IVF and ICSI

What is IVF treatment?

IVF treatment the process where eggs are collected from the ovaries and fertilised in the laboratory. A fertilised egg has the ability to develop into an embryo, and a single embryo is then placed back into the uterus with the hope that it will result a successful pregnancy. Many patients will have additional embryos from their cycle, which can be frozen.

IVF treatment is the preferred method for overcoming fertility issues such as blocked or damaged fallopian tubes, male factor infertility, previous male and female sterilisation, unexplained infertility and a variety of other conditions outlined in causes of infertility.

What is involved?

The term “IVF cycle” is used to describe one round of IVF treatment, and begins with ‘day one’ of your period. A more detailed description of what is involved in an IVF cycle is outlined below:

Booking on

The first day of your IVF cycle will begin with ‘day one’ of your period. You will be asked to contact the nurses on this day, and they will talk you through the next steps.

Stimulatory injections

Stimulating your ovaries involves approximately 10-12 days of daily injections. These are self-administered injections, and your fertility nurse will talk you through how to give these injections prior to commencing treatment. Your stimulation protocol will be tailored to your individual circumstances and your fertility doctor will advise you on the most suitable protocol for you.

Monitoring the cycle

We will be monitoring your cycle to check how the follicles are developing using ultrasounds and blood tests. The ultrasound scan will look at the number and the size of the follicles in each ovary and involves a transvaginal scan where an ultrasound probe is inserted internally. Your partner is welcome to attend, and our nursing team will support you throughout this process.

Once the follicles reach a certain size, you will be advised to have a trigger injection to prepare the ovaries to release the eggs. Your fertility nurse will tell you exactly when to take this injection in order to correctly schedule the egg collection.

Egg collection

During the egg collection (also known as an egg pick-up), the eggs are removed from the ovaries. This occurs in our Day Surgery rooms under a light anaesthetic, and usually only takes about 20-30 minutes.

The fertility doctor will use an ultrasound to guide a needle into each ovary and drain the fluid from the follicles. This fluid is immediately examined under a microscope for the presence of an egg. At the end of the procedure, you will know how many eggs were able to be collected.

Recovery from this procedure only takes about 30-60 minutes; however, you will need to have a support person to take you home as you will not be able to drive afterwards.

Luteal phase support

This medication usually starts two days following the egg collection and must be taken at least until the pregnancy test to support embryo implantation and development. Your fertility nurse will advise you when and how to take this medication.

Fertilisation - standard insemination versus ICSI

Sperm is required on the same day as the egg collection in order to fertilise the eggs. There are two main methods used to fertilise eggs: IVF (also known as standard insemination) or intracytoplasmic sperm injection (ICSI).

IVF (standard insemination):

During IVF, the eggs are combined with a pre-defined amount of sperm in a culture dish and left overnight to allow fertilisation to occur. This method relies on the sperm entering the egg naturally and requires a certain number of moving sperm in order for this to be successful.

ICSI:

ICSI involves a single sperm being injected into each mature egg under a microscope using a very fine needle to assist with fertilisation. The sperm are chosen based on their appearance under the microscope, which can also be supported by the use of more refined selection methods such as SpermSlow if required.

ICSI may be recommended for the following reasons:

• If the sperm quality in the semen sample is not optimal (i.e. low count, low movement, or a high number of abnormally shaped sperm);
• If previous IVF cycles have resulted in low fertilisation outcomes;
• If the sperm has been collected using a surgical sperm retrieval; or
• If the eggs that are being fertilised have been previously frozen.

Your fertility doctor will be able to guide you through in more detail about which method will be most appropriate for you based on your individual circumstances.

Embryo development

If the sperm successfully fertilise the eggs, they have the potential to become embryos. Our embryologists will be monitoring the embryos over the next five to six days and will keep them in perfect conditions for growth and development to occur.

Unfortunately, not all eggs will fertilise and not all embryos will reach day five or six of development. We understand that this is an important time for you to find out about how things are progressing, so the embryologists will be contacting you to keep you updated.

Embryo transfer

If you are having an embryo transfer, we recommend transferring only one embryo due to the risks associated with multiple pregnancies. On the day of transfer, our embryologists will select the best quality embryo available and any remaining good quality embryos can be frozen for later use. The embryo transfer will be performed by a fertility doctor under ultrasound guidance.

The transfer is normally a very simple procedure and is similar to undergoing cervical screening. You will be awake, and you can get up straight afterwards to continue with your day. The lining of your uterus will be quite sticky during this time, so the embryo will remain in place. Your partner or support person is always welcome to be present during this procedure.

Pregnancy test

Approximately 16 days after your egg collection, you will have a blood test to measure the levels of the pregnancy hormone hCG (human chorionic gonadotropin). The presence of hCG in your bloodstream will usually result in a positive pregnancy test.

Often it can feel like a long wait between the embryo transfer and the blood test, and it can be hard not to become anxious about the result. Our nursing staff and counsellor are here to support you and help manage the stress of fertility treatment at any time prior to, or during your IVF cycle.