In vitro fertilisation (IVF)

In Vitro Fertilisation (IVF) is used to treat a wide range of fertility problems. The treatment involves fertilising the egg in vitro, or outside the body. For many people it may be the first-line treatment, while others may only have a recommendation if other treatments have failed.

We’ve helped thousands of people become parents, with more than 21,000 babies born following IVF treatment at the Lister Fertility Clinic. On this page you’ll find answers to some of our patients’ most often-asked questions as well as information on fees, open evenings and much more.

IVF: How does it work?

At your appointment, we’ll talk to you at length about your options and your individual circumstances, involving you in the decision-making process at every step of the way. Once the mutual decision to embark on IVF has been made, the process (and often the paperwork!) can seem quite daunting. 

Find out more about consent paperwork for IVF

Please don’t worry. We’ll be with you every step of the way, helping to guide you with as much written information as we can. We’ll make sure you have continuity of care with a dedicated consultant to guide you through your treatment and the same sonographer for each scan. Our highly trained counsellors are also available to provide further support as you need it.

More about our fertility counselling team

There are several steps to an IVF cycle. They are as follows:

1. Ovulation stimulation
   You’ll have daily follicle stimulating hormone injections (FSH) to stimulate your ovaries to produce multiple follicles (each follicle potentially contains an egg). We’ll talk to you beforehand, and involve you at every stage of the decision-making process to ensure you’re completely comfortable with this process before starting the treatment. The dose and type of drug and protocol used will be tailored to your individual needs.
   
   You’ll also have a second type of medication to stop you ovulating and releasing these eggs before we collect them. This is given either as a nasal spray or injection depending on your agreed personalised treatment plan.
   
   
2. Monitoring your response
   While taking these injections, you’ll be scanned on average four times over a period of around two weeks to monitor the number and size of the follicles. Along with blood tests we’ll take at each scan, these will help us correctly time when we should collect the eggs and allow us to increase or decrease the drug doses as necessary to give you the best possible outcome.
   
   
3. Preparing for egg collection
   When the leading follicle reaches the optimum size of 18mm+*, we’ll make preparations for egg collection. The final preparation involves a hormone injection given 33-39 hours pre-operatively. This triggers the eggs to reach maturity, making them ready for fertilisation.
   
   * in some cases, the doctor may trigger at less than 18 mm. This will be a decision based on your individual needs and form part of your personalised treatment plan.
   
   
4. Egg collection
   We’ll then collect the eggs using a minor vaginal procedure. This is performed under ultrasound guidance, during which a special needle is directed alongside the ultrasound probe, through the vaginal wall and into the follicles growing in the ovary.
   
   The fluid in each of the follicles that usually contains an egg is then aspirated into a test tube for the embryologist to assess. To minimise any discomfort, this is usually performed under a light general anaesthetic or sedation. It’s difficult to predict the number of eggs available from the ultrasound scan picture, so we may collect fewer eggs – or occasionally more – than anticipated.
   
   In rare circumstances, despite the appearance of follicles on the scan picture, we fail to collect any eggs. If this happens, we won’t be able to proceed with the treatment cycle, and you’ll be given an appointment to see the doctor to discuss your future options.
   
   
5. Fertilisation and embryo culture
   After the eggs are collected, and if the sperm numbers are adequate, approximately 50-100,000 sperm will be placed with each egg in a culture dish and incubated overnight to undergo fertilisation. If there are any concerns regarding sperm quality, we’ll recommend ICSI or IMSI to fertilise the eggs.
   
   You can read more about ICSI and IMSI here.
   
   On average, approximately 65–75% of eggs will fertilise. These embryos are then cultured in the lab and their development monitored for between two-five days. Natural selection means that those embryos that develop to day five (the blastocyst stage) will give you the best chance of achieving a successful pregnancy. We now recommend that all couples wait until day five before we perform a transfer to give the selection the best chance of success.
   
   Read more on our Blastocyst page
   
   
6. Embryo transfer
   We’ll usually transfer the embryos on day five. Of course, no two patients are the same and, occasionally, we may also transfer them on day two, three or six after collection. The number we transfer will depend on your age, the quality of the embryos, and your previous history, trying to maximise success rate while minimising the risks of a multiple pregnancy.
   
   We’ll show you your embryos using a camera located under the microscope, before placing the embryos through the cervix into the uterus using a small, soft catheter. The procedure is painless (similar to a smear test) and requires no anaesthetic. We would encourage partners to attend the transfer procedure as well.
   
   On occasion we will have decided to freeze your embryos to allow genetic testing (PGT-A) before transfer in a subsequent cycle. You can read more about genetic testing here.
   
   
7. Post-transfer
   There are many myths surrounding the post-transfer period. It is true that it can be a stressful time waiting for the test day (typically two weeks after egg collection), and we encourage our patients to resume normal activities during this time.
    
   You’ll be taking progesterone supplements to support the lining of your uterus and, in the event of a positive pregnancy test, you’ll continue taking this until week 12 of the pregnancy.
   Get your in-depth, step-by-step IVF / ICSI cycle overview here