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IVF (In-Vitro Fertilisation)

This is the most used assisted conception technique worldwide. IVF literally means fertilisation "in-glass", hence the origin of the name "test tube baby". For IVF, eggs are collected from the ovaries and then put together with sperm to fertilise in a laboratory dish before being transferred into the uterus (womb).

Ovarian stimulation protocol

IVF involves taking daily fertility drugs (hMG or recombinant FSH or recombinant FSH/LH with or without GnRH agonist or antagonist) to stimulate the ovaries to produce a high number of oocytes (eggs). The recruitment and development of follicles, which contain the eggs, is tracked by regular transvaginal ultrasound scans and sometimes blood tests. When at least three follicles are mature (greater than 17mm in diameter) a hormone injection (hCG) is given to ripen the eggs. Egg collection is performed generally under ultrasound guidance, and very seldom using laparoscopy 34-36 hours later. The egg collection procedure takes about 20 minutes.

The ovarian stimulation protocol is individualised to maximise the chances of success while reducing the risks, complications and possibly the costs of treatment.

Natural cycle

Sometimes it is possible to proceed to IVF without using any drugs for ovarian stimulation. In most cases only one or two eggs are collected but immature eggs can be matured in vitro before being fertilised. In most cases only one healthy embryo is available for transfer. Usually there are not enough embryos to be stored. Some people argue that using "natural cycle IVF" the endometrium (lining of the womb) may be more receptive to the implanting embryos.

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