In-vitro fertilisation is a very advanced and physically demanding form of fertility treatment, which is usually recommended only as a last resort in a couple's efforts to get pregnant. In IVF, the fertilisation process happens outside the female partner's body - namely, in a dish in a laboratory.
IVF involves a strict and complicated regimen of drug injections, blood tests and scans. Couples may need as many as three (or more) cycles of treatment before they conceive. Risks do exist for the female partner, as it is her body that is subjected to the drugs and medical procedures. IVF is, however, a safe fertility treatment when a woman is kept under close observation.
The IVF Process
For IVF to be successful, your fertility specialist basically needs to take complete control of your reproductive system.
Stimulation of the ovaries - On or around the third day of your menstrual cycle, you'll start a daily routine of injecting drugs to suppress your natural ovulation cycle, and more drugs called gonadotropins to stimulate your ovaries into producing multiple follicles and multiple eggs. Yet more drugs (GnRH agonists or GnRH antagonists) will be given to prevent your ovaries ovulating (releasing these eggs). These injections typically go on for about ten days. During this time, you'll have to undergo blood tests and scans to check how the follicle developing is progressing.
Egg retrieval - When your specialist is ready to induce ovulation, he'll inject you with human chorionic gonadotropin (hCG). This would normally trigger ovulation within a day and a half, but your specialist will intervene before this happens. He'll sedate you and then use a long, fine needle inserted through your vagina, and into your ovaries to retrieve the mature eggs and remove them from your body. He then places them in a dish with a sample of your partner's sperm.
Fertilisation - your egg cells and your partner's sperm cells are left for one or two days in close proximity to one another, thereby increasing the chances that fertilisation will occur. If this does indeed happen, some of the resulting embryos (fertilised eggs) will be transferred back to your uterus.
Embryo transfer - for embryo transfer to be ultimately successful, at least one embryo must implant in the lining of your uterus where it can develop and grow. You may therefore be given drugs to help maintain your uterine lining at optimum thickness. To increase the chances of implantation, more than one embryo will be transferred (perhaps two or three, depending on your age). Transfer is carried out much in the same way as egg retrieval - by means of a fine needle inserted through the vagina into the uterus.
The waiting game - the next part of the IVF process is the hardest for many couples. Now there isn't much you can do other than rest and hope that one of the embryos will implant - making you pregnant!
In the UK, between 20 and 25% of IVF cycles result in a live birth. Therefore you shouldn't get too disheartened if you don't succeed on the first try. On the other hand, you should bear this relatively low success rate in mind when deciding whether or not to put your body through such a gruelling process. IVF is the right choice for many couples, but not for all couples - there are other options, including surrogacy and adoption.