An IVF cycle is how we describe one round of IVF treatment starting with the first day of your period.
As part of your fertility plan, you may start medication or injections before the first day of the cycle.
Step 1: Your Menstrual Cycle
While IVF does involve manipulation of the ovaries, using fertility injections to stimulate egg maturation and release, we still work with your body’s natural menstrual cycle and hormone production. Thus, your IVF cycle will begin on the first day of the menstrual period closest to when you have scheduled your IVF treatment.
In most cases, once your period begins, we will administer oral contraceptives that help to regulate hormone levels more precisely, while simultaneously limiting any potential cysts from developing as cysts can compromise fertilization. The contraceptives are typically taken anywhere from two to four weeks.
Step 2: Ovarian Stimulation
The ovarian stimulation phase starts from day 1. In a natural monthly cycle, your ovaries normally produce 1 egg. You’ll take medication for 8-14 days to encourage the follicles in your ovaries (where the eggs live) to produce more eggs.
Your specialist prescribes medication specific to your body and treatment plan. It’s usually in the form of injections, which can vary from 1-2 for the cycle, or 1-2 per day. It can be daunting, but your fertility nurse will be there to show you exactly how and where to give the injections.
We keep an eye on your ovaries and how the follicles are developing with blood tests and ultrasounds. Your medication will be adjusted if needed. Our team will support you through these processes and make you as comfortable as we can.
Step 3: Egg Retrieval
Egg retrieval, or egg ‘pick up’, is a hospital day procedure where the eggs are collected from your ovaries. An anaesthetist will get you ready for a general anaesthetic. You’ll be asleep and the procedure takes about 20-30 minutes.
Your fertility specialist uses the latest ultrasound technology to guide a needle into each ovary. It’s delicate work where every millimetre counts, and this is where the experience of our specialists pays off. You can’t see an egg with the naked eye; they’re contained in the fluid within the follicles in your ovaries. The specialist removes fluid from the follicles that look like they’ve grown enough to have an egg inside.
Recovery takes about 30 minutes and you’ll be able to walk out on your own. It’s a good idea to have a support person with you as you won’t be able to drive after the procedure.
Step 4: The sperm
If you’re a couple planning on using fresh sperm, the male will produce a sample the morning of the egg retrieval. If you are using frozen or donor sperm, our scientists will have it ready in the lab.
The sperm is graded using 4 different levels of quality. It’s washed in a special mixture to slow it down so our scientists can spot the best ones under the microscope. A perfect, healthy sperm is not too fat or thin, with a tail that’s not too long or short. The best sperm are selected, and they’re ready and waiting in the lab to be introduced to the eggs.
Step 5: Fertilisation
Your fertility specialist gives our scientists the eggs they have retrieved, still in the fluid from the follicles of the ovaries. The scientists use powerful microscopes to find the eggs in the fluid so they can be removed.
It’s important the eggs are fertilised quickly. The eggs and some sperm are placed in a dish. They have the chance to find each other and fertilise like they would naturally within your body.
Step 6: Embryo development
If the sperm fertilises the egg, it becomes an embryo. Our scientists put the embryo into a special incubator where the conditions for growth and development are perfect. Our scientists keep an eye on the embryos over 5-6 days.
We know implanting embryos at the blastocyst stage into the uterus boosts your chances of a successful pregnancy.
Unfortunately, not all eggs will fertilise and reach embryo stage. The eggs might not be mature or the sperm not be strong enough. We know you’ll be waiting on news, so we’ll keep you up to date with the progress of your egg, sperm and embryo development.
Stage 7: Embryo transfer
If your embryo develops in the lab, you’re ready for it to be transferred into your uterus. Your fertility nurses will explain the process. We use ultrasound technology to get the embryo in the perfect spot, and it helps to see the lining of the uterus.
The embryo transfer is a very simple process. It takes about 5 minutes, you’ll be awake, there’s no anaesthetic, and you can get up straight away. You can continue with your day, the embryo can’t fall out if you stand up or go to the toilet.
A scientist talks to you about your embryo prepares it by placing it in a catheter. Its critical this is done by an expert to disturb the embryo as little as possible.
An embryo is only 0.1 millimetre, and the specialist has a target area of approximately 1 millimetre to play with. If it’s placed in the wrong spot, the embryo may not ‘stick’ and there is risk it’ll find a home outside the uterus.
Two weeks after your embryo transfer, you’ll have a blood test to measure your levels of the hormone hCG (human chorionic gonadotropin). hCG in your bloodstream usually means a positive pregnancy test.
The time between the embryo transfer and the blood test is often called the ‘two week wait’ (2WW).
It can be tough not to be anxious about the result. If you need some help to cope or someone to talk to, our counsellors are ready to help you.