What is IVF?
IVF is an abbreviation for In Vitro Fertilisation and is also called ‘test tube’ treatment.
During IVF treatment mature oocytes (eggs) are collected from the ovaries and fertilised with sperm in a petri dish in an incubator in the laboratory. Here the fertilized eggs (embryos) develop during the first cell divisions. After three or more days the best embryo or embryos are transferred to the uterus so they can attach to the endometrial lining and continue their development into a foetus, just like after normal conception.
Fertilisation with ICSI
(Intra Cytoplasmic Sperm Injection, ‘mikroinjection’, ‘mikroinsemination’).
ICSI is an extension of the standard IVF method, which is used if the number of sperm cells is very low or if a previous ‘standard’ IVF treatment has resulted in a low fertilisation rate.
With ICSI, the hormone treatment and oocyte pick-up is done exactly as for IVF. The only difference is the way that the oocytes are fertilised.
The fertilisation with ICSI is performed with a special microscope with ‘micromanipulators’. With this microscope, an oocyte can be held with a holding pipette and a normal-looking sperm cell can be selected and picked up with an extremely thin pipette. The sperm cell is then injected through the egg-’shell’ and into the egg. After the ICSI fertilisation procedure, the cell divisions continue just like with standard IVF.
IVF/ICSI treatment - step by step
IVF/ICSI treatment follows the steps outlined below:
- Hormone stimulation of the woman monitored by ultrasound scans and in some case also blood tests for hormone levels.
- Final oocyte maturation injection
- Oocyte pick-up
- The sperm sample
- Fertilisation of the eggs and the first cell divisions in the laboratory
- Embryo transfer
- Hormone supplementation to strengthen the endometrium until the pregnancy test (and in some cases longer)
- The pregnancy test (blood test)
- Scanning of the pregnancy if the test is positive
The chance of becoming pregnant by IVF/ICSI
In order for IVF treatment to result in a pregnancy, all steps in the treatment must be successful. It is never possible to predict if the treatment will be successful in a particular woman and cycle. Our statistics are based on average probabilities from our own clinic and on data from the international scientific literature. National Danish results may be found on The Danish Fertility Society’s website www.fertilitetsselskab.dk.
Since the start of our clinic in 1993, we have performed more than 19.000 IVF/ICSI cycles and several thousand treatments with cryopreserved embryos.
The highest success rates are obtained when the woman is young (less than 38-40 years). When there are two fertilised embryos of good quality for transfer the pregnancy chance is optimal. In this situation, the chance of a positive pregnancy test is between 40-50% per transfer. After subtracting the miscarriages (approximately 20% of the pregnancies) the chance for giving birth to one or two children is around 30-35%.
After three successfully completed treatment cycles on average 70-75% of the women will have given birth. The pregnancy chance declines gradually as the woman’s age increases regardless of the cause of infertility. Therefore the pregnancy chance is higher the younger the woman is. In women above 40 years the average chance for pregnancy/birth is approximately half of the figures mentioned above.
We are increasingly culturing embryos for more than 3 days.
A blastocyst is the developmental stage that an embryo normally reaches 5-6 days after fertilisation. A blastocyst consists of approximately 100 cells. Blastocysts consist of a fluid-filled centre surrounded by a wall of cells. A small group of cells on the inner side of the wall (‘the inner cell mass’) are those cells that will develop into the embryo. Embryos in the blastocyst stage hatch out of the surrounding ‘egg-shell’ (‘zona pellucida’) and begin to implant in the endometrium around 6-7 days after fertilisation.
With a high performance laboratory, it is possible to obtain significantly higher pregnancy rates per transferred embryo with longer (blastocyst) culture than with transfer on day 3. Embryo culture beyond 3 days demands a very high level of precision in the laboratory, specialised culture media, and very well defined constant conditions such as temperature and gas composition in the incubators.
We have spent a lot of effort optimising our blastocyst cultures. We use the best available culture media and we culture the embryos at low oxygen tension in order to mimic the environment in the fallopian tube.
For blastocyst culture, it is desirable that there are five or more good quality embryos on day 3 after the oocyte pick-up. During the culture period, the laboratory will keep you informed about the development of your embryos on their way towards the blastocyst stage.
Book an appointment
To find out if IVF or ICSI can help you achieve a pregnancy, please call us or book an appointment.