IVF (In-Vitro Fertilisation)
Also known as: Assisted Reproductive Technology (ART), TMC Fertility, Frozen Embryo Transfer, Fertility Treatment
- Light activity the following day
- Avoid heavy exercise 5–7 days
About IVF (In-Vitro Fertilisation)
Treated areas:Ovaries, Uterus
IVF is an advanced and effective method to help people have a baby. It means fertilizing an egg with sperm in a lab, then placing the resulting embryo into the womb to start pregnancy. “In vitro” means “in glass”, referring to the lab dish used.
Benefits of IVF
Advanced Fertility Support
IVF bypasses many natural barriers to conception, making pregnancy possible for patients facing complex infertility challenges.
Embryo Screening Options
Genetic testing of embryos (PGT) to help identify chromosomally healthy embryos before transfer.
Fertility Preservation
Eggs, sperm, or embryos can be frozen for future family planning.
Ideal Candidate
Couples that wanting for a child but face problems:
- Blocked or damaged fallopian tubes
- Male fertility problems (low count or poor quality sperm)
- Endometriosis
- Irregular or no ovulation
- Unknown causes of infertility
- Lower fertility due to age
- Genetic conditions
- Single people or same-sex couples planning a family
Proven Results
- Successful pregnancy
- Healthy baby birth
- Chance to have a baby even with complex fertility issues
- Option to freeze embryos for later use
How It Is Performed
- Initial Assessment (both partners):
- Woman: Hormone profile (AMH, FSH, LH, oestradiol, TSH, prolactin), antral follicle count by transvaginal ultrasound, hysteroscopy or HSG to assess uterine cavity
- Man: Semen analysis; DNA fragmentation index; infectious disease screening (HIV, Hep B/C, syphilis)
- Personalised Stimulation Protocol: Based on AMH and antral follicle count, the fertility specialist prescribes a bespoke ovarian stimulation protocol using daily self-administered gonadotrophin injections for 9–12 days.
- Monitoring: Serial transvaginal ultrasounds (and oestrogen blood tests) every 2–3 days during stimulation to track follicle growth and adjust dosing.
- Trigger Injection: When follicles reach the optimal size (≥18 mm), a trigger injection (hCG or GnRH agonist) is given to complete final egg maturation. Egg retrieval is scheduled 34–36 hours later.
- Egg Retrieval (Oocyte Pickup, OPU): Performed under IV sedation (or general anaesthesia) in an operating theatre; a fine needle guided by transvaginal ultrasound aspirates follicular fluid from each mature follicle. Eggs are immediately handed to the embryologist.
- Laboratory Fertilisation:
- Conventional IVF: Eggs placed with a defined number of motile sperm in culture media; natural fertilisation occurs
- ICSI (Intracytoplasmic Sperm Injection): A single selected sperm is injected directly into each mature egg under microscopic magnification — used for male factor, low fertilisation rates, or poor sperm quality
- Embryo Culture: Fertilised eggs (zygotes) are cultured for 3–5 days in specially designed incubators; embryos are assessed daily for development quality
- AI-Assisted Embryo Selection: Time-lapse incubator systems (e.g., EmbryoScope) capture continuous images of embryo development; AI algorithms score each embryo’s development patterns to identify the best candidate for transfer
- Pre-Implantation Genetic Testing (PGT) — optional:
- PGT-A (aneuploidy): A biopsy of the trophectoderm (outer cell layer of the blastocyst) is sent for chromosomal analysis; only euploid (chromosomally normal) embryos are transferred — significantly improving implantation rates and reducing miscarriage risk, particularly in women 35+
- PGT-M (monogenic): Testing for specific inherited genetic conditions (e.g., thalassaemia, cystic fibrosis)
- Embryo Transfer: A thin, soft catheter is passed through the cervix into the uterine cavity; the selected embryo is deposited at the optimal fundal position. No anaesthesia required — similar to a cervical smear.
- Luteal Support: Progesterone supplementation (vaginal pessary, injection, or oral) is prescribed from egg retrieval to support the uterine lining for implantation.
- Pregnancy Test: A blood beta-hCG test is performed 10–14 days after embryo transfer.
- Frozen Embryo Transfer (FET): Surplus good-quality embryos are vitrified and stored. FET cycles are planned in subsequent months using a medicated or natural cycle protocol — without the need for another ovarian stimulation.
Your Timeline
Preparation
- Both partners: complete infectious disease screening (HIV, Hepatitis B/C, syphilis, rubella)
- Woman: AMH, antral follicle count, uterine cavity assessment (HSG / saline sonogram / hysteroscopy)
- Man: Full semen analysis; DNA fragmentation index if indicated
- Folic acid 400 mcg – 1 mg daily beginning at least 1 month before the cycle (preferably 3 months)
- BMI optimisation: ideal BMI 18.5–30 kg/m²; significant obesity or underweight adversely affects response and outcomes
- Smoking cessation (both partners): smoking reduces ovarian reserve, egg quality, and sperm parameters
- Alcohol reduction; avoid excessive caffeine
- Vaccinations updated: rubella, varicella, COVID-19 as recommended
- Injection training session with fertility nurse before the stimulation begins
Followup Care
- Post-egg retrieval: Rest 1 day; report severe abdominal pain/bloating (signs of OHSS)
- Post-embryo transfer: Normal daily activity; avoid heavy exercise and hot tubs; progesterone supplementation continues
- If pregnant: Serial beta-hCG at day 14 and day 16 to confirm rising levels; early pregnancy ultrasound at 6–7 weeks; obstetric handover at 10–12 weeks
- If not pregnant: Review appointment to discuss cycle outcomes, potential improvements, and planning for next attempt (FET or new stimulation cycle)
- OHSS management: Mild OHSS is managed at home with hydration and rest; moderate-to-severe OHSS (rare with modern trigger protocols) may require clinic review and occasionally hospitalisation for fluid management
Frequently Asked Questions
How many IVF cycles might I need?
While some couples achieve a successful pregnancy with their first IVF cycle, most fertility specialists recommend planning for up to 2–3 complete cycles to achieve a cumulative success rate of 60–80% for appropriate candidates. Vitrifying all good-quality embryos from each stimulation cycle for sequential FET maximises the total number of transfers from each egg collection.
What is ICSI and do I need it?
Intracytoplasmic Sperm Injection (ICSI) involves injecting a single selected sperm directly into each mature egg using a microscopic needle. It is recommended when there are significant male factor problems (low count, poor motility, or abnormal morphology), when previous IVF cycles have had low fertilisation rates, or when surgically retrieved sperm are used. At many centres, ICSI is routinely used for all IVF cycles.
Does IVF work for women over 40?
IVF can be successful for women over 40, though age-related decline in egg quantity and chromosomal integrity does reduce success rates. PGT-A (pre-implantation genetic testing for aneuploidy) — which identifies and selects only chromosomally normal embryos — significantly improves outcomes in this age group by eliminating the implantation failures and miscarriages caused by aneuploid embryos. Using donor eggs (from a younger woman) is another option that dramatically restores success rates for
Is IVF safe?
IVF is a well-established and extensively studied technology with an excellent safety record. The main medical risk is Ovarian Hyperstimulation Syndrome (OHSS) — an over-response to stimulation causing abdominal swelling and discomfort. Modern "freeze all" strategies (vitrifying all embryos for FET rather than fresh transfer) combined with GnRH agonist trigger protocols have virtually eliminated severe OHSS. The risk of multiple pregnancy — historically the major concern with IVF — is managed by
How many embryos should be transferred?
The global standard of care is elective single embryo transfer (eSET) — transferring one high-quality embryo at a time. This achieves equivalent cumulative pregnancy rates to double embryo transfer while virtually eliminating the risk of twin pregnancy, which carries significantly increased obstetric risk (premature birth, low birth weight, maternal complications).
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