In-vitro fertilisation (IVF)

IVF is one type of treatment that can help people with fertility problems have a baby and allows us to use sperm and egg to create an embryo in a laboratory setting.

The sperm and egg can come from you and your partner or from donors. We then support you to prepare your body for pregnancy and when we reach the optimum time, insert the embryo in a woman’s body to develop. This process enables us to control more of the factors involved in developing an embryo and conceiving a pregnancy and for some people, can offer a better chance of conceiving a healthy baby than trying naturally.

What to expect

Stimulation

A typical IVF cycle takes four to six weeks. This includes:

  • your booking appointment
  • administering injections at home for 10 to 12 days
  • egg collection (37 to 39 hours after your final injection)
  • embryo transfer (two to five days after your egg collection); and
  • taking a pregnancy test 14 days later

You will have regular scan and blood test appointments throughout your cycle. If you are pregnant, you will continue your hormone treatment for another 10 weeks before transferring to the care of a maternity team.

Treatment will include tablets or injections used to stimulate your hormones and control ovulation. You will need to take follicule stimulating hormone (FSH) every day, via tablet or injection, for 10 to 12 days. During this period, you will need to visit our unit for vaginal ultrasound scans to monitor how your ovaries and the lining of your uterus respond to your daily FSH treatment. Some patients will have two scans, others will have as many as five. Your scan appointments will typically take about 15 minutes, with another five minutes for blood tests.

Egg collection

At the end of the stimulation phase, we will instruct you to give yourself a final injection of human chorionic gonadotrophin (HCG), which matures your eggs. Your eggs should be ready for collection within 37 to 39 hours, so we will schedule another appointment for you then.

You and your partner will need to attend your egg collection appointment together. You will be sedated and your eggs will be collected using ultrasound guidance. This appointment will take two to four hours. On the same day, your partner will be asked to produce a semen sample. The eggs will be mixed with the sperm and cultured in the laboratory. The embryology staff will call you to let you know how many eggs have been fertilised.

You will need to return to clinic for your embryo transfer appointment within two to five days. Your embryo transfer appointment will take two to three hours. Following embryo transfer, you will go home and take a daily dose of the hormones progesterone and oestrogen until you perform a pregnancy test, which is usually done 14 days after egg collection.

Pregnancy test

If your pregnancy test is positive, we will invite you in to perform a scan and confirm your pregnancy. You will then continue your hormone treatment until you are at least 10 weeks pregnant.

Wolfson Fertility Clinic patient:

”Words cannot describe how thankful we are to you”

At that point, we can refer you directly to our maternity service, or back to your GP to discuss your options for maternity care. Find out more about NHS and private maternity services at Imperial College Healthcare, which are the first in London to receive an outstanding rating from the Care Quality Commission (CQC).

If we identify any potential risks or complications when we perform your scan, we will refer you directly to the early pregnancy unit at Queen Charlotte’s & Chelsea Hospital.

If your cycle has not been successful, we will offer you a consultation to discuss your next steps.

The risks

Fertility treatments are very safe, but they do carry some risks.

Ovarian hyperstimulation syndrome (OHSS) is a reaction to fertility drugs used to stimulate egg production. In some women, fertility drugs stimulate the ovaries to develop too many eggs, resulting in large and painful ovaries. Around one third of women will have mild OHSS, while fewer women will have moderate or severe OHSS. In very rare cases, severe OHSS can be life-threatening. Symptoms include:

  • Swollen stomach and stomach pains
  • Nausea and vomiting
  • Shortness of breath
  • Faintness
  • Reduced urine output

Most women who develop strong OHSS symptoms do so the week after egg collection. Please contact us immediately if you experience these symptoms.

Multiple births (twins, triplets or more babies) are high-risk for women and babies. At least half of twins are born premature and underweight, which can lead to serious health problem and even death. You’re also more likely to miscarry if you are pregnant with multiples. In addition, women pregnant with multiples are more likely to suffer from high blood pressure, gestational diabetes, anaemia and haemorrhage during pregnancy.

IVF carries a higher risk of multiple pregnancies. Overall, one in 80 pregnancies are multiples, while in one in five pregnancies after IVF are multiples. As a result, most women opt for an elective single embryo transfer (eSET). This is when one embryo is transferred into the womb during a round of IVF. However, we may determine that it is more suitable to transfer more than one embryo during a round of IVF, depending on your particular circumstances. We will discuss this with you.

Visit HFEA to see our latest multiple birth rates.

An ectopic pregnancy occurs when a baby develops outside the womb, usually in the fallopian tube. Unfortunately, the pregnancy is lost as it is not possible to move the baby to the womb. While all pregnant women are at risk of ectopic pregnancy, women of receive IVF treatment may be more at risk.

Symptoms include:

  • a one-sided low abdominal pain
  • vaginal bleeding or dark brown or red vaginal discharge
  • diarrhoea or pain when you go to the toilet.

Please contact us immediately if you experience any of these symptoms.

The HFEA offers more information about the risks associated with fertility treatment.

The risk of birth defects is very low – about two per cent of children in Europe are born with birth defects. Some research has suggested fertility treatments may be associated with an increased risk of birth defects. However, it is not yet clear whether that risk is linked to the fertility treatments themselves or to fertility challenges in parents. Research in this area is on-going.
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