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IVF is the process by which a woman’s (or donor’s) eggs are fertilised with either her partner’s (or donor’s) sperm inside a glass dish, In-vitro (Latin for ‘in glass’). In order for this procedure to be carried out, the woman’s normal fertility cycle must first be suppressed, clinically referred to as ‘down regulation’. This is done using fertility drugs known as gonadatrophins, which are normally administered either as a nasal spray or injection. Down regulation can take anything between 7 to 28 days to occur with an average of 15 days. During down regulation you may have a period but this is not always the case; blood samples and scans may be used to check that you have down regulated satisfactorily. Once the normal hormonal cycle is suppressed, doctors now have control over your cycle, which enables them to stimulate your ovaries using gonadotrphins in the form of daily hormone injections. The hormone injections usualy last between 7 to 14 days, with an average of 10 or 11 days.

Throughout the treatment, close monitoring of the patient is required in order to determine the number of follicles developing. This is done using both transvaginal scans and blood tests. Once enough follicles have developed to a suitable size, which is normally anything between 16 to 22mm in diameter, only then will the daily injections cease and a booster injection of hCG be administered 36 to 40 hours before egg collection is arranged. The Human Chorionic Gonadotrophin (hCG) is given in order to mature the eggs ready for collection.

The eggs are collected from the follicles using a long thin needle. This procedure is usually completed under heavy sedation and it is unlikely that the patient will be aware of anything that is going on. It feels similar to a general aesthetic, only you are more easily roused.

During egg collection your partner has to produce a semen sample, usually within the hospital, as it requires immediate preparation.

Your consultant or a doctor will usually speak with you immediately after your egg collection and inform you if any eggs have been retrieved. If eggs are retrieved they are sent to the embryologist who will begin preparation for egg and sperm to undergo fertilisation. Before leaving you will be told to contact the clinic the following day, when you will be informed if you have fertilised embryos and, if so, how many. The best embryos (usually up to a maximum of two) will be replaced in the uterus on day three, and any additional embryos suitable for storage will be frozen.

The embryos may or may not be transferred to the uterus using a guided abdominal ultrasound. If an ultrasound is used you may notice a tiny white flash on the screen - these are your embryos. Your partner can be present at this time.

Before leaving the clinic you will usually be given progesterone pessaries which you will continue to use twice daily until your outcome day. You will return to the clinic in approximately two weeks with a urine sample to be tested for hCG hormone, which indicates pregnancy.

If you have a positive result you will return to the clinic in three weeks (at which time you are classed as 7 weeks pregnant) for a transvaginal scan which checks for multiple pregnancy.

If your result is negative then you will normally be given an appointment with your consultant to discuss your options.

This information is not meant as medical advice.