So, before we discuss what IVF or in vitro fertilisation is, we should perhaps talk a
little bit about natural conception. So that there is successful natural conception. We
need to have a robust ovulation process. This is a process by which an egg is released from
the ovary normally on a monthly basis. We also need sperm of good quality. Sperm of
low count or sperm of low motility will not allow fertilisation. We also need healthy
tubes. The tube is there to collect the egg from the ovary when the egg is released and
is there to allow passage of sperm from the uterus into the tube so fertilisation can
occur in the tube. IVF is essentially a process or treatment during which the location of
fertilisation is changed. It's no longer in the tube; in the fallopian tube, the fertilisation
occurs in the lab in a dish.
So, the first cases of IVF were meant to treat
women with blocked fallopian tubes. If the fallopian tube is damaged, it cannot collect
the egg that is released from the ovary and it cannot allow passage of sperm into it and
therefore fertilisation cannot happen in the tube, but once we started treating couples
with all sorts of fertility issues, we realise that it can also help in the case of men with
low sperm count. By putting the sperm in the dish with the egg and saving the sperm they
need to swim through the uterus into the fallopian tubes to fertilise the egg, we increase the
chances of fertilisation. Finally, we found that couples who have normal ovulation process,
normal fallopian tube, normal sperm count and suffer with what we call unexplained subfertility
can still benefit from IVF treatment.
So, IVF treatment can be carried out using
the female natural cycle. During such cycle only one egg is matured and only one egg is
retrieved. The other way of doing this is to give the women medication to cause maturation
and collection of several eggs. It appears that this second method is associated with
a better pregnancy rate and the vast majority of IVF treatment cycles that we carry out
nowadays use ovarian stimulation. After a period of ovarian stimulation when there are
several eggs matured, these eggs need to be collected by a minimally invasive procedure
that is normally done in theatres under sedation. The eggs retrieved are given to a scientist
and embryologist who incubates these sperm with the egg in a dish overnight. The following
day the scientist looks at the fertilisation of the eggs and at this point it is already
possible to put back one or more fertilised eggs, but normally we keep the fertilised
eggs in the lab for a bit longer to see how the embryos develop and then we transfer on
day two, three, four or five; one or two good-quality embryos back inside the uterus.
So, the first part of treatment, the part during which the female partner takes medication
to mature several eggs or the part during which we just monitor the natural cycle, it
takes about 10 to 14 days. During this period the female partner will be requested to come
for a few scans to monitor the development of her follicle or follicles if it is a stimulated
cycle. The egg collection is a day case procedure. It takes half an hour and you expect it to
spend two hours in the unit before you can go home. As I earlier said, it takes between
two to five days after egg collection to transfer the embryos and then about 10 days to know
whether you're pregnant or not. The whole process should take you around 28-day time
between the start of the process and until you know whether you're pregnant or not.
The cost of treatment varies between patients and between clinics. Not all patients need
the exact same treatment and therefore the cost may change and some units charge more
for the same services than others. My advice to you is to contact your clinic and get a
cost estimate for the specific treatment you're going to need.
So generally speaking, once you hit the age of 45, the chances that IVF will result in
the birth of a baby is estimated to be around 1%.
The success rate of IVF treatment is age dependent. Mostly female age dependent. Men's age play
a role but the role is not that significant. Under the age of 35, the chances of live birth
resulting from a single IVF treatment cycle are estimated to be between 40 to 50 percent.
Once you get to the age of 38 to 40, this halves and is around the figure of 20 percent.
Between the ages of 43 to 44, this drops to 3 to 5 percent and as earlier mentioned at
the age of 45-46, you're looking at only one percent chance of having as a baby as a result
of a single IVF treatment. Obviously these figures refer to IVF treatment during which
you use your own eggs. Once couple opt for egg donation, the chances of pregnancy are
much, much better even when they are 46, 47, 48, and 49.