IVF and Advanced Embryology
IVF, or in vitro fertilization, is a medical procedure involving an egg being fertilized outside of the human body in a laboratory. It is a highly controlled science-driven method of optimising your chance for a healthy pregnancy. IVF has the highest chance of achieving a pregnancy of any fertility treatments we can offer, but is not a guarantee of success. It should also be noted that IVF involves small risks of surgical complications from the egg collection process, and a risk of Ovarian Hyperstimulation Syndrome (OHSS) where the ovaries and abdomen can swell for a short period of time. The risk of OHSS requires close monitoring by Dr Weston and his team.
Here is the step by step of the IVF process
01
In the majority of cases, hormonal medication is used to stimulate the ovaries to produce a larger number of eggs than the ovary normally produces in a natural cycle. How many eggs are usually collected in an IVF cycle? We aim for 8-12 eggs.
02
Egg collection occurs, typically with a light anaesthetic, or sedation, with an ultrasound-guided needle via the vagina.
03
The eggs are fertilized by one of two basic methods – standard insemination (eggs and sperm mixed together overnight in culture media) or intracytoplasmic sperm injection (ICSI – a sperm injected into each egg via a microscope). What is the difference between IVF and ICSI? With IVF an egg is incubated with thousands of sperm overnight, allowing the egg to undergo sperm selection, which sometimes leads to better embryo quality, but has a lower fertilization rate than ICSI.
04
Eggs which successfully fertilize become embryos, and are grown under careful supervision in the laboratory for up to 6 days.
05
The best embryo (sometimes two) are selected by the laboratory for transfer into the patient’s uterus. The transfer occurs under ultrasound guidance in the chair while the patient is awake.
06
What happens to “extra” embryos? Remaining embryos not transferred, but meeting a particular quality can be frozen and stored for future use, either for additional attempts at a pregnancy if the first transfer is unsuccessful, or for further babies after the patient has delivered their first baby.
While the above step by step is the basic IVF and ICSI process, many patients require more advanced techniques to achieve their goals. These are not available at all IVF units.
Advanced IVF Treatment Options
Dr Weston only works in units with a full range of advanced IVF treatment options.
These include, but are not limited to:
- Laparoscopic egg collection of inaccessible ovaries from a vaginal approach.
- Adjuvant treatments (add on therapies) to improve egg maturity, egg quality, and egg numbers.
- Obtaining sperm by surgical sperm extraction where there is no sperm in the ejaculate – needle testicular biopsies, open testicular biopsies, and microTESE (microscopic- assisted open testicular biopsy)
- Advanced fertilization techniques – calcium activation, HA-ICSI sperm selection, calcium ionophore treatment of eggs, PIEZO-ICSI technique
- Superior embryo culture – using EmbryoScopes for time lapsed imaging of embryo development
- Preimplantation genetic screening (PGS) after embryo biopsy for single gene disorders and structural rearrangements of the chromosomes, as well as general screening of embryos by genetic biopsy for major chromosomal errors which increase in incidence as patients age. All patients 37 years or over should consider PGT, as well as all patients who have had three or more failed implantations of embryos.
Comprehensive assessment of patients with recurrent implantation failure.
What is recurrent implantation failure?
Recurrent implantation failure is the failure to achieve a healthy pregnancy after three consecutive embryo transfers. The assessment can include, but is not limited to:
- blood tests,
- a camera to investigate the uterine cavity, called a Hysteroscopy,
- a biopsy of the endometrium to investigate Natural Killer Cells, or to assess the bacteria living in the reproductive tract with an EMMA and ALICE test.
Treatment for recurrent implantation failure
- hormonal infusions,
- immune therapy,
- antibiotics / probiotics
Seeking a second opinion
If your IVF therapy is not going as expected, and your doctor is not able to discuss any or all of the advanced techniques listed above, we recomment you seek a second opinion.
Dr Gareth Weston is one highly qualified sub-specialist in infertility ready and able to assist you. He is available for regular consultations in Richmond, St Albans, Point Cook, Springvale, and regional Gippsland. For patients in other Victorian locations, interstate, or even overseas, Dr Weston regularly provides telehealth services.
Your First Step to Fertility Support
A fertility assessment with Dr. Weston seeks to understand your reproductive health and the essential factors for conception. This proactive check-up is the foundation for creating your personalised care plan.
