If you’re anything like us, unless you have been through IVF or have friends who have, you probably have no idea what IVF treatment involves.
Until we were faced with entering that world, we actually thought it would entail a couple of trips to the hospital and then boom, you were pregnant! Unfortunately the reality is very different, so I thought it would be useful to set out the basic steps involved in an IVF cycle. Obviously these are the typical steps taken, however every individual case is different and may vary in certain areas.
One IVF cycle takes approximately 8-10 weeks, and that is only if everything goes to plan. Understandably things can go wrong every step of the way and the most important thing we have discovered is that timing is everything. You are relying on your body to respond and react as it needs to, but a lot of factors can be detrimental to this happening, stress being one of the biggest, hence the continual message from the fertility clinic to RELAX.
Depending on the cause of your infertility you may need to commence a course of fertility drugs before beginning the main cycle. This may help to stimulate the problem factor and increase your chances with the IVF.
You are also poked a prodded quite a lot before the actual main event, with several blood tests and countless internal ultrasounds which just get more delightful every time.
Step One – Suppressing Your Cycle
The first significant step is to suppress your natural hormones, which involves taking a tablet three times a day from day 21 of your menstrual cycle for approximately 2 weeks. The aim is to stop you ovulating, i.e. releasing an egg, so you can save your supply for your next cycle when your eggs are retrieved. As with everything these tablets can come with side effects which will affect everyone differently.
Step Two – Hormone Treatment for Boosting Egg Supply
Once step one is completed you receive a ‘base line’ scan, to check everything is still as it should be, and then you commence your hormone treatment. The most crucial part of IVF centres on your eggs and the quality and quantity that you can provide.
Ordinarily women only produce 1 egg per month, but the premise behind IVF is to produce as many as possible of an excellent standard so when they come to extract them, you have a better chance of having as many as possible that can turn into a viable embryo. The ideal is to produce between 10 – 15 but it only takes 1 good one to make a baby, so a smaller number can be ok too as long as they are of good quality.
The hormones act in such a way to basically ‘pump up’ your egg supply, hopefully making your eggs multiply and become big and strong.
The hormones come in the form of an injection, which have to be administered yourself at home every evening. Previous scans have indicated that I would potentially not produce many eggs, therefore I am on the highest dose of hormones, which means 2 injections every night for me!
As with any other hormones the side effects can vary from person to person but can include hot flushes, cramps, increased moodiness (poor Dave!), sickness, bloating, migraines, blurred vision and most importantly, OHSS which stands for Ovarian Hyperstimulation Syndrome. This is caused by too many hormones in your system meaning you produce far more eggs than your body can cope with, resulting in some pretty scary side effects and a danger of falling seriously ill. Because of this the fertility clinic like to keep a close eye on you during your hormone treatment, meaning ultrasound scans every few days. If it is noticed that you may be at risk of OHSS, your hormone intake will be reduced.
Step Three – Egg Retrieval
Now we come to the most important day of any IVF cycle, the egg retrieval day. This is the day when you find out if your body has come out fighting, completely let you down, or finished somewhere in the middle. The clinic informed us that this procedure was the most unpleasant of all we will go through as your eggs are extracted using a very long needle and the whole process can be very uncomfortable and pretty painful plus you are awake through it all!
I have heard of some fertility centres giving a general anaesthetic for this procedure, however our clinic told us that it only takes approximately 30 minutes to perform therefore they do not think it’s worth knocking someone out for so short a time. You are, however, given pain medication stronger than morphine so I’m hoping I will be as good as conked out anyway!
The eggs that you have produced are then graded based on their chances of development, placed in an incubator for approximately 8 hours before being mixed with Dave’s contribution. They are then monitored in the lab for a few days whilst fertilisation takes place.
There is a period of up to 5 days after egg retrieval where the embryo can be implanted back and the ideal is to make it to the 5 day mark before you go for the implantation, as that means that your egg is strong and has fertilised well. However, there is the possibility that if your embryo is weaker or not performing as well as it should that you could be back to the clinic the very next day for your transfer.
Step Four – Embryo Transfer
The Embryo Transfer is a fairly uncomplicated procedure and again should only take about half an hour. Using a very long tube, the embryo is implanted back into your womb, exactly where an embryo from a natural pregnancy would sit.
There will only be 1 embryo that will be implanted back into your system, (sometimes they will implant 2 depending on your circumstances), however any others that have survived can be frozen for future use through a scheme our clinic runs called E-Freeze, where your embryos can be stored for up to 10 years, which we have opted into.
Step Five – Waiting
Then comes the worst part; the agonising 2-week wait to find out if the treatment has worked.
I think waking up on that day and taking a pregnancy test could potentially be the worst or the best day of our lives. I can’t tell you how much I want to look at a pregnancy test and actually see the word ‘Pregnant’ without the word ‘Not’ in front of it. Sometimes I feel like we will never get there, never get to see that one little world that would change our entire lives and make us feel like the happiest and luckiest people on the face of the earth. All we can do is hope and pray and do everything within our power to give ourselves the best chance.
If you are successful, the clinic keep a close eye on you for the first few months of your pregnancy especially as the chance of miscarriage is extremely high.
Apart from that however, there is absolutely no reason why you would not be able to enjoy a perfectly normal pregnancy as though you had got pregnant naturally. There is also no evidence to show that babies born from IVF are any different from those born from natural means.
If you are unsuccessful, you will be asked back to the clinic for a scan so they can try and determine what went wrong and what they can do differently next time. You are allowed to start your next cycle as soon as you want after your failed attempt and if you have frozen embryos from your first cycle, you will be able to jump straight to embryo transfer and avoid starting from the beginning again.
I guess the natural instinct would be to rush straight in again, however Dave and I have agreed that if out first attempt does not work out, we will give ourselves a few weeks off to comes to terms with everything, maybe take a holiday and make sure we are mentally, physically and emotionally prepared to start all over again.
As I’ve mentioned previously, the success rates for IVF are not brilliant and can vary depending on what clinic you use. Some clinics in larger cities offer alternative methods which can often be more successful, however this increases the cost you pay as the patient and more importantly, for the amount of times that you have to visit the hospital during a cycle, it is imperative that you live as near as you can to your clinic. If Dave and I did decide to use another clinic at any stage it would involve relocating for a few weeks.
The 2016 statistics for The Aberdeen Fertility Centre had an average pregnancy success rate of 30% from IVF treatment. Obviously this is not great, but is a lot better that some other clinics throughout the country and most importantly, the rates have increased year on year, which indicates that they have improved their methods and are finding out what works and what doesn’t. Not to mention the fact that all the staff we have met are qualified to the highest degree and the consultants are experts in the field of IVF.
Let’s just hope they can help us have the longed for baby that we desire so much.