1. Initial consultation
Our specialists assess your fertility and create a personalised treatment plan that is best suitable for you. We use prediction models to estimate the chances of treatment resulting in a healthy baby.
2. Suppressing the natural menstrual cycle hormones
You will take daily injections to temporarily suppress your own hormones interfering in the treatment cycle. This may start during your current cycle or in the previous cycle.
3. Ovarian stimulation
You will be taught to administer daily gonadotropin injections to stimulate the ovaries to produce multiple follicles (egg containing sacs). Most women need injections for 9-14 days and this stage is closely monitored by doing trans-vaginal (internal) ultrasound scans (+/- blood tests).
4. Trigger injection
When follicles reach the right size, a trigger injection (hCG or GnRH analogue) is given 34-36 hours before the egg retrieval procedure, to help mature eggs in the follicles.
5. Egg retrieval or collection (Trans-vaginal Oocyte Retrieval)
- You will be given conscious sedation and pain killers through your vein. You do not feel any pain and you generally do not remember about it afterwards.
- A hollow needle attached to the ultrasound scan probe is passed through the vagina to aspirate eggs from the ovaries. Not all the eggs come out from all the follicles
- The procedure takes about 30 minutes.
- You will be discharged home the same day
- You may experience some period-like cramps, feel a little sore and bruised and/or experience a small amount of bleeding for few days.
- Very occasionally, the procedure to retrieve eggs may have to be performed trans-abdominally (through your abdomen).
6. Fertilisation – IVF or ICSI
- IVF: Sperm is added to the eggs, allowing fertilisation to happen by natural mechanism
- ICSI: A single sperm is directly injected into each egg under a microscope.
7. Embryo development
- The fertilised eggs (embryos) are monitored for several days.
- Generally, on day 5 of embryo development, a best quality embryo is selected for transfer.
- Occasionally, we advise against fresh embryo transfer - we suggest you to freeze all the embryos and to come back for a frozen embryo transfer
- Any surplus good quality embryos are stored for future use.
8. Embryo transfer
- You will be asked to attend with a full bladder, as an abdominal ultrasound scan will be carried out.
- A speculum is passed inside the vagina
- A thin catheter containing the embryo is passed inside the uterus (womb) under ultrasound guidance and the embryo is placed at the top of the womb cavity.
- The embryo transfer procedure takes around 10-15 minutes.
- Your partner will be able to come with you into the embryo transfer procedure room.
- Sedation is not generally needed; however, some may require gas and air or mild sedation.
- You will be able to go home straight after the procedure.
9. Luteal Phase Support
- Progesterone supplements (pessaries and/or injections) help to embryo implant and support early pregnancy.
- These are used usually until the pregnancy scan, but may be extended in certain circumstances
10. Pregnancy Testing and Scans
- Urine pregnancy test is done two weeks after the egg retrieval procedure. You should use the first urine sample in the morning and a good quality urine pregnancy test kit.
- Please contact us to advise the outcome of the urine pregnancy test so that we can arrange an early pregnancy scan for you if it is positive or a Review appointment if negative. The early pregnancy ultrasound scan is performed at 6-7 weeks of pregnancy. This will be a trans-vaginal scan and is safe for the developing pregnancy.
- Depending on the implantation and development of pregnancy, you may need blood tests and/or repeat scans to ensure that the embryo has implanted in the right place and is developing normally.
