In-vitro fertilisation (IVF) refers to fertilisation outside of the body. Eggs are collected and mixed with sperm in the laboratory. At Repromed we offer two different types of IVF treatment:
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.
Below is a step by step guide to what happens during an IVF cycle:
Step 1: Egg collection
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.
At time of egg collection there are usually 5 – 10 follicles that have grown, however the number can vary immensely. 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 good 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 a 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
Embryo development is monitored daily (apart from day 4) and performed in the morning by our scientists. At Repromed, we offer two different stages of embryo culture – ‘cleavage stage’ or ‘extended/ blastocyst stage’. Cleavage stage is the term used for either day two or day three embryo culture. This option is used in clients who have usually more than 2 embryos. The embryos will then continue to grow in the uterus until the time that they may potentially implant. Extended/ blastocyst stage is the term used for day five embryo culture. This is beneficial as it allows our scientists to further monitor your embryos and choose the most advanced embryo for transfer.
EmbryoGen is a treatment available exclusively at Repromed. The treatment involves incubating fertilized eggs in a culture called EmbryoGen, which contains GM-CSF – a growth factor that occurs naturally in a woman’s uterus. There is an additional cost per cycle and may be suitable for women who have had previous IVF failures, multiple miscarriages or who are older than 38. Your doctor will be able to discuss if this is right for you. Read more about EmbryoGen on our Repro Fact sheet here.
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. The embryos will then continue to grow in the uterus until they implant.
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.
hCG Infusion is a IVF treatment add-on which may be suggested by your fertility doctor. There is some evidence that uterine infusion may increase the clinical pregnancy and Live Birth rate for women undergoing Day 2 or 3 transfer. Read more details here.
Please note that all semi-surgical procedures such as egg collections are carried out in affiliation with Repromed’s DAA accredited surgical unit ACSS (Auckland City Surgical Services) within the same building and using Repromed doctors.