IVF or test-tube fertilisation is the process of collecting eggs from a woman and fertilising them with sperm outside the body. The woman is given drug therapy to encourage the ovaries to produce more eggs. This will often consist of drugs designed to suppress hormones followed by another course of drugs designed to super-stimulate the ovaries to produce eggs. The almost menopausal state that results from the suppressants seems to encourage the ovaries to respond more actively when the stimulants are given. As soon as the drugs are stopped at the end of treatment, the 'menopausal' effect ceases. Once the eggs are ready, they are removed from the woman's ovary and mixed with a fresh sample of her partner's sperm. If fertilisation occurs, the developing egg or embryo is then placed back into the woman's uterus. Two, or occasionally three, embryos are inserted into the uterus, after which the woman may take progesterone to support any possible pregnancy. Most couples then have to wait two weeks, one of the most difficult times, before finding out whether a pregnancy is developing. If sufficient embryos of good quality develop, there may be an option to freeze them and replace them, after thawing, in a subsequent cycle.
A variation of IVF, GIFT involves taking an egg and sperm from a couple, mixing them together and putting them back, right away, into the fallopian tubes. Fertilisation can then take place within the fallopian tubes, as it would do naturally. This is the treatment's main difference to IVF.
artificial insemination (AI) refers to a range of techniques of placing sperm directly into either the cervix or the uterus. The procedure takes about five minutes during which – often after a course of drug therapy to stimulate the ovaries – the doctor places a carefully prepared semen sample into the woman's cervix or uterus, or at the top of her vagina. Fertilisation is then allowed to take place naturally.
ICSI, a relatively new procedure, involves injecting a single sperm into the very centre of each egg, thus helping the sperm through natural barriers it may not be able to tackle on its own.
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