Assisted Conception

Question 1

What is the 1st step in IVF?

Answer 1

Multiple follicular development.
Involves 2 weeks of daily FSH injections +/- LH. With an additional drug to prevent an endogenous LH surge and premature ovulation.

Question 2

What is the 2nd step in IVF?

Answer 2

Ovulation and egg collection.

Once an optimal number of follicles are a mature size (confirmed by scan) the Gonadotrophins are stopped.

A single injection of LH id given to stimulate final oocyte maturation.

36h later the eggs are collected by TVUSS guided aspiration.

Question 3

What is the 3rd step in IVF?

Answer 3

Fertilisation and culture.

The eggs are incubated with sperm. The fertilised eggs are cultured until day 2-3 or 5-6 depending on the practice. Spare embryos can be frozen.

Question 4

What is the 4th step in IVF?

Answer 4

Embryo transfer.

Two embryos are transferred into the womens uterus.

Progesterone or HcG is given until 4-8 weeks gestation .

Question 5

What is IUI?

Answer 5

Intrauterine insemination.

Sperm are injected directly into the uterine cavity.

This can be done on a women natural cycle with testing to ensure ovulation.

Or after gonadotrophin ovulation induction.

Question 6

What is ICSI?

Answer 6

Intracytoplasmic sperm injection

A sperm is injected directly into the oocyte cytoplasm.

Used as an adjunct in IVF when there is also male factor infertility.

Question 7

What is preimplantation genetic diagnosis?

Answer 7

In IVF before embryo transfer 1 or 2 cells are removed for the embryo and tested using PCR for chromosomal and genetic abnormalities.

Only healthy embryos are implanted.

Question 8

What are the risks of IVF?

Answer 8

Multiple pregnancies are common

Failure (only successful in 35% of under 35’s only 10% successful in over 40’s)

Increased risk of ectopics.

Slightly higher rates of prenatal mortality.