Step 1: egg collection
After a course of Buserelin, you will have your first ultrasound scan. If the ovaries show signs of continuing activity, you will be asked to continue the Buserelin for a further week. However, if the scan shows the ovaries to be inactive, you will begin the course of FSH injections.
The Follicle Stimulating Hormone (FSH) injections should cause follicles to grow in the ovaries. A follicle is a little sac of fluid in which an egg develops. In a normal cycle, only one egg is produced, but in an In Vitro Fertilisation (IVF) cycle, we want to obtain a number of eggs in order to increase the chance of pregnancy at the end of your treatment.
A second and third scan are performed on the 10th and 12th days of treatment with FSH. When the follicles are large enough you can stop the FSH and will be asked to have the hCG injection to prepare the eggs for collection and fertilisation 32-39 hours later.
Before the egg collection at the Victory day surgery unit (B4) at St Helier Hospital, you decide with your doctor whether you opt for a general anaesthetic or if you prefer sedation only. Egg collection is performed using a needle guided by a vaginal ultrasound probe which punctures and drains all the follicles.
The follicular fluid containing the eggs will be placed in sterile test-tubes, which in turn will be placed into a transport incubator. The incubator keeps the eggs at body temperature while they are taken by your partner to the central London hospital (either King's or The Bridge).
Step 2: In Vitro Fertilisation
Your partner will be asked to produce a sperm sample when he arrives at the central London hospital (with the incubator!). The embryologist will examine the follicular fluid under a microscope to detect the eggs. Each egg is surrounded by approximately 100,000 healthy sperm, and fertilisation should occur 12-18 hours later.
An embryologist will call you to let you know if fertilisation has occurred. If it has, you will be given an appointment for embryo transfer, usually two days later. If fertilisation has not occurred, an apointment will be made for you at St Helier Hospital to discuss the situation.
Step 3: embryo transfer
You will be told about your embryos and shown them on a TV screen. Two (or very rarely three) embryos are transferred into the uterus via a catheter. The procedure should only take a few minutes and is usually quick and painless.
Two weeks after egg collection you will have a blood test to determine whether the treatment has been successful. The result will be phoned through to you. If the result is positive, we will arrange a vaginal scan two weeks later in order to confirm that all is well with the pregnancy. In the unfortunate case that the result is negative, one of the fertility nurses at St Helier Hospital will make an appointment for you to see one of our consultants to discuss your treatment cycle with you.
At any time, whether before, during or after your treatment, we will do our best to help you with any problems or questions you may have. If there is a particular member of staff you feel able to talk to, you are welcome to approach them directly. Alternatively, if you would prefer to speak to a specially trained independent counsellor, we can arrange this for you.
