In vitro fertilisation (IVF) is one of several assisted reproductive technologies (ART) used to help infertile couples to conceive a child. Approximately 20 per cent of couples experience fertility difficulties.
IVF is the process of fertilising eggs with sperm outside of the human body. Once the eggs are fertilised, the resulting embryos are placed in the woman’s uterus in the hope that a successful pregnancy will follow.
Success rates vary across IVF clinics and procedures, and with the woman’s age. Some clinics achieve pregnancies in about 90 per cent of women aged under 35 years, 85 percent of women aged 35 to 39, and 45 per cent of women aged 40 to 44.
The IVF procedure
IVF is not one simple procedure, but a series of steps over several weeks. The steps involved in this procedure are:
- Stimulating the ovaries
- Collecting the eggs
- Embryo transfer.
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 blood tests and ultrasounds that ensure eggs are collected at precisely the right time.
Collecting the eggs
When the time comes to collect the eggs, an ultrasound probe is placed in the vagina while the woman is under light sedation. The ultrasound monitor shows where the follicles are within the ovaries.
A fine needle is passed through the vaginal wall and into the ovaries. Each follicle (sac of fluid) in the ovary is pierced in order to collect its egg.
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 two to five days while it continues to grow and divide.
Once the embryos have grown to a predetermined size, one or two will be transferred back to the woman’s uterus at the appropriate time in her menstrual cycle. This procedure involves passing a very fine plastic tube (catheter) through the cervix and into the uterine cavity under ultrasound guidance.
Embryo transfer is very similar to a pap test, is generally painless and usually involves no anaesthetic. Only one or two embryos are transferred at a time.
Two weeks after the transfer, blood is taken and tested to determine if the woman is pregnant.
Risks and side effects of IVF
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 the levels of the hormone oestrogen rise too high, causing a condition called ovarian hyperstimulation syndrome (OHSS). This is an unpleasant experience, which may include marked abdominal swelling, nausea, vomiting and diarrhoea, lower abdominal pain and shortness of breath. OHSS is rarely severe enough to require hospitalisation.
There is also a theoretical risk (very rare) of damaging other organs, or causing infection or bleeding, with the collection needle.
Where to get help
- Your local doctor
- Obstetrician or gynaecologist
- Your local community health centre
- Family planning clinic
- IVF clinic
Things to remember
- IVF is a process in which fertilisation of an egg occurs outside 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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