In vitro fertilisation (IVF)

In vitro fertilisation (IVF) is the process used to conceive a child outside the body. A woman’s eggs and a man’s sperm are placed together in a plastic dish for fertilisation. Once fertilised, the resulting embryos are placed back in the woman’s uterus in the hope that a successful pregnancy will follow.

The IVF procedure
IVF is not one simple procedure, but a series of steps over several weeks. The steps involved in this procedure are outlined below.

Stimulating the ovaries
Hormones are usually given to stimulate the ovaries to produce more than the usual one egg per cycle. This is to enable the collection of several eggs.The development of the eggs is monitored by one or two blood tests and ultrasounds. The ultrasound and blood tests ensure that eggs are collected at precisely the right time.

Collecting the eggs
The ultrasound is inserted in the vagina and a very fine needle is threaded through a guide, which is attached to a probe. Only a light anaesthetic is required for this procedure. The ultrasound monitor shows where the follicles are. The needle pierces the follicle and extracts the follicular fluid, which contains the egg.

Fertilisation and embryo transfer
A couple of hours after egg collection, the man provides a sample of semen. In a standard IVF treatment, the eggs are mixed with the sperm in a culture dish. For intracytoplasmic sperm injection (ICSI) treatment, one sperm is injected directly into the cytoplasm of each egg.

If an egg is fertilised by a sperm, a zygote or pre-embryo will begin to develop. The pre-embryo remains in the incubator for one or two days, until it has divided into two or four cells. Following fertilisation, two to three embryos will be transferred to the uterus using a soft, fine catheter. This procedure (known as embryo transfer) is quite painless, similar to a smear test, and requires no anaesthetic.

For the gamete intrafallopian transfer (GIFT) program, eggs and sperm are placed directly into the fallopian tubes, allowing fertilisation to take place in the natural way. The procedure is performed using a laparoscope, and a general anaesthetic is required. This procedure is rarely used now.

Pregnancy test results
Two weeks after the transfer, a blood test is taken to determine if the woman is pregnant.

Possible risks and side effects
There is no clear evidence that infertility medicines, if properly used, increase the risk of birth defects or cancer. The increase in the hormone oestrogen can cause breast tenderness, slight nausea, dizziness and slight abdominal swelling. Occasionally, too many follicles develop and a condition called ovarian hyperstimulation syndrome (OHSS) may occur. This is an unpleasant experience, which may include marked abdominal swelling, nausea, vomiting and diarrhoea, lower abdominal pain and shortness of breath. There is also a theoretical risk (very rare) of damaging organs, or causing infection or bleeding, with the collection needle.

Where to get help

• Your doctor
• Your local community health centre
• Family Planning Clinic
• Monash IVF Tel. 1800 628 533

• IVF is a process where fertilisation of an egg occurs outside of the body.
• IVF is not one procedure but rather a series of steps taken over several weeks.
• While infertility drugs have some side effects, there is no evidence that they cause cancer or birth defects.

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