What is In Vitro Fertilisation (IVF) Treatment?

IVF treatment was originally developed for women with damaged or missing Fallopian tubes and has been the standard treatment for infertility since 1983. Since then, more than 5 million babies have been born worldwide as a result of IVF treatment. In fact, IVF treatment success rates are now comparable – and even superior – to those of nature.

What does IVF Treatment involve?
In the simplest terms, IVF treatment is a process of assisted reproduction where the egg and sperm are fertilised outside of the body to form an embryo, which is then transferred to the uterus to hopefully implant and become a pregnancy.

Fast Facts

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*** ‘Vitro’ is derived from the Latin ‘vitrum’, which means glass. In vitro fertilisation (IVF) literally means ‘fertilised in glass’, which is why children resulting from this treatment are often referred to as ‘test tube babies’.

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However, IVF treatment is not a single event, but rather a series of procedures that are completed over five stages to complete a treatment cycle.

IVF treatments commence with a course of hormone therapy to stimulate the development of several follicles in the ovary. Under ultrasound guidance, these are then punctured with a specialised needle to retrieve eggs, which are then fertilised in a petri dish (‘in vitro’ which literally means ‘in glass’) to create several embryos. After three to five days in an incubator, one or two of these embryos are transferred through the vagina to the uterus, where implantation occurs and pregnancy begins. The whole process from commencement of ovarian stimulation up to the embryo transfer stage usually takes just under three weeks.

As in natural conception, not every embryo implants to become a pregnancy. For this reason, the surplus embryos are frozen for subsequent transfer, if the first treatment cycle fails.

The five basic stages involved in the IVF procedure are detailed below.

The Five Basic Stages in the IVF Procedure

Stage 1: Ovarian Stimulation and Monitoring
Stage 2: Egg Retrieval
Stage 3: Fertilisation and Embryo Development
Stage 4: Embryo Transfer
Stage 5: Luteal Phase Support

Stage 1: Ovarian Stimulation and Monitoring

In the ovarian stimulation phase, your ovaries are stimulated to produce more eggs than usual with daily hormone injections that are taken for about 8 to 10 days. These hormone injections will stimulate your ovaries to produce several follicles, each of which may contain an egg. In addition, two types of medication are used during this stage to suppress ovulation.

During ovarian stimulation, Medfem Fertility Clinic uses ultrasound to monitor your ovaries, and to determine the number of follicles and the follicle size. Blood tests are used to measure your estrogen levels.
An ovulation injection (Ovitrelle or Lucrin) is usually given at a specific time in the evening. Egg retrieval will then take place 36 hours or so after this ovulation injection.

Stage 2: Egg Retrieval

Once the ultrasounds and blood tests show that you have a reasonable size and number of follicles, you will take an injection of hCG (human Chorionic Gonadotropin) to trigger final maturation of the eggs. Egg retrieval is arranged just prior to expected ovulation, usually 36 hours after the administration of the ovulation inducing drugs.

Egg retrieval is done under local anaesthetic, most commonly by ultrasound guided fine needle. The mature follicles are identified using ultrasound, and then a needle is passed through the vaginal wall into the follicle and the fluid withdrawn from the mature follicle with gentle suction. The fluid is immediately examined under a microscope to see if an egg has been retrieved. The process is repeated for each mature follicle in both ovaries.

Your doctor will try to retrieve as many mature eggs as possible. The average number of eggs retrieved is between eight and nine and the retrieval process lasts approximately 20-30 minutes.

Most commonly, sperm is collected from the male partner about two hours before egg retrieval. The sperm is then processed to select the strongest and most active sperm. This is called sperm washing.

Stage 3: Fertilisation and Embryo Development

The eggs are placed into a dish that contains a highly specialised growth medium. The medium allows the eggs and later embryos to continue developing as they would in the fallopian tubes. The sperm is then placed with the eggs in an incubator set to the same temperature as a woman’s body and fertilisation occurs naturally.

At Medfem Fertility Clinic, one of our embryologists examines the eggs the next day for fertilisation and will contact you telephonically to report how many of your eggs have been fertilised. With a normal sperm sample, we expect about 70% to 80% of the eggs to be fertilised.

Embryos are cultured for up to six days in a temperature-controlled incubator and evaluated every second day for quality and development. This information assists your fertility specialist to determine the appropriate day for embryo transfer – typically day three or day five of embryo culture. Our embryologists will call you after each examination to provide you with an update on the embryo quality and to answer any questions you may have.

Stage 4: Embryo Transfer

Three to five days after egg retrieval, the embryo is placed in a catheter and transferred to the uterus via the vagina opening.

Generally, one to two of the healthiest embryos will be transferred to the uterus. The number of embryos transferred depends on a your age, cause of infertility, pregnancy history and other factors.

The procedure only takes a few minutes and most women do not find it uncomfortable. Following the procedure, you will rest for 30 minutes in our recovery room before returning home.

The embryo transfer is a very special experience. Our team at Medfem Fertility Clinic will send you pictures of your embryos being transferred.

Stage 5: Luteal Phase Support

The Luteal phase is the two-week period between the embryo transfer and the pregnancy test. Starting the day of the egg retrieval process, you will be prescribed progesterone in the form of pessaries or injections to support a developing pregnancy.

A pregnancy test is performed 14 days after embryo transfer. To confirm a positive pregnancy test, we will schedule an ultrasound two weeks following these pregnancy tests. During this visit we will be looking for implantation of embryos and fetal heart motion.

What is the Success Rate for IVF Treatment?

The success rate of IVF is high and is now comparable – and even superior – to those of nature. Since 1983, more than 5 million babies have been born worldwide as a result of IVF treatment. Here at Medfem Fertility Clinic, we are proud to have played a role in bringing more than 16,000 babies into the world. Medfem Fertility Clinic has success rates consistent with the highest reported amongst clinics worldwide.

However, it is important to know that not every follicle will contain an egg, not every egg will be fertilised, and not every egg that is fertilised will go on to form a good-quality embryo. For the majority of couples, multiple IVF treatment cycles may be necessary.

The first step

Starting IVF treatment can be a very exciting time, taking you another step closer to becoming parents.

The first step to receiving IVF treatment is as simple as contacting us. To book an initial consultation, click here or contact us telephonically on +27 (11) 463 2244.

We look forward to meeting you!

At the first consultation, you will meet one of our four IVF specialists to discuss your medical history, conduct a comprehensive infertility work up, explore the options, and start to plan your journey to parenthood.