IVF

In vitro fertilisation (IVF) is a fertility treatment where the egg is removed from a woman's body, and is fertilised by a sperm in a laboratory to create an embryo. The embryo is then placed inside the woman's womb. IVF literally means 'fertilisation in a glass', and coined the phrase 'test tube baby'. It is normally only used when other fertility treatments haven't worked. IVF doesn't always work, and is physically and emotionally difficult. Before you start IVF treatment, you will be offered counselling.

Your doctor may recommend IVF for you if you have unexplained infertility (where no known cause for your infertility is found), your fallopian tubes are blocked, other fertility treatments haven't worked, or the male partner has fertility problems (severe cases of male infertility are more suited to intracytoplasmic sperm injection (see Alternatives to IVF for more information.)

Criteria

You may be able to get IVF treatment funded by the NHS, but access to NHS treatment varies across the country, and waiting lists can be long. People seeking IVF on the NHS also need to satisfy criteria, which can differ across Primary Care Trusts. To be eligible for IVF on the NHS, the woman needs to be between 23 and 39 at the time of treatment, the couple have to have a known cause for their fertility problems, or they have to have been trying to conceive for at least 3 years. Priority is commonly given to couples who don't already have any children. The National Institute for Clinical Excellence (NICE) recommends that each eligible couple be offered up to 3 rounds of IVF, and PCT's are striving towards this, but at the moment the provision of IVF treatment varies across the country, so some eligible couples might only get one or two cycles of IVF.

If you aren't eligible for IVF on the NHS, you may want to consider paying privately for IVF at a HFEA clinic. To find a HFEA licensed clinic, visit www.HFEA.gov.uk. Clinics vary in how much they charge for IVF treatment, but the average cost of one cycle of IVF is £5000.

How it works

Clinics often vary in their IVF treatment, and they usually tailor their treatment to your individual circumstances. The first step in IVF treatment is to take a drug to suppress your natural monthly cycle. This is given as a daily injection for 2 weeks, or a nasal spray. The next step is a fertility hormone, to increase the number of eggs you produce. This medicine is given as a daily injection for 12 days. During this treatment, the clinic monitors your progress by transvaginal ultrasound scans and blood tests. Just before you are due to ovulate, you will be given an injection to help your eggs mature. The clinic can then collect the eggs, using a needle attached to a probe which is inserted into each ovary. Once the eggs have been collected, they can be mixed with your partner's sperm, and the egg can be fertilised. If any eggs do become fertilised, the clinic chooses the best one or two embryos to transfer into the woman's womb. If the woman is over 40, three embryos may be used to ensure the best chances of success. The final stage of IVF treatment is the transfer of the embryos into the womb. Before this takes place, you will be given medicine to help prepare the lining of your womb for the embryo, which is given as a gel, pessary or injection. One cycle of IVF takes 4-6 weeks.

How successful is it?

IVF can be performed using either your own eggs, or a donor's eggs. The chances of conception are higher using your own eggs. For women using their own eggs, data from 2009 shows that the chances of having a live birth from IVF treatment are as follows:

32.3% for women under 35

27.2% for women between 35-37

19.2 for women between 38-39

12.7 for women between 40-42

Women who have been pregnant before or have had a baby have a higher chance of having a baby through IVF.

How to find out more

Talk to your doctor about whether IVF may be right for you. To find out more about IVF, visit the Human Fertilisation and Embryo Authority at. Information is also available at http://www.nhs.uk/Conditions/IVF.