Within this section, you can find information explaining everything about IVF, including what it is, how it works, fertility challenges it can overcome, success rates and costs.

In natural conception, when an egg is ovulated each month, sufficient numbers of actively swimming sperm need to enter the cervix, work their way up the uterus and into the fallopian tubes. An egg must be released from the ovary and make its way down the tube to meet the sperm – the timing for all this needs to be right so that the egg and sperm can combine. Then, if the sperm successfully fertilises the egg, the dividing egg makes it way back down to the uterus to implant into the lining of the womb.

A problem with any of these steps in the reproductive process may result in difficulties in becoming pregnant. There are a number of reasons why this process may not work efficiently and this is where IVF can help. Whilst it is not a cure for infertility, IVF can overcome issues that obstruct natural conception and help people to have a baby.

What is IVF?

IVF (in vitro fertilization) is a fertility treatment where fertilization occurs outside of the body. It is one of several techniques available to help people with fertility problems have a baby.

Getting pregnant is often more difficult than people think, especially as we get older. It’s helpful to be aware of the fertility issues that people can have when they are trying to conceive and how IVF works to address these problems.

Fallopian tube damage

IVF was originally developed to overcome damage to the fallopian tubes. Blockage in a fallopian tube prevents sperm from reaching the egg to fertilise it. Fertilisation in the laboratory overcomes this problem. During IVF, your ovaries are stimulated to produce eggs, which are retrieved during a short procedure called egg collection. Your eggs are then fertilised with your partner’s or donor sperm in the laboratory, and your fertilised embryos are placed into your uterus through the cervix where they can implant and grow, so the fallopian tubes are bypassed all together.

Endometriosis

Endometriosis is a condition where tissue that normally grows in the uterus implants and grows in other places in your body and can cause scarring, which may block your fallopian tubes. If you have mild endometriosis, a procedure known as a laparoscopy may improve your chances of a successful pregnancy. If your endometriosis is severe, you may still have a chance of getting pregnant naturally, however if you have damage to your fallopian tubes your doctor is likely to recommend IVF. You may end up choosing IVF because you prefer this to surgery, or you may already have had surgery but not conceived. If you endometriosis is not severe enough for surgery but you haven’t conceived after a few years of trying then you may also consider IVF.

Age and your eggs

A woman’s most effective reproductive years are in her 20s. Fertility gradually declines in the 30s, particularly after age 35. Even a healthy, fertile 30-year-old woman has only a 20 percent chance of getting pregnant naturally each month. The impact of age on your eggs is twofold. Firstly, as you get older, your eggs decrease in number. Age is the biggest factor affecting egg supply. The older you get, the fewer eggs you have. Women are born with their lifetime supply of eggs, your body does not produce more eggs. Secondly, egg quality deteriorates with age and this has a significant impact on the viability of embryos and chromosome disorders become more likely. For women, the ability to conceive is influenced by the quality of her eggs. Decreased egg quality means it becomes more difficult for the sperm to fertilise the egg naturally.

IVF and egg quantity

In a normal menstrual cycle you release one egg each month. In an IVF treatment cycle, we are able give you a course of fertility drugs to stimulate the development of follicles in your ovary to produce a number of eggs, (your chances of becoming pregnant are greater with more eggs). We collect your eggs during a simple procedure and put them in to a special culture medium. We then safely transfer them to an incubator to provide exactly the right environment and temperature conditions for them. We spin the semen sample in a special media to isolate the good quality sperm and then wash this in another media to purify the sample. The next step is to fertilise your eggs with the sperm to form embryos. We then grow your precious embryos in carefully controlled conditions until they’re ready to be transferred into your womb. Usually we will transfer one embryo, and hopefully you may have surplus embryos which can be frozen and used either if initial treatment is not successful or if you wish to have another child.

IVF and egg quality

If the quality of an egg is poor, then most likely it will not fertilise. Some may even fertilise but then the embryo doesn’t implant or results in a miscarriage. There are a number of things which can be done during an IVF treatment cycle to optimise embryo selection and increase your chances of pregnancy.

Blastocyst embryo transfer

A blastocyst is an embryo that has been developed in the laboratory for five or six days after insemination. A day 5 or 6 embryo is a much more advanced structure than a 3 day old embryo and the real advantage is the potentially higher live birth rate associated with this type of transfer.

PGT-A

By using pre-implantation genetic testing (PGT-A) in an IVF treatment, our embryologists have up to an 85% chance of singling out embryos with abnormalities before transfer. This can improve IVF success rates and reduce both the chance of miscarriage.

Ovulatory issues

Ovulatory issues have a significant impact on fertility. The process of maturing and releasing an egg, is essential when you’re trying to conceive, and there are a number of things which can interfere with ovulation. These include Polycystic ovarian syndrome (PCOS) which can result in hormone imbalance and, among other symptoms, can cause irregular menstrual cycles. Women with PCOS may have difficulty getting pregnant because they do not ovulate in a regular pattern and if an egg is not being released it will be impossible for one to be fertilised naturally. In an IVF treatment cycle, the goal is to have the patient ovulate mature follicles.

With IVF we can develop a specific stimulation protocol for you to help optimise the number of eggs you produce in your cycle, monitoring you closely to establish the correct time to collect your eggs. We fertilise them in the lab with your partner’s sperm and monitor your embryos closely. When the time is right, we select for embryo transfer the one which we think has the highest chance of implanting successfully.

If you’re concerned that PCOS is going to make it difficult for you to have a baby, try not to worry. Most women who suffer from this condition go on to have successful pregnancies. IVF is a very successful treatment for women who have PCOS and the large majority of women who have not managed to become pregnant with other treatments will be able to get pregnant and have a baby with IVF if they are under 40.

Male fertility problems can be due to a number of issues and diagnosis usually involves a general physical examination and semen analysis. We can offer cutting edge male diagnostic tests too, which check for chromosomal issues, or sperm DNA damage.

You can read more about these tests below.

Hormone screening

Hormone screening and testing, also sometimes known as a male hormone profile test, can give us an indication of everything from how many sperm you’re able to produce, to whether you might have an underlying medical condition – and all of this information will help us to give you the right fertility treatment.

Could testing my hormones be for me?

In men, particular hormones can be good indicators of how much sperm you’re able to produce.

If you’re a new patient or suffering from unexplained fertility problems we’re likely to suggest hormone screening, as it can really help us to better understand your needs. Following these tests we will be able to recommend the best fertility treatment for you. If able to use your own sperm this is likely to be:

• IUI
  • Intrauterine Insemination (IUI) simply means putting prepared sperm into the uterus. It has been more commonly known as artificial insemination.
• IVF
  • In vitro fertilisation (IVF) is a method of fertilising an egg by placing it with a specially-prepared sperm sample.
• ICSI
  • Intracytoplasmic sperm injection (ICSI) is a laboratory procedure carried out during fertility  treatment where an individual sperm is injected directly into an egg.

What does hormone screening involve?

The levels of follicle stimulating hormone (FSH) and luteinizing hormone (LH) in your blood can help us get an idea of how much sperm you might be producing. We’ll also check your testosterone levels.

Virology Screening

Virology Screening is required of all our patients who are planning on using their own sperm in their fertility treatment. This important first step is where we check for viral infections, such as Hepatitis B, Hepatitis C and HIV, which you may not be aware you have but could impact your fertility and your treatment. Knowing if you have any of these viral infections will allow us to advise you on what steps, if any, need to be taken before starting treatment.

What does virology screening involve?

The virology screening is a relatively quick and painless step at the start of the fertility treatment process. We check for viral infections by taking a small blood sample for testing.

Semen analysis

The quality of your sperm is really important in deciding your next steps.

What is semen analysis?

Semen analysis is the process where we analyse a sample of your semen using various techniques and equipment  to determine the quality of your sperm.

How can semen analysis help me?

Male fertility problems are one of the largest known causes of infertility in couples – in fact, they contribute to up to 30%–50% of cases. Sperm analysis is essential to both diagnosis and treatment, so when you come to us, your sperm is one of the first things we’ll need to check.

Could semen analysis be right for me?

Whether or not you’re generally healthy or have had a child before, we’ll always recommend semen analysis to every man that comes to CARE. When couples are struggling to start a family around 30% of cases are related to sperm, so it’s essential we see whether this is a possibility.

We’d usually book you in for semen analysis before your first consultation or as part of a fertility assessment. That way, the results will be ready when you meet your consultant.

How to prepare for semen analysis

Before the sperm test, you’ll need to abstain from sex for three to five days. Ideally also avoid, alcohol, majuiana and any herbal remedies such as St John’s Wort.

What does semen analysis involve?

Before the sperm test, you’ll need to abstain from sex for three to five days. When we test your semen sample, we’ll assess:

• Ejaculate volume
• Sperm concentration (number)
• Sperm motility (how well they’re swimming)
• Sperm morphology (their shape, size, and appearance)
• Presence of white or red blood cells
• Whether there’s an immune response, known as anti-sperm antibodies, against sperm proteins