process and give you tools to cope through the process of infertility.
We wish you all love and light on your IVF journey