Zoe Fertility Clinic | IVF
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In Vitro Fertilization

Appropriate treatment developed in the case of infertility to help women with damaged or blocked fallopian tubes by placing the embryos directly into the uterus bypassing the damaged area and possible cases of male infertility.

 

A woman’s egg must be retrieved from the ovary, as to make its way down the fallopian tube to meet the sperm. The timing needs to be accurate for the egg and sperm to combine. The sperm is meant to successfully fertilises the egg, the egg divides and makes it way back down to the uterus to implant into the lining of the womb. If any irregularities occur with this reproductive process, the pregnancy may become problematic. There are several reasons why this process may not work efficiently and this is where IVF (in vitro fertilisation) can help. IVF can overcome issues that obstruct natural conception and help people who can’t conceive naturally to conceive a healthy baby (babies).

The IVF procedure includes a number of steps which include:

  1. A woman’s ovaries are stimulated with fertility drugs to produce multiple mature eggs
  2. The eggs are then collected from her body
  3. Her eggs are then fertilised with her partner’s sperm in the embryology lab.
  4. The resulting embryos are cultured for three to five days
  5. One of the embryos is transferred back into her uterus

A typical IVF treatment takes approximately seven weeks from when you take your first drug, until your pregnancy test.

IVF science has advanced very rapidly in recent years and Zoë Fertility Clinic has been at the forefront of these advances, helping to initiate more effective treatments and broadening the range of people who can be helped. We pride ourselves with the advantage of not only science related methods, but natural methods to for our patients’ choice.

How does IVF work?

Pregnancy is more complex than people think, especially when we are in the midst of the aging process. It’s helpful to be aware of the fertility issues that people can have when they are trying to conceive and how IVF works to address these proplications.

 

An egg must be released from the ovary and make its way down the tube to meet the sperm – the timing for all this needs to be right so that the egg and sperm can combine. Then, if the sperm successfully fertilises the egg, the dividing egg makes it way back down to the uterus to implant into the lining of the womb. A problem occurring with any of these steps in the reproductive process may result in problems becoming pregnant. There are a number of reasons why this process may not work efficiently and this is where IVF (in vitro fertilisation) can help. Whilst it is not a treatment cure for infertility, IVF can overcome issues that obstruct natural conception and help people who can’t conceive naturally to have a baby.

How does an IVF treatment cycle work?

There are seven main stages of an IVF cycle defined below. The most successful IVF treatments are designed around specific patient needs so individual treatment plans may be slightly different. All of our patients have unique needs and we take great care in providing everyone with tailored treatments. We will give you advice based on your individual circumstances and/or past test results so your treatment plan may vary slightly from this guide. We will always explain everything clearly to ensure you understand and are happy with your treatment plan.

You are always welcome to ask specific questions and we will be happy to assist you with the most relevant solution.

Consultation and tests

Note by: In visiting Zoë Fertility Clinic for your consultation please be sure to have your medical history, your current health information available in progressing forward about your treatment plan. At Zoë Fertility Clinic your consultation will be with an experienced and dedicated Specialist who will provide the most appropriate advice. We may need to perform certain screening tests before treatment can be started. The tests are important and will provide us with crucial insights into the most appropriate treatment plan for you.

Ovarian stimulation

Fertility drugs are used to stimulate your ovaries, this maximises the number of eggs you will produce in your cycle. There are several different types of drugs, and different ways that the drugs can be given. The specific type of regime for you will be your ‘Protocol’. One of the medical or nursing team will go through your Protocol in detail with you, we’ll give you a written outline of everything and any further advice or help will be available whenever you need it from our nursing team.

Monitoring

During the stimulation phase of your treatment, we monitor your progress closely to establish exactly when is the best time for your eggs to be collected. The monitoring phase will last several days, the exact number of days will vary for each person and will depend on how many follicles have been stimulated and how fast they grow. A typical monitoring phase is 3-7 days.

 

You will be told when to take the drug which triggers ovulation. This will be at a very specific time and will determine when you attend for egg collection. The ovulation drug is taken in the evening and around 36 hours later, in the morning, you will be ready for egg collection.

Egg and sperm collection / Egg collection

This is a straightforward procedure which takes around 30 minutes, and is performed with sedation or local anaesthetic and pain relief. To collect the eggs, we pass a scan probe into the vagina and use ultrasound to guide a needle into one of the ovaries. We then extract eggs from the ovarian follicles; we can usually collect from nearly all of the larger follicles. It’s normal to feel a few twinges during collection, but it isn’t painful. After collection, we recommend you have a short rest before going home.

Sperm collection

We’ll usually ask for the sperm sample to be given at the time of the egg collection. Please remember that your semen sample is generally at optimum quality after 2 – 3 days abstinence from ejaculation, so we advise ejaculation 2 -3 days prior to the day of egg and sperm collection and then to abstain until you produce your semen sample.

 

In certain conditions sperm are not present in the ejaculate due to absence or blockage of the tube carrying the sperm from the testes. Minor surgery can be performed to obtain sperm from the reproductive tract. Whilst these sperm are functionally competent they can only swim very weakly, if at all. However, they can be injected into and successfully fertilise eggs using the ICSI technique. The only difference between IVF and ICSI is that with ICSI the sperm are injected directly into the egg

Fertilisation and embryo development

Once your eggs have been recovered, they will be put in to a special culture medium and safely transferred to an incubator to provide exactly the right environment and temperature conditions.

 

We spin the semen sample in a special media to isolate the dense, good quality sperm. We then wash the isolated sperm in another media to purify the sample.

 

Next, we fertilise the eggs with sperm to form embryos. We then grow the embryos in carefully controlled conditions until they’re ready to be transferred into the womb. The first signs of fertilisation are shown by the presence of two nuclei within the egg.

 

If this has occurred, the fertilised egg should then divide in to two, and subsequently three, four or more cell embryos. At this stage, a nurse or embryologist will arrange a time to give you your fertilisation result and also when we need to see you again for embryo transfer.

Embryo transfer

This procedure is straightforward and almost always performed without the need for sedation. Your transfer specialist will use a speculum (like the one used for smear tests) and the embryologist will load the embryos into a fine, soft catheter for the transfer specialist to place through the vagina and cervix and in to the womb. The embryo(s) will be injected in to a tiny drop of culture medium and the catheter will be removed and checked under the microscope to ensure they have been successfully transferred. The process should take about fifteen minutes.

The 'Two Week Wait'

During the period after embryo transfer, it is important that you take the hormone progesterone, this helps prepare the lining on the womb for the implanting embryo. It is important that the progesterone is taken until your first pregnancy test.

 

This period, often referred to as ‘The Two Week Wait’, can be challenging and it can seem like forever to pass because, of course, you’re anxious to learn the result of your treatment. Try to stay positive, you’ve done everything you can. If it helps, you could use our Bulletin Board to speak to other women at the same stage of their IVF treatment – there is a section called the two week waiting room. Remember – you are not alone.

Pregnancy test

Assessing the outcome of your treatment is performed in two ways – the Pregnancy Test and the Pregnancy Scan. Your pregnancy test is usually taken 14 – 16 days after embryo transfer and indicates whether or not your embryo has implanted. It may sometimes be necessary to repeat this test, we’ll advise you.

 

If your pregnancy test is negative or we don’t find an ongoing pregnancy during your scan we know you’ll feel upset. When you feel ready, we’ll book you a follow up appointment with your consultant to discuss your next steps.

 

If your test is positive, we’ll invite you to come into the clinic 2 to 4 weeks later for an ultrasound scan to check for a heartbeat to show an ongoing pregnancy. Once this is confirmed, we’ll discharge you into the care of your GP who will arrange your antenatal care.

Reassurance testing in early pregnancy

A Non-Invasive Pre-Natal test (NIPT) is designed to check your pregnancy for chromosome abnormalities and can be performed at Zoë Fertility Clinic as early as 10 weeks, accurately detecting Downs Syndrome (trisomy 21), Edwards Syndrome (trisomy 18) and Patau Syndrome (trisomy 13). Your nurse will discuss this with you.

IVF is used to treat a range of fertility problems, including unexplained infertility. But how do you know if you fall in to the category of having fertility problems? Your GP can answer some of your basic fertility questions and give you some tests but at some point, if you do have fertility issues, you may need to seek the help of a fertility specialist and decide whether you need IVF to help you have a baby.

 

Around 1 in 8 people in the South Africa need help to have a baby. Generally, it is recommended that you see a fertility specialist if:

 

  • You’ve been having regular, unprotected intercourse for one year (or six months if the female partner is over 35) and you have not become pregnant

 

  • You are over 35.  As women get older, they have fewer eggs available each month for ovulation, and also a deterioration in egg quality.  This means that the likelihood of ovulating a chromosomally normal egg each month is significantly lower than in women in their 20’s and early 30’s. It is estimated that even in young women, approximately half of all eggs have chromosomal abnormalities. This increases to around 90% as a woman reaches her early to mid-forties. If an egg is chromosomal abnormal then it is unlikely to make an embryo or if it does the baby will have a condition such as Down’s Syndrome. When recurrent pregnancy loss is related to chromosomal abnormalities, IVF with Pre-implantation Genetic Screening could be a likely option

 

  • The woman has irregular or painful periods or a history of abdominal or pelvic surgery you have a prior history of sexually transmitted diseases (STDs).

 

  • Diseases such as chlamydia  can result in Pelvic Inflammatory Disease, causing pelvic scarring and potentially blocked fallopian tubes

 

  • You’ve had 2 or more miscarriages, since this can indicate that there may be a problem which prevents your embryos from implanting
  • You have experienced early menopause or premature ovarian failure

 

  • The man has a history of low sperm count, poor motility (the sperm doesn’t swim or move quickly), or abnormal morphology (the shape of his sperm cells are irregular)

 

  • You have had cancer Treatment as chemotherapy or radiation can permanently damage your reproductive system.

 

  • You are extremely underweight or overweight. Excessive weight can result in overproduction of estrogen, which can act in the same way as the birth control pill – actually preventing pregnancy. Being underweight can result in a lack of estrogen, potentially disrupting the menstrual cycle and compromising fertility.

 

  • You smoke or your alcohol consumption is high. Smoking can have a potentially harmful effect on the reproductive system. Women whose alcohol intake is high have been found to have higher rates of menstrual problems which can prevent conception.

 

  • You are at risk of passing on a genetic disease such as cystic fibrosis. Then you may have IVF with Pre-implantation Genetic Diagnosis.

If any of the issues described apply to you,  please don’t worry, it doesn’t mean you won’t ever have a baby. For some couples, it just may require fertility drugs, surgery, or IVF. It’s easy to arrange a consultation with one of our fertility specialists.  They can help you.  Based on your medical history they will develop a tailored plan for diagnosis of the exact nature of your fertility issue and then implement an individual treatment plan for you.