All you need to know about in vitro fertilisation

"In vitro fertilisation (IVF) is a procedure where eggs are extracted and fertilised in the laboratory," says Dr Sulaiman Heylen from the Cape Fertility Clinic. "The resulting embryo is then transferred to the woman's uterus to implant and develop naturally. Usually, two to four embryos are placed in the woman's womb at one time. Each attempt is called a cycle. IVF is usually the treatment of choice for a woman with blocked, severely damaged, or no fallopian tubes. IVF is also used to overcome infertility caused by endometriosis or problems with the male's sperm, such as low sperm count. Couples who simply can't conceive and have tried other infertility methods that have not worked for them can also try IVF."

How it works
- Treatment is usually started within the first two to three days of the woman's period.
- Medications are given to stimulate egg growth.
- The eggs are triggered 36 hours prior to the egg collection by using an injection called HCG (human chorionic gonadotrophin).
- The egg collection procedure is performed in a procedure room with sedation. A transvaginal ultrasound is performed and a fine needle, which is attached to the ultrasound, is used to extract the eggs.
- A progesterone hormone is given after the egg collection, to prepare the lining of the uterus prior to embryo transfer.
- A sperm sample is given on the same day as the egg collection, and the eggs are fertilised after collection. The embryos are grown in the laboratory for three to five days and then replaced into the uterine cavity.
- Extra embryos are frozen and stored in liquid nitrogen. They can be used in future treatment cycles.
- Embryo transfer is performed in a special procedure room. This is a painless procedure and no anaesthetic is necessary. A thin plastic tube is used to transfer the embryos directly into the uterine cavity. An ultrasound scan is performed to ensure the embryos are transferred into the correct place in the uterine cavity.
- After the embryo transfer, the progesterone medication and folic acid vitamin tablets should be continued. A blood test to check for pregnancy will be performed 14 days after the egg collection.

Intra cytoplasmic sperm injection (ICSI)
"ICSI is a type of IVF. This is a procedure used in specific circumstances during in vitro fertilisation," says Heylen. "In this procedure, we would inject one single sperm cell into every egg. ICSI is the ultimate answer for men with a poor sperm count - nearly every man has the possibility to have his own biological child."

Important factors to consider
- The success rate of IVF depends mainly on the woman's age. It can be 50% per cycle for young women and decreases by 5% per year after the age of 35. The success rate is virtually zero from the age of 45.
- The costs also depend on many factors. You can pay R25 000 to R35 000 for a single procedure.
- Multiple births often occur in women who use IVF. About 63% are single babies, 32% are twins and 5% are triplets or more.
- The rate of miscarriages with IVF pregnancies is the same as that with normally conceived pregnancies.