IVF (In Vitro Fertilization), also referred to as test-tube fertilization, is the most common type of treatment within assisted reproduction. IVF treatment with donated sperm is referred to as donation IVF (D-IVF). Before starting treatment, the woman and possible partner should have had a fertility investigation. If you have already had a fertility investigation done at another clinic, it is important that we have access to all medical records and laboratory results.
The objective with hormone stimulation is to produce more mature eggs than in a normal menstrual cycle. Shortly before egg retrieval, the hormone FSH (or hMG) is used which you take via injection. The injections are taken in varying doses for about 10-14 days. The doctor responsible for planning your treatment will decide which medications and doses you should take. The injection technique is simple and instructions are given at the clinic but you can also watch a film on medicininstruktioner.se.
During treatment, we monitor the growth of the ovarian follicles with ultrasound which is usually done on 2-3 occasions. It is normal after a few weeks of hormone stimulation for your stomach and breasts to feel tense and sore. Ring 1177 for advice and if you have any queries.
At the pharmacy, you can obtain a container to collect your used syringes. The container shall be returned to a pharmacy after your treatment is over to ensure that the syringes are sorted correctly, read more here.
When the doctor determines that your ovarian follicles are large enough, the time for your final injection is decided which will induce the final maturation of your egg cells. It is important to have this injection at the exact time specified as this may otherwise affect the outcome of your treatment. Egg retrieval takes about 10-15 minutes and we recommend that you don’t work on this day because you will be given pain relievers. After the procedure, you are welcome to drink some tea or coffee at the clinic. You can usually go home after an hour or so.
On the day that your eggs are retrieved, male partners provide their sperm. The man can use a small room where he ejaculates into a plastic cup. A sample can also be taken from home if the journey to the clinic takes less than an hour. Before sperm is collected, you should not have ejaculated for two days, and no longer than five days should have elapsed since your last ejaculation. Lubricant or condoms must not be used when masturbating to acquire the sample.
For those using donated sperm, the laboratory will have already prepared for this.
It is most common that the mature egg cells are placed together with the sperms which find their way to the eggs for fertilization (IVF) but if there are signs of reduced sperm quality a technique called Intra Cytoplasmic Sperm Injection (ICSI) is used. The sperm is then injected through the shell of the mature egg cell so that fertilization can take place in a natural way.
When all goes as it should, the fertilized egg cell divides into more cells and develops into a growing embryo.
After the retrieval of the eggs a few days are allowed for the embryos that have been created to grow before insertion into the uterine cavity via embryo transfer (ET). This is done as a regular gynaecological examination, in which a very thin catheter is introduced through the cervix and into the uterine cavity. Via the catheter, the embryo is placed in the uterine cavity.
The emptied ovarian follicles will produce progesterone, and when the egg is transferred, extra progesterone will be given in the form of a vaginal tablet. Progesterone is needed to prepare the endometrium (mucosa of the womb) for implantation (attachment) of an embryo. After the embryo has been transferred into the womb, you can live your life as normal but you should avoid alcohol and nicotine.
Normally, one embryo is transferred into the womb, the embryos that are of a good quality that are not transferred can be frozen and can then be used at a later date if the treatment is not successful or for sibling treatment. Read below about frozen-thawed embryo transfer.
After two weeks, a pregnancy test is taken at
home to see if the treatment has been successful, otherwise your menstruation
usually comes 1-2 weeks after embryo transfer.
By law, embryos may be kept frozen for 10 years from the date they are frozen. If you have frozen embryos as a couple, both need to provide their consent for each transfer. Consent is given personally in connection with the transfer or by via 1177.
If there is no consent, the treatment will not
be carried out.
If you want to destroy embryos for any reason, a form must be completed which you will find here.
We recommend that you refrain from unprotected sexual intercourse once your treatment has started. Avoid alcohol and nicotine as well.
Please look through the instructional videos one more time on Medicininstruktioner.se before starting with the injections.
At Fertilitetsråd.se you can obtain more information about childlessness.
At Unilabs.se you can find the nearest testing clinic.
Read more here about Reproductive Medicine regulations and the basic requirements for assisted reproduction via the public health services.
Find which ovulation test we recommend here, Ovulation test.