What is IVF? A brief overview
What is IVF? A brief overview
When Rachel and I were going through IVF one of the things that made us aprehensive was not knowing what to expec from IVF this article will give you a quick overview of what you can expect.
What is IVF?
IVF (In vitro fertilisation), is an assisted reproduction procedure which takes about 8-10 weeks including appointments. It takes either your own or a donor’s eggs and sperm by stimulation of hormones then retrieving the eggs via minor surgery. The eggs are retrieved and fertilised with the sperm in a petri-dish. These are incubated and assessed throughout. 3-5 days after retrieval the embryos are then implanted back into the uterus.
IVF is a form of assisted reproduction so what is assisted reproduction?
Assisted reproduction is a range of procedures which aid couples suffering with infertility to become pregnant. In the UK the main assisted reproduction procedures are: –
- IUI (intrauterine insemination) – This is artificial insemination of sperm into the uterus
- ICI (intracervical insemination) – The artificial insemination of sperm into the cervix
- IVF (In vitro Fertilisation) – The fertilisation of male and female gametes (egg and sperm outside the body)
- ICSI (intracytoplasmic sperm injection) – Direct injection of the sperm into the egg
What is an IVF Protocol?
Firstly, let’s define a protocol in medical terms, it’s:
A detailed plan of a scientific or medical experiment, treatment, or procedure.
It is a framework outlining the care that will be provided to patients in a designated area of practice. They do not describe how a procedure is performed, but why, where, when and by whom the care is given.
So, in terms of IVF this is how and why will you be treated through IVF and takes into account your medical history, tests and previous responses to past IVF cycles.
What are the different IVF Protocols in the UK?
The 3 main IVF protocols are Long protocol, short protocol and flair protocol.
Long Protocol more formally the down regulation protocol– This is the administration of down regulation drugs from approximately day 21 of your cycle. It normally takes 2-3 weeks and is to stop your own hormones interfering with subsequent stages. This is the standard IVF protocol. From there you can move on to stimulation drugs to grow your follicles.
Shot Protocol more formally known as the antagonist protocol – This is generally used where women have responded poorly to the long protocol (i.e. less than 3 follicles) or suffer with PCOS. This is what is says on the tin, you start injections much earlier in your cycle they are a lower dose and you do less of them.
The Microdose Flair Protocol – This involve using the same down regulation drugs in down regulation starting between day 1-3 of your cycle, these will only be injected for 3-5 days. The evidence behind it is enables a flair of FSH from the pituitary gland which may help the stimulation drugs work. You will normally be on the pill for the month before. This is sometimes used for women with low ovarian reserve.
Learn more about the drugs used in IVE cycles in our article Starting IVF – What medications will I take & how will they impact me?
What does the IVF treatment involve?
We have done a detailed article called How Does IVF Work: What can you expect from the IVF process?
But as a quick overview the normal process (there are other protocols) involves 6 keys steps
- Down regulating your natural cycle – The aim here is to supress your natural menstrual cycle to reduce activity in your follicles and thin the womb lining. For standard IVF (long protocol) this will generally start around day 21 of your cycle and involves injection of dugs containing hormones.
- Stimulation of your egg supply – Medications are used to boost encourage your ovaries to produce more follicles to maturity than during a normal cycle where 1 would occur, so that a greater number of mature eggs can be collected.
- Monitoring and then Triggering – You will be closely monitored during this phase to ensure that the follicles and womb lining are developing as they would expect, this is done through transvaginal ultrasound. When the specialist sees the right moment, you will take a trigger injection which will cause your eggs to fully mature to a state just before ovulation.
- Egg Retrieval – This is a minor surgical procedure; it requires a day’s admission to the clinic. You will be given drugs to help you relax and not feel anything. A needle inserted through the walls of the vagina into the follicles and the eggs are extracted. At the same time if required the man will give a sample of semen.
- Fertilisation – The eggs and sperm are analysed and prepared. They are then put together and incubated, fertilisation usually takes about 18 hours and you get a call the next day from the embryologist to tell you how many have been fertilised.
- Embryo Transfer day – You will have 1-2 embryos (fertilised eggs) implanted on either day 3 or day 5. The procedure involves a small tube being inserted through your cervix to a specific point in your uterus and the embryo released.
You will then have the challenging 2-week wait to find out if your IVF treatment has resulted in a successful pregnancy.
What will IVF do to me?
As a quick overview; IVF treatment will take you on an emotional rollercoaster of a journey. You are forcing your body into an exaggerated state during both down regulation and stimulation using hormones. You will experience emotional and physical changes during this process, and it is important that you have a support network around you, whether that be friends and or family who understand, online support groups, or professional therapy it’s whatever works for you. You can learn more about the emothional impacts on our article IVF and Fertility counselling – don’t under-estimate the emotional impacts of IVF