What is IVF?
In vitro fertilisation (IVF) is a procedure used to treat infertility that has not responded to other medical interventions. It is a very successful treatment and for many individuals and couples provides the best chance to have a baby.
IVF has been in use for over 40 years and is now common worldwide to help people have healthy babies. Since the birth of the first IVF baby, Louise Brown, in 1978, more than 5 million babies have been born thanks to this procedure.
How does IVF work?
Once you’ve met with your fertility specialist and undergone fertility testing your doctor may recommend IVF. You will receive a personal IVF treatment plan that is tailored to your specific needs.
The process of IVF involves fertilising an egg with sperm outside the body in a specialist incubator. After several days the fertilised egg, which is now an embryo, is transferred back into the female partner’s uterus. The whole process, up to the embryo transfer stage, usually takes around three to four weeks.
What does the IVF process look like?
At City Fertility, we understand that every fertility journey is as unique as the person or couple embarking on it. That’s why we’re here to guide you with care and compassion through every step of your IVF treatment. Your fertility specialist and the team of nurses, scientists and administration staff, will make sure you’re informed and supported as you navigate your IVF timeline.
The IVF Process
1. Ovarian Stimulation
Ovarian stimulation is the first step in an IVF cycle. It involves a series of daily follicle-stimulating hormone (FSH) injections self-administered at home from Day 2 or 3 of your menstrual cycle. This medication is used to stimulate the ovaries to encourage the growth of multiple follicles containing eggs.
2. Control and Monitoring
Your fertility specialist will closely monitor your ovarian response during the stimulation phase with ultrasounds and/or blood tests. This is important as medications may be adjusted to control the size and amount of follicles.
3. Egg Release
To assist with the final maturation of the egg and loosening of the egg from the follicle wall ready for egg collection, an injection of Human Chorionic Gonadotrophin (hCG). This is often referred to as ‘the trigger injection’.
4. Egg Retrieval
The egg retrieval is performed 35-38 hours after ‘the trigger injection’ under ultrasound guidance and takes place while you’re lightly sedated. It is important to note that not every follicle will contain an egg, and not every egg will fertilise.
5. Insemination
Your partner (if applicable) will be asked to produce his semen sample on the day of your procedure. If you are using frozen sperm, the sample is thawed on the day of your procedure. The sperm sample is washed and concentrated, then added to the eggs. If your specialist has recommended Intracytoplasmic Sperm Injection (ICSI), one sperm will be injected directly into each mature egg. ICSI is usually recommended for male factor infertility or previous suboptimal outcomes with standard IVF insemination.
6. Fertilisation
The inseminated eggs are placed in an incubator and checked for fertilisation 16-18 hours after insemination. You will receive an update from the embryologists at this time. The normally fertilised embryos are then grown for five days. It is important to note that not every egg will fertilise, as several factors may affect the fertilisation ability of an egg and/or sperm.
7. Embryo Transfer
Five days following egg retrieval, the embryos are assessed by the embryologists for development and quality. The best embryo is selected for transfer into the uterus using a fine plastic tube (transfer catheter). Usually, only one embryo is transferred. If more than one embryo is to be transferred, this must be discussed with your clinician before the transfer takes place. Embryo transfer is a relatively quick procedure and discomfort should be minimal.
8. Vitrification
Any remaining embryos that meet the requirements in terms of development and quality will be frozen. These frozen embryos are then stored until required for a subsequent transfer. The vast majority of frozen embryos survive the freezing process and pregnancy rates are comparable with the transfer of fresh embryos.
9. Pregnancy Test
The final stage of IVF is called the luteal phase and it’s the two weeks between the egg collection and the pregnancy test. Many people find this to be the most difficult time to endure. Whilst it’s an exciting and optimistic time of the treatment cycle, it can often be emotionally charged with expectation and anxiety. You will be encouraged to limit your activity for 24 hours after the embryo transfer, eat well, stay hydrated and keep busy while you wait for your pregnancy blood test.
Want to learn more about the IVF process? Book an appointment with one of our fertility specialists to discuss your options, or check out our in-depth IVF process guide and IVF factsheet.
Please click on the image below to view it in full and download our infographic.
What are the potential risks associated with IVF?
Potential risks and side effects associated with IVF procedures include:
- An exaggeration of menstrual cycle symptoms – (e.g. bloating, breast tenderness, mood swings) because the ovaries have been stimulated to produce more than a single follicle.
- Ovarian Hyperstimulation Syndrome (OHSS) – This can develop in 1% of cases where ovaries become enlarged, and fluid accumulates in the abdomen. This complication requires rest, monitoring, intravenous fluids and sometimes drainage.
- A multiple pregnancy – single embryo transfer is the standard practice in Australia today. A fertility specialist may agree to a double embryo transfer in certain individual cases, which does carry a risk of multiple pregnancy. Multiple pregnancies have a higher risk of preterm delivery. Single embryo transfer can also result in identical twinning; however, this is rare.
- Potential increased risk of breast, ovarian, or uterine cancer – Fertility drugs have not been proven to increase breast, ovarian or uterine cancer risk. However, women who have never been pregnant have a higher risk of breast or ovarian cancer. Past or future use of the birth control pill lowers your risk of ovarian cancer.
How much does IVF cost?
We understand that every IVF journey is different. At City Fertility we tailor our fee schedule to your individualised treatment plan, created for you, by your Fertility Specialist.
For a broad overview of our costs, you can visit our cost section for more generalised information about our fees and IVF Medicare rebates.
For international patients, registration for IVF treatment is free, but initial consultations, IVF cycles and fertility preservation come at a cost. See our pricing page for more details.
IVF Treatment FAQs
How does the IVF embryo retrieval process work?
The egg retrieval is performed by an ultrasound-guided needle puncture through the top of the vagina.
The egg retrieval process takes 15-20 minutes and involves these steps:
- You are given light sedation.
- The ultrasound-guided needle is passed through your vaginal wall and into each follicle on your ovary.
- The fluid in the follicle is aspirated into a test tube and examined under a
- You rest in the recovery area for about an hour.
Some cramping and discomfort after egg retrieval are common, as is vaginal spotting or bleeding.
After egg retrieval, you may commence medication that will support the development of the lining of the uterus in preparation for embryo transfer.
Semen collection
Your partner (if applicable) will be asked to produce his semen sample on the day of your procedure. A private room is available for this at our clinic. It may be possible to produce the sample at home and take it to the clinic – this can be discussed at the start of your cycle. If you have any concerns, please discuss them with us before starting your cycle.
How does the IVF embryo retrieval process work?
Three to five days following egg retrieval, an embryo is transferred to the uterus using a fine plastic tube called a catheter. This procedure takes only a few minutes and is not usually uncomfortable. Many women suggest it is a similar experience to having a pap smear.
The embryo transfer steps are:
- Embryo/s chosen for transfer is/are loaded into a catheter, passed through the cervix, into the uterus and the embryo released into the uterus gently.
- The catheter is slowly removed and checked under the microscope to ensure the embryo has been expelled from the catheter in this process.
- Some patients will have other embryos that are suitable for freezing (vitrification)
The best-quality embryos (those most likely to result in pregnancy) are usually transferred in the treatment cycle. In order to be viable for transfer or freezing, embryos must show minimal or no sign of fragmentation (cell breakdown) and no sign of abnormal development.
Can you choose gender with IVF?
Gender selection is not permitted in Australia unless it’s for medical reasons, such as preventing genetic conditions.
What does IVF stand for?
IVF literally means “fertilisation in glass”, except today instead of glass it is done in plastic. The process involves fertilising an egg with a sperm sample in an incubator outside the body, then transferring the best embryo back into the female partner’s uterus.
Does IVF hurt?
Every individual has a different pain threshold. For the majority of patients, the injections taken on the IVF cycle leading up to egg collection are easy to use and relatively painless. The injection technique to minimise any pain will be taught to you by our experienced IVF nurses.
The egg retrieval procedure is a minor surgery that can be completed either with sedation that is inhaled or it can be intravenous. This means you are either quite drowsy or asleep whilst eggs are collected. Minor cramping is often experienced after an egg collection but usually lasts only a few hours. Pain relief is given and available after the procedure.
Embryo transfer is a minor procedure usually involving no sedation. It is described by patients as a similar experience to a pap smear, with most having only very minor cramping (if any) afterwards. Panadol is usually sufficient to assist with any cramps at this time.
What day of your cycle do you start IVF injections?
IVF injections commence on day two or three of the patient’s period, all depending on the fertility specialist’s individualised plan for the patient.
Still have a question about IVF? Check out some more common IVF questions answered by our fertility specialists.
Download our IVF infographic for more information.
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