IVF is a type of assisted conception used to help couples who are struggling to become pregnant on their own naturally. The letters IVF stand for in vitro fertilisation. IVF is a medical procedure where eggs are taken from your body and fertilised in a laboratory, rather than inside your body as would happen naturally.
In vitro means ‘in glass’, which leads many people to assume that embryos are created in glass test-tubes hence the term ‘test-tube babies’. But, eggs, sperm and embryos are kept in plastic dishes in the laboratory, and the phrase in vitro has a more general definition of ‘in an artificial situation’, or specifically outside the body.
So, IVF involves taking eggs from your ovaries and mixing them with sperm in a dish. If a sperm successfully penetrates your egg and fertilises it the egg will become an embryo which is transferred to your womb, where it is hoped it will thrive.
Every attempt you have at becoming pregnant through IVF is called a cycle. Drugs are given to you so that your doctor can control your hormones so that you produce more than one egg.
In a natural cycle, most women will produce only one mature egg at a time. However, the drugs used in IVF stimulate your ovaries so that they produce several eggs to maximise the chances that some of those eggs will fertilise and result in you becoming pregnant.
How natural human reproduction work
A woman releases an egg from one of her ovaries each month and a fertile male is constantly making more sperm. If the couple have intercourse at the time an egg is released (around your fertile window), sperm will travel from the vagina up through the cervix and into the fallopian tubes to fertilise the egg.
You must be releasing eggs (or ovulating), if one of your eggs is going to be fertilised to result in a pregnancy. Women usually start ovulating when they reach puberty and they continue to have periods until they reach menopause.
Egg production is regulated by hormones. So, for the eggs to start to grow in your ovary inside their little fluid-filled sacs called follicles, you must produce follicle-stimulating hormone, or FSH. At the same time, the endometrium (or lining of your womb), starts to grow thicker, preparing for a fertilised egg to implant and continue to grow. (Your endometrium is what you shed each cycle when you have your period).
Once the follicle stimulating hormone has stimulated the follicles, next the hormone oestrogen, is produced. When the oestrogen reaches a certain level, it is time for your egg to be released during ovulation. It normally takes about 14 days to reach this point in the cycle, but this varies from woman to woman. Please don’t assume you ovulate on or around day 14, it may be much earlier or later in your cycle.
As soon as your egg is ready, the body produces a surge of luteinising hormone, or LH, which triggers ovulation, causing your egg to burst out of the follicle it was inside of. Now that the egg is released, it begins to travel down the fallopian tubes towards the womb.
Unlike women who are born with all their eggs, men make millions of sperm every day, from the time they reach puberty. Most men will still be able to produce viable sperm that can fertilise an egg well into their twilight years, although the process slows down as they get older.
Sperm production is also controlled by hormones. It is often thought that testosterone, the hormone responsible for sex drive, is also responsible for sperm production, but most of the work is done by the same two hormones that control most of the female cycle: follicle stimulating hormone (FSH) and luteinizing hormone (LH).
Men produce both these hormones all the time, and it is the follicle stimulating hormone that stimulates the production of sperm in the testicles. Sperm production takes about 60 days, as the sperm must mature and grow in order to be capable of penetrating an egg and fertilising it. Mature sperm are stored in the man’s testicles.
During sexual intercourse semen is ejaculated into your vagina. Semen is comprised of both the sperm and seminal fluid that carries the sperm from the testicles to the vagina. Although only one sperm is required to fertilise your egg, there will be millions in the ejaculate. Most of the sperm are killed by the acid conditions inside your vagina and a few hundred may make it to the cervix. If this coincides with you ovulating, the fertile cervical mucus around the cervix will have become watery, thin and receptive to sperm, so that the sperm can swim up into the womb nourished and supported along the way by your fertile cervical mucus. Once inside your body, sperm can survive for up to 7 days although most sperm won’t last longer than a couple of days.
The surviving sperm reach your womb and then continue towards your fallopian tubes. If an egg has recently been released from your ovary (ovulation), it will be travelling down your fallopian tubes towards the sperm to meet them. The sperm will normally fertilise your egg in one of the fallopian tubes rather than in your womb.
The outer coating that surrounds the sperm’s head is stripped off as it passes through your fallopian tube which will help the sperm to fertilise the egg. Dozens of sperm travel up the tube at the same time, and each sperm will try to be first to break through the outer coating and bind itself to your egg. As soon as one sperm manages to penetrate your egg, enzymes immediately act on the shell of your egg to make it into a hard barrier so that no other sperm can penetrate it.
Your fertilised egg begins dividing a day later, first into two cells, then into four cells and again to make eight. Soon your fertilised egg, or embryo, will be ready to implant itself into the soft lining of your endometrium and grow into a baby.
This is from my program ‘Everything you need to know before starting your IVF/ART’.
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