The Repromed lab is where life begins. In Vitro Fertilisation (IVF) refers to fertilisation outside of the body. Eggs are collected and mixed with sperm in the laboratory.
We offer two different types of IVF treatment – standard IVF and ICSI.
Once embryos are created they are grown (cultured) in the laboratory where their development is observed. One embryo is replaced back to the uterus, hopefully generating a successful pregnancy.
Standard IVF is used for clients who have normal sperm parameters – normal numbers, normal motility and normal morphology. Standard IVF involves the insemination of prepared sperm into each dish containing eggs. The sperm are left to swim up to and fertilise the egg overnight.
Sperm related infertility accounts for around 50% of the infertility cases we see. But with specialised Intra-Cytoplasmic Sperm Injection technology (ICSI), we can often find sperm to use even in cases where there appears to be little hope.
ICSI involves the insertion of a single selected sperm directly into the cytoplasm of a mature egg. This procedure can overcome many barriers to fertilisation which can include failed fertilisation from previous use of standard IVF and in cases where there is extremely low sperm counts or motility.
If you’re wondering if sperm is playing a factor in your fertility, we recommend getting a sperm test – there are at home sperm testing kits or, your GP or Repromed can arrange a test.
Sperm meets egg in this video showing Intra-cytoplasmic Sperm Injection technology (ICSI). Watch this fascinating process.
IVF treatment involves obtaining eggs from the ovaries. Ovaries are stimulated by administering injections of FSH (Follicle Stimulating Hormone), which encourages the development of several follicles (fluid filled sacs in the ovaries that usually contain eggs). This process normally takes about two weeks. Some clients with PCOS may also require Metformin. (Learn more about Metformin here.)
At time of egg collection there are usually five to ten follicles that have grown, however the number can vary greatly. Once enough follicles have matured the eggs are removed from the ovaries by passing a needle into the follicles and aspirating the fluid. The fluid is observed under a microscope where the eggs are removed and placed in a culture dish. This is a simple procedure that is performed in theatre by a doctor under light anaesthetic.
Step 2: Sperm preparation
Following egg collection the semen sample will be collected and prepared. Sperm parameters will determine which preparation method is used, the aim is to harvest a high concentration of highly motile, morphologically normal sperm. The prepared sample is viewed under a microscope and sperm counted.
Step 3: Insemination
Standard IVF insemination involves a calculated volume of sperm being inseminated into each dish containing the collected eggs. For ICSI the procedure is quite different, it involves one of our scientists injecting a single sperm into each egg. After the sperm has come in contact with the egg, the dishes are left in the incubator overnight in the hope fertilisation will occur.
Step 4: Fertilisation
The morning after the egg collection, our scientists check the eggs for signs of fertilisation. If normal fertilisation has occurred the fertilised eggs are now called ‘embryos’ and are grown in the laboratory until they are ready to be placed back into the uterus.
Step 5: Embryo culture
The embryos are cultured at body temperature in our incubators for up to 5-6 days with the intention that an embryo will be transferred or frozen at the 60 cell plus stage. For some people however, they may require their embryos to be transferred at the earlier “8 cell cleavage stage” on Day 3, depending on the number of embryos they have.
Step 6: Embryo transfer
Based on the information gained from daily observations, our scientists will decide when is best for your embryo to be transferred. The scientist will assess your embryos prior to transfer and choose the best quality embryo. This procedure is very simple, much like a smear test, and does not require an anaesthetic.
Step 7: Remaining embryos
Following your transfer, any remaining viable embryos will be cultured and observed up to day six with freezing on day five and day six of suitable embryos. Our scientists will continue to inform you about what happens to your remaining embryos.
Step 8: Pregnancy test
Fourteen days following your egg collection you will be asked to take your pregnancy test. This is done by a simple blood test.
Example of a high quality Day 5 blastocyst stage embryo showing the gelatinous shell (Zona) that contains the 60 or so cells that have differentiated into two cells types; the Inner cell mass that forms the fetus, and the trophectoderm cells around the fluid filled cavity that becomes part of the placenta.
Our Repromed doctors offer a range of personalised treatment options called Add-ons which are innovative treatments based on scientific evidence that may help to enhance your chance of getting pregnant, based on your personal needs. Learn more here.
If you’re a new client and not sure where or how to begin with your fertility journey, we offer a free 15 minute phone consultation with a fertility doctor.
Or, if you are ready to get started with treatment, you can book a first consultation with a fertility doctor where we can go in more depth with a treatment plan, provide you with next steps and if applicable, review eligibility for public funding.
Megan leads the nursing team through the continually changing face of IVF. She works in a multidisciplinary team, providing the essential organization between the doctors and laboratory and ensuring communication between all departments.
Megan started her IVF nursing career in the United Kingdom, working in two large London clinic’s before returning to New Zealand. She is also the Secretary of Fertility Nurses of Australasia.