In vitro fertilization (IVF) is a kind of artificial insemination in which the fertilization of the oocyte does not take place within the mother’s body, but rather in a laboratory. Since this usually happens in a glass dish, it’s often referred to as ‘in vitro’, meaning ‘in/behind glass’.
An IVF treatment could be useful in, for example, the following situations:
If the mother’s ovaries are blocked or have been removed;
If the father’s sperm quality is lower than normal;
If the mother suffers from (severe) endometriosis;
If several IUI treatments have failed to result in a pregnancy;
If no cause for infertility has been found despite an inability to conceive (idiopathic subfertility)
The odds of success when undergoing an IVF treatment increase dramatically when multiple oocytes are made to mature fully at the same time. The maturation of multiple oocytes is stimulated using a hormone treatment. If it is not possible or not desirable to have multiple oocytes mature at once, for example due to a relatively small ovarian reserve or religious reasons, IVF can be done using fewer oocytes. This is known as mild-stimulation IVF. We aim for stimulating at least four oocytes to mature at a time.
As soon as the oocytes have matured fully, your treating nurse or physician will use a hollow needle to suck them out, while monitoring the procedure using an ultrasound. This is called an oocyte retrieval. An oocyte retrieval will generally take mere minutes. During this procedure, we offer the possibility of taking painkillers intravenously. Thank to this, most women find this procedure relatively easy to endure. After the retrieval, the obtained oocytes will be taken to our laboratory immediately, where they’ll be prepared for fertilization.
In our laboratory, the processed sperm cells will be combined with the oocytes. In the case of an IVF treatment, the sperm cells will then have to fertilise the oocytes without any further support. On the day after the oocyte retrieval, we check whether any oocytes were fertilised. The fertilized oocytes will develop into embryos, which we keep in an incubator for five days.
A physician will use a smooth, flexible catheter to place an embryo into the uterus. The treatment itself will only take a few minutes. Usually, we’ll only transfer a single embryo at a time. Depending on the age of the hopeful mother and the number of previous (failed) IVF/ICSI treatments, we may occasionally choose to transfer two embryos instead. After being transferred, the embryo can start to lodge in the endometrium and start the next stage of its development.
After roughly 14 days, you’ll be able to perform a pregnancy test to determine whether the treatment was successful or will need to be repeated.
For an IVF treatment, the odds of conceiving largely depend on the mother’s age and the reason for the treatment. You can ask your doctor for the latest statistics for your personal situation.
When there are several developing embryos, we offer the possibility of freezing them (cryopreservation) for use at a later date. Transferring a cryogenically preserved embryo at a later date means that the mother will not need to go through the hormonal treatment and the oocyte retrieval next time.
Cryopreservation has been a commonplace procedure for many years, and most research supports the notion that it doesn’t cause any negative effects. Of course, personal advice from a physician tailored to your situation should always be considered in your treatment.
In the Netherlands, IVF treatments are covered by basic insurance. Basic insurance will cover three complete IVF treatments. One IVF treatment consists of the hormonal stimulation, the oocyte retrieval, and the transfer of all resulting embryo into the uterus.