IVF is an acronym for in vitro fertilization (‘in vitro‘ meaning ‘in glass’). This is often used when a male partner’s sperm is put into the female’s eggs in a laboratory to produce embryos.
The woman’s hormone production is temporarily switched off using medication, to enable the control of egg production and release. The ovaries are then stimulated with hormone injections to produce eggs – monitored using ultrasound scans. When the follicles reach the right size (usually after 12-14 days), and the uterus lining is of the correct thickness, the eggs are collected.
The eggs and sperm (produced by the partner on the day of egg collection) are placed together in a laboratory dish to allow fertilisation and embryo growth to occur. The embryo is placed in the female’s uterus – usually on the second, third or the fifth day after egg collection when the fertilised egg has divided and contains four, eight or reached the blastocyst stage (day 5).
Intracytoplasmic Sperm Injection is used when the sperm quality is suboptimal. This is a highly technical procedure where by a single sperm is injected into the centre of an egg to achieve fertilisation.
Stimulation and egg collection in an ICSI cycle are the same as in an IVF cycle. The difference between the two is that in an ICSI cycle, mature eggs are directly injected with sperm instead of being placed together in a dish.
IUI may be appropriate in treating couples with unexplained infertility.
In an Intrauterine Insemination cycle, a sample of sperm is prepared by the embryologist and placed directly inside the uterus using a very fine catheter. The sperm is deposited before the release of an egg or eggs in a natural or stimulated cycle. Conception occurs naturally inside the body.
The cycle can be monitored at the SPC and the sperm preparation and IUI is performed at Guy’s ACU.
Based on current HFEA (Human Fertilisation and Embryology Authority) guidelines, only two embryos (or a maximum of three if the woman is over 40) may be transferred after a treatment cycle.
If the treatment produced more than two (or three) good quality embryos, those that aren’t used may be frozen for future use. These embryos will be frozen at extremely low temperature, which ensures that they do not deteriorate over the number of years they are stored.
In a Frozen Embryo Replacement Cycle the woman takes medications to prepare her womb to receive these embryos. The advantage of this treatment is that there is no need to use hormone injections to stimulate the ovaries.
An ultrasound scan is performed to assess the lining of the uterus to determine whether it is ready to receive the embryo. Once the lining is ready, embryos are thawed and transferred.
Preimplantation genetic diagnosis is a specialised treatment for couples who carry an inherited genetic defect that could cause serious health risks for their children, such as cystic fibrosis, sickle cell disease or Huntington’s disease.
PGD involves the use of Assisted Reproductive Techniques (ART) such as IVF or ICSI to stimulate the ovaries to produce multiple eggs. The aim is to obtain and fertilise a number of eggs. The resulting embryos are allowed to develop for three (or sometimes five) days, before a single cell is removed from each embryo and the genetic material (DNA and chromosomes) tested for the disorder.
Up to two unaffected embryos are then transferred into the uterus. If successful, the pregnancy should be unaffected.