Are you IVF-curious? You’ve clicked on the right link. You might be fertility challenged, have had troubles conceiving via sex, thinking about embracing the single mum life, in a same-sex relationship, or a career tycoon who’s decided it’s time to tackle a new adventure. Whatever your reason for exploring IVF treatment, we see you, and we’ve got you, girl. Here’s a 10-minute explainer on IVF: how it works, its success rates, risks, costs, and what to do next.
What is IVF?
IVF stands for in vitro fertilisation, and it’s a form of assisted reproductive technology. It’s a process where an egg (or multiple eggs) is mixed with sperm in a laboratory to hopefully fertilise before being popped into your or a gestational carrier’s uterus, where it will hopefully implant and grow into a beautiful bebe.
What’s the IVF process?
You’ll have noticed that we called IVF a “process”. That’s because it’s actually a series of procedures. We’ll break it down:
1. Ovulation induction
You’ll start the IVF process by tracking and managing your ovulation to plan when to retrieve your eggs. You’ll do this by taking medication that stimulates ovulation to trick your body into producing multiple eggs rather than the single egg it usually develops each month. (Retrieval of multiple eggs is the aim so that you’ve got options for fertilisation.)
During this time, your fertility doctor will also monitor your eggs’ production via ultrasound to ensure they don’t miss the window for the egg retrieval – if you happen to ovulate early, for example, it’s all over this round.
2. Egg retrieval
When it’s ‘go time’, you’ll take an injection of hCG, a hormone that matures your eggs. Then, around 34-36 hours later (it sounds like we’re baking a cake here, no?), your doctor will perform the egg retrieval procedure.
The procedure is done at your doctor’s office or in a clinic. You’ll be sedated and given pain medication, and your doctor will use ultrasound and a very thin needle to remove the eggs from your ovaries. The procedure takes around 20-30 minutes.
3. Sperm retrieval
If you have a partner providing semen, they’ll make a donation of little soldiers, usually while you’re having your eggs retrieved. This might be through masturbation or, in some cases, a surgical procedure where sperm is extracted directly from the testicles (We know which one we’d prefer!).
Now that the eggs and sperm are where they need to be (a couple of Petri dishes in a lab), it’s time for fertilisation. First, your doctor will check your eggs to ensure they’re healthy and mature, and your partner’s sperm will be separated from the semen. Then eggs and sperm will be placed in a special culture to party on down (fertilise).
5. Embryo transfer
About two to five days later, your doctor will select the healthiest-looking embryos. Then, you’ll decide together how many to transfer into your, or a gestational carrier’s, uterus.
The embryo transfer process takes place at your doctor’s office or in a clinic. You’ll be given a mild sedative, and your doctor will place the embryo(s) directly into your uterus using a special catheter. From there, if successful, the embryo(s) will implant.
At this point, any embryos you don’t use can be frozen and stored for later use should this round of IVF not succeed, donated to another couple in need, or discarded. And if this cycle of IVF doesn’t work, your doctor will discuss your options for another round or alternative methods for expanding your family.
Here’s a chart that illustrates a conventional IVF timeline:
Source: CNY Fertility
We must point out that this timeline, while helpful, isn’t one-size-fits-all. For example, you might be doing IVF using donated eggs or sperm or a gestational carrier. If this is the case, the process will include finding a donor or carrier, organising the egg/sperm retrieval, and the embryo transfer into the carrier. Or, your doctor might halt your IVF process mid-way through the timeline, for example, if issues arise, like premature ovulation, too many or not enough follicles developing, or other medical issues.
Why might you use IVF?
There are many reasons why you might use IVF, including if:
- You’ve got impaired reproductive function, fertility challenges, or unexplained infertility.
- You’re using an egg, sperm, or embryo donor – e.g., you’re a single mum, in a same-sex couple, or a mum of a ‘certain’ age. (Regarding age, the older you are, the fewer eggs you have, meaning you’re more likely to need to use an egg donor if you’re 40+.)
- You’re using a surrogate or gestational carrier – e.g., you’ve got impaired uterus function, or you’re in a same-sex male couple.
- Other fertility treatments haven’t worked for you.
Know that we’re all different, with different things goin’ on, and it’s ok – wonderful, even! – to seek help with your goals of conceiving.
What’s the IVF success rate?
Generally, IVF has a good success rate. For women under 35, the percentage of live births per egg retrieval is 54.5 per cent.
But (there’s always a but!), the IVF success rate depends on a range of factors, including:
- Your age – your chances of IVF success decline as you age. As mentioned, the older you are, the fewer eggs you have. Plus, you’ve got a higher chance of complications during pregnancy.
- Your reproductive history – if IVF has worked for you before, it’s likely to work again. However, if it hasn’t, your chances of success are lower.
- Your cause of infertility – women who have severe endometriosis are at higher risk of experiencing pregnancy loss, so they are less likely to see IVF success, for example.
- Your lifestyle choices – those who smoke generally see fewer eggs retrieved during IVF treatment and have a higher chance of pregnancy loss. Drinking, obesity, excessive caffeine, and certain medications can also affect your ability to get pregnant.
Again, what works for others might or might not work for you. So speak to your doctor to know if IVF is a fit for you.
What are the risks?
While IVF is relatively safe, it’s still a medical procedure. So there are risks involved, such as:
- Cramping, infection, or bleeding during or following the egg retrieval or egg transfer procedures.
- Developing ovarian hyperstimulation syndrome (OHSS) thanks to the fertility drugs used to induce ovulation. OHSS can cause your ovaries to become swollen and painful and requires hospitalisation in severe cases.
- Experiencing a multiple pregnancy. You might choose to transfer more than one embryo to increase your chances of IVF success. However, all those embryos might implant, leaving you pregnant with two or more babies. And a multiple pregnancy has its own set of risks, including low birth weight babies and premature birth.
As with anything medical, it’s essential to discuss the risks with your doctor.
How much does IVF cost?
On average, the IVF cycle cost in Australia is around $10,000. With research suggesting that most women will need more than one cycle to be successful. This may not even account for the cost of IVF medications, or storage of frozen eggs, sperm or embryos too (yikes).
In addition, using donated eggs, sperm or embryos can add as much as $2,000 to IVF treatment costs.) The moral of the story: understand all the costs upfront, so you know what you’re getting into.
The good news: Many IVF treatments attract a Medicare rebate, so it’s a good idea to register for the Medicare Safety Net and ask your doctor upfront what will be covered by Medicare, or your insurer (if you have private health insurance) and what you will need to pay out of pocket.
Is IVF covered by insurance?
A burning question, now that we’ve broken down the IVF costs. Some insurers might cover all or some of the cost of infertility diagnosis and treatment, depending on your health fund, and the level of cover you have. They may also have certain requirements, for example, that you have tried conceiving through sex for a year before exploring IVF treatment or that you attempt artificial insemination first before exploring egg donation. You may also have lengthy waiting periods before being able to make a claim. The takeaway here? Call your insurer and get crystal clear on exactly what you’re covered for, girl.
How to start and prepare for IVF?
If you think IVF is for you, you’ll need to find a fertility doctor or clinic. You could do this through recommendations from your family doctor, OB-GYN, or even a friend or family member. Otherwise, the Australian Government has set up an interactive online tool that reports on the IVF success rate of clinics throughout Australia.
Once you’ve found a fertility doctor or clinic, your specialist will run various tests to understand your situation and if IVF is a match for you. And as with any pre-pregnancy prep, it’s wise to ensure your body is in fighting form by taking prenatal vitamins, eating well, and exercising to help give yourself the best chance for IVF success and a healthy pregnancy. Your doctor can advise any lifestyle updates you might need to make.
Let’s say that IVF has worked. Yay! Now what?
About 12-14 days after the embryo transfer procedure, your doctor will do a blood test to detect if you’re pregnant. If you’re pregnant (HOORAY!), your doctor will refer you to an OB-GYN or another pregnancy specialist for care throughout pregnancy.
An IVF pregnancy is much the same as any other pregnancy – most proceed without complications, though some may see complications crop up. Some complications that can occur are thanks to pre-existing factors like age and medical conditions. However, others, like abnormal bleeding, gestational diabetes, preeclampsia, premature labour, and the need for induction and caesarean birth are more likely after IVF conception. IVF regardless, it’s essential to have regular prenatal health checks so that any complications can be detected.
We’ll leave you with this, mama: IVF is a journey. It might be a long-winding road or a straight shot to Mount Parenting. It might work, it might not; it might take time, or it might happen the first go. Having a solid AF support network of friends and family around you for the experience is invaluable. And know that there are ways and means of expanding your family, regardless of your situation.