Couples undergoing IVF must first participate in a counselling programme, the
aim of which is to give them realistic expectations about the procedure.
Once the couple are deemed suitable for IVF, the woman will be given special
fertility medication or hormonal preparations to help stimulate ovulation and
to support the development of the uterine lining in preparation for pregnancy.
This medication is usually taken daily and can be administered by injection.
Fertility medication suppresses normal hormone function and reduces the risk
of eggs being released from the ovary before they can be retrieved. Mid-way
through the menstrual cycle, more medication is given to the woman to enable
her ovaries to produce several mature eggs at the same time. At this stage,
the woman is carefully monitored by way of ultrasound and blood tests to assess
the maturity of the eggs and the body's response to the medication.
When is it decided that enough eggs have matured, further medication is given
to stimulate the release of the eggs from the ovary.
How are the eggs retrieved?
The egg retrieval process often referred to as 'harvesting' is always done
under strict medical supervision. In this country, the woman is usually admitted
to hospital for this procedure. She is sedated to make her comfortable and a
special ultrasound device is inserted into the vagina to see the follicles in
the ovaries, which house the mature eggs. A needle is inserted through the vaginal
wall and the eggs are withdrawn. The entire procedure can take up to an hour
to complete and usually only causes mild pelvic discomfort.
Once the eggs have been retrieved, they are incubated for several hours under
strict laboratory supervision before a freshly donated sample of the partner's
semen is added. The semen sample is usually donated by masturbation.
The fertilised eggs are replaced into the woman's uterus about three to five
days later in a short procedure, which feels similar to a smear test. No anaesthesia
is used for the procedure, which involves the use of a soft flexible catheter
attached to a syringe.
What happens next?
The woman will be asked to take it very easy after the embryos have been transplanted.
This may involve complete bed rest for several hours or a few days. A pregnancy
test is performed about 10 to 14 days later to confirm if a pregnancy is present
or not. If a pregnancy has been confirmed, an ultrasound scan will be ordered
to confirm if one or more embryos are present. The woman will be monitored very
carefully for the remainder of her pregnancy.
What complications can arise?
Between 20 and 30% of all IVF pregnancies result in multiple births. While
this in itself is not regarded as a complication, it does impose additional
strain on the woman and she needs to get plenty of rest during her pregnancy.
With IVF, there is also a slight risk of a pregnancy developing outside the
womb (ectopic or tubal pregnancy). If this occurs, it will be detected when
an ultrasound scan is performed. Ectopic pregnancies rarely survive beyond 12
Other complications, which may arise with IVF, include:
- accidental damage to other organs near the ovaries and uterus during the
- allergic reaction to any of the many medications which are used during the
It is a medical fact that approximately 20% of all pregnancies fail regardless
of the way in which they were conceived. However, the trauma of losing a pregnancy,
which is conceived through IVF, is often far greater than one might expect.
One of the reasons for this is because childless couples sometimes see IVF as
being their last chance of being able to give birth to their own child. The
rewards of IVF are great when it succeeds, but the risk of failure is also very
Is it expensive?
In some European countries and in the UK, in-vitro fertilisation is available
on the National Health Service. It is only available on a private basis in Ireland
and can work out very expensive because of the high costs of medication and
the length of time it takes to complete the IVF procedure - from the initial
consultation and counselling process right through to the egg retrieval and
fertilisation process. The pregnancy must then be monitored closely and this
may involve hospitalisation for some women who are carrying twins or triplets.
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