People talk a lot about IVF when discussing infertility options - but what actually happens to you when you undergo the procedure? ?


Whether you've been referred to an NHS clinic or are paying for a private one, there is a general process each IVF patient goes through over a (roughly) 2-month period.

How yours looks may vary slightly depending on your own circumstances, but here's an overview of what to expect, provided by Dr Geetha Venkat, director of the Harley Street Fertility Clinic (HSFC)...

1. Waiting for IVF treatment to begin

The biggest difference between NHS and private patients is the fact that NHS patients may have to wait a little bit after being referred to their clinic, before they can make a move with their treatment.

HFEA reports that many NHS clinics operate an 18-week (4-month) waiting list, though whether you'll get that, or have a longer wait time before you can start your IVF, will really vary depending on where you live.

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2. Preparing for IVF physically and emotionally

Once your wait is over, and you're ready to go, the first thing the clinic will do is advise you to prepare yourself both physically and mentally for what's to come, says Dr Geetha.

This can include lifestyle changes like cutting back on or quitting booze, eating a healthy diet, stopping smoking, and ensuring you're the optimum weight for conceiving - but also advising you to ensure you're in the right frame of mind, and have a positive attitude towards treatment, too.

This bit's REALLY important, and we can't stress that enough.

Mums from our MadeForMums community who've been through IVF, like Dolly, really drill home the toll the process can take on our forum - for both you and your partner.

"I just wasn't prepared for how I felt emotionally, I'm a pretty strong person and my relationship is rock solid but it definitely takes you to be in this together," she writes.

"The bloating and pain and lack of sex really does take it's toll and my husband didn't really know what to do for the best at times."

So, it's crucial that you go in with a good attitude, while still being well aware of what's to come.

There's also a lot to take in during the first bit of the process, so mum Louise advises to save yourself a headache and keep notes throughout the journey.

"When you go to an appointment write everything down - there is so much info that your brain can't take it all, even if like my clinic they tell you each stage as you get to it rather than everything in one go.

"It's fine to check information and ask them to hold on while you jot it down."

Also, you'll undergo a series of screenings and tests to insure you're free of infections like HIV, Hep B and Hep C, to make sure you're healthy.

Then, whether you're NHS or private, you'll be asked to sign several legally-binding consent forms.

"We go through what you and your partner would like us to do with your gametes, with your embryos, what you would like us to do [if you want to] cancel the embryo," Dr Geetha explains.

"You have to consent to whether we can freeze your embryos or not. And in case something happens to them, what do you want us to do with your embryos?

"These are consent forms from the Human Fertility & Embryology Authority (HFEA), and everyone has to fill them in.

"Then, there are some in-house forms that give us permission to do the egg collection procedure."


4. Supressing menstruation

You'll be given daily medication designed to stop your natural menstrual cycle. Often, you'll take these yourself, in the form of a nasal spray or injections.

The NHS website writes that this helps the next stage of injections work more effectively.

5. (Maybe) going for an endometrial scratch

Some clinics (though not all) may offer to perform an endometrial scratch - a surgical procedure which helps embryos attach after embryo transfer.

This is done 7 to 10 days before your period begins.

6. Scan during your period

When you begin your period, you'll be called in on the 2nd or 3rd day for a scan.

7. Starting injections to help grow your eggs

"After the scan, if everything is satisfactory, we start with the hormone injections to grow your eggs," explains Dr Geetha.

"The nurses will go through the instructions regarding the injections and will teach you to do the injections at home."

MFMer Louise found the injections one of the toughest bits of the process - but insists though they are scary, you do get used to them.

"Injections aren't fun but they do get easier," she admits. "I was covered with bruises the first week but consider myself pretty much an expert now!"

Elle agrees that the first shot is the hardest one to take: "Did my first injection this morning - flippin ouch!

"Actually putting the needle in was fine but it burns when you put the stuff in - and then my leg went all red and itchy and sore for about quarter of an hour.

"It's fine now though - bit of swelling where it went in but that's all, so I'm very relieved that's the first one out of the way - think the thought of it is worse than the actual event!!"

And it's true that the logistical side of ensuring to take the injections at the same time each and everyday can be a bit of a nightmare.

"The hard thing as to do it the same time every day," explains Lucy, a member of our MadeForMums community.

"My partner is very supportive but also very squeamish, and the look of terror on his face as I stood there day after day after day willing myself to shove this needle into myself is one that I will never forget."

She also adds that what you're injecting can shift your mood and make you feel a bit naff:

"I won't lie, it did get easier. Some days it would sting more then others but OK, you have to go through this... the drugs can also make you feel rubbish!"

After 4 days of injections, you can expect to go for what's called a 'fast check' ultrasound scan and/or blood test to check your hormones.

"For the IVF treatment, we will have you coming to hospital every other day or so to have blood tests," she adds.

"This monitoring process is important because we are looking at the hormonal balance and recording the response in the ultrasound scan.

"In any NHS IVF clinic, they will do the regular scan monitoring. Some IVF clinics may not do the blood test, but normally the monitoring tests are an important part of the IVF cycle."

After 10 to 12 days of injections, you'll be ready for the egg collection op. Then, 36 hours before the procedure takes place, Dr Geetha says you'll be given one last injection: an HCG injection, which contains a hormone produced by the placenta during pregnancy.

8. Egg collection procedure takes place

The collection procedure should take 15 - 30 mins depending on how many eggs you have (the more you have the longer it takes), and usually takes place in the morning.

"You'll be asked to come on the morning on the day of the egg collection without having eaten anything," Dr Geetha explains.

"It will not be done under general anaesthesia usually, but there will be anesthetic. You won't feel any pain.

"The egg collection part involves introducing using a vaginal scan probe, and a needle attached to the probe which will go in and try now to access the ovaries. We look for the large follicles containing the mature eggs."

After the procedure, the woman goes to recovery and is usually taken home an hour or so after the op.

9. Meanwhile, time to prep the sperm...

While all this is happening, the sperm sample is collected and checked. This is called sperm-washing.

It's then determined whether you'll need traditional IVF (sperm placed next to the egg in a dish) or if you'll need ICSI, where a single sperm is selected for its high quality and directly injected into the egg, to maximise chances of fertilisation taking place.

You might already know which option is right for you based on tests you or your partner have had in the past.


10. Fertilisation in the lab

The afternoon after the egg collection procedure, the sperm and egg will be placed together. The embryologist will monitor whether or not the egg and sperm have fertilised, creating an embryo.

You'll be informed of the results, and if the embryo has successfully formed, it'll be kept in incubation.

11. Keeping an eye on the embryos

"The next day, we see how the embryos are thriving and progressing, with something called embryo assessment," says Dr Geetha.

The assessment is crucial, as it determines when you'll be having your embryo transfer.

12. Transferring the embryo(s) to your uterus

Depending on your individual circumstance - the quality and number of the embryos you have available - your transfer will take place on day 3 or day 5 after your egg collection procedure.

On day 3, you will receive the embryo transfer if you have few embryos and it's clear which embryos are the most likely to succeed.

The procedure on day 5 is called a blastocyst transfer. As the embryos (called blastocysts at this stage) will be further developed, this type of transfer is often used if there are several good embryos at the day 3 stage, and it's not clear which embryos will remain a viable option.

Whether you'll have one or 2 embryos transferred to the womb is also decided at this stage.

"The couple usually decides how many they would like to have," private specialist Dr Geetha admits.

"Though if it's their 1st cycle, if she has top grade embryos then we tell them to have an embryo put back because we don’t want to give them the risk of having a twin pregnancy."

How many embryos you have put in can also depend on your age, says the NHS. It's suggested that women 39 and under only have one, while women 40 and over have 2.

13. Testing for a pregnancy

Two weeks after the egg collection takes place, a blood test will often be done in the clinic to determine whether or not you're expecting.

Despite the prodding, the poking and the self-inflicted injections taking their toll, many say the 2-week wait can feel like the worst bit of the whole process.

One mum Heather, described her wait as "torturous" ?

Two weeks can suddenly feel like a lifetime, and many hopeful women want to jump straight into taking a pregnancy test.

However, we'd say its crucial to follow your specialist's advice here about when and how to check you're pregnant.

My 1st IVF cycle was successful – I’m pregnant! What happens now?

Two to 3 weeks after you've taken your pregnancy test, you'll be roughly 6 - 7 weeks pregnant.

Therefore, you should be asked in for an ultrasound scan and, all being well, you will see the baby/know how many babies you have, and hear the heartbeat during your scan.

My 1st IVF cycle was unsuccessful - when can I try again?

Two to 3 months after your failed cycle, you can begin with another, say the lovely ladies on our forum.

But just to be safe, we reckon you're best off speaking to your specialist about this one. The answer to this question will so different for everyone who reads it, depending on specific circumstance.

You may also want/need to speak to a your medical professional about future options - especially if you're only able to have the one attempt for free on the NHS, and would have to consider spending to go private if you wanted to continue.

In short, though, you can keep on trying. Your docs should guide you through this next part...

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