IVF is used in all cases of involuntary childlessness. And after three attempts with IVF as many as almost two thirds are parents.
In order to increase the possibility of succeeding with IVF, more than one egg is needed. Thus the woman is treated with the body's own hormones that will induce the ovaries to produce more eggs while at the same time preventing ovulation; the point is to manage to collect the eggs before they start off into the Fallopian tubes.
There are two methods for maturing eggs. The longer method starts with the woman taking hormones, using a nose spray, that reset the body to zero. She simply lands up in menopause, before she is given hormones to stimulate egg maturation. The shorter treatment is about curbing ovulation towards the end.
Bringing eggs to maturation usually takes about 10 days. The level of hormones needed to stimulate the ovaries is very individual. Therefore blood tests are taken several times during the process of the treatment in order to make sure that the correct dosage is being given. The woman gives herself the hormones by using an injection pen - it looks more or less like a pen, but with a needle instead of a nib. It is adapted for usage by someone without any medical training.
As always when it comes to hormones, both mood and body are affected although in what precise way they are affected is very much an individual matter. But, one thing is certain; this is in many ways a very trying period for the woman.
Towards the end of the treatment ultra sound is used in order to determine when it is the right time to collect the eggs. Via the vagina and the womb the doctor is able to see the fluid-filled blisters with the eggs on the ovaries. A thin needle, on the end of the ultra sound bar, sucks out the fluid from the blisters. It takes between 20 and 40 minutes, and is quite painful. Naturally one is given sedation.
After the extraction the doctors will have a test-tube with hopefully more than one egg. But remember, one can be enough.
At the same time as the eggs are being collected the man will have supplied his contribution.
In the next stage the sperm are centrifugilized so that only the very best remain. The eggs are rinsed clean from blood and other fluids with the help of a nutrient solution. Then the egg and the sperm are laid together in a so-called cultivating bowl (not a test-tube). The bowl is put into a heating cabinet where the conditions, as far as possible, shall liken those of the human body with regard to temperature, pH and moisutre. Now it is time for the sperm to fertilize the egg. There is also a possibility of helping the sperm get into the egg with a thin needle if this should be required.
As early as the next day one can see the first sign of fertilization; two seeds that soon melt together and the first cell division takes place. An average of approximately 80% of all mature eggs get fertilized in the cultivation bowl.
After about three days a fertilized egg is chosen (if there are more than one the remainder are frozen in case they are needed at a later stage). The egg is planted in the womb with the hope that it will burrow itself into the inner membrane of the uterus, the endometrium, become attached and then just continue to grow. Exactly as in a normal pregnancey.
And now it is time to wait. Again.
Waiting is something that all IVF-couples know everything about. One has waited for months for ovulation and menstruation. Then for investigation, for answers, for IVF... One is an expert at waiting. But the waiting that most couples experience between time of the implantation of the egg and the first pregnancy test that shows whether or not it has succeeded, is worse than any other waiting. Two weeks of perfectly excrutiating waiting. And, from a positive pregnancy test to the first ultra sound, it is the same thing.
Two of three get children
If the test shows negative. And the woman gets her period. There was no child. Well, then a new period of waiting starts for the next attempt.
After one IVF-attempt every third woman gets a child, but the total likelihood increases if more attempts are made. Of the women who make three attempts almost two thirds get children. And this is hopeful.
But one thing is for sure; it can be a good idea that, before embarking on the IVF treatment, one has spoken to each other and agreed on how many attempts one will make.
Otherwise the waiting might easily lead to collapse.