THE ABC OF IVF (II) - Everything you need to know about test tube treatment

In Vitro Fertilisation (IVF): This is the procedure classically known as the test tube baby technique. There are five stages to IVF as follows:

1. Down regulation:
So called because the woman is given drugs (such as Buserelin or Naferelin) which shut down her ovaries so her cycle can be carefully controlled. This will put her into a temporary menopause.

You can have an injection of the drug once a day in your buttock or thigh. They can be given by a nurse or your partner – or you can do it yourself. If you are squeamish about needles you can use a nasal spray to inhale the drug several times a day but this is more expensive than injections. You do this for two to three weeks. But be warned – you will feel as if you have PMT to a factor of ten.

2. Egg production:
You then add a second injection of drug called human menopausal gonadrotophin (HMG), a hormone highly purified after being taken from pregnant women’s urine, or FSH. This stimulates the ovaries to produce several egg-containing follicles rather than the one that would happen naturally. During this process you will be carefully monitored by ultrasound and will feel quite bloated but not as bad-tempered as in Stage One.

3. Egg collection:
When the follicles reach the right size and maturity you will be given an injection of human chorionic gonadatrophin (HCG). This mimics the surge in hormone which normally triggers ovulation. Thirty-five hours later the eggs are collected, either by laparoscopy or via the vagina, before they have the chance to move down the Fallopian tubes naturally.

The operation is carried out under general anesthetic or vaginally under sedation and may leave you feeling sore. The more eggs that are collected, the more painful it can be but it increases the likelihood of success.

4. Fertilisation:
At the same time the eggs are collected, the man has to provide a sperm sample. The eggs and top-quality sperm (200,000 sperm per egg) are placed in a glass dish by an embryologist. If successful, fertilization will take place within 24 to 48 hours and throughout this period you will be feeling tearful and anxious.

5. Embryo transfer:
The two best quality (fertilized eggs) are put back into the womb via a catheter. You may be offered progesterone to increase your chances of getting pregnant.

This experience is an emotional rollercoaster. You and your partner will have an anxious two-week wait to find out whether the embryos have become implanted and you are pregnant.

Unfortunately, hormone levels caused by the drugs can make you feel pregnant even if you are not. So if you are unsuccessful the arrival of your period can be even more devastating than normal. Success rates on average are 25 per cent per cycle.

Intracytoplasmic Sperm Injection (ICSI): This is a way of fertilizing eggs by injecting a single healthy sperm into an egg by using a glass needle that is one-fourteenth of the thickness of a human hair.

As with IVF, the woman takes a course of drugs before collection of the egg. ICSI is used where the man has a low sperm count or fertilization is a problem. It costs (£5,000) about N700,000 which includes IVF treatment and the drugs you need.

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