IVF can be carried out in a normal cycle, without any drugs being used. This is known as natural-cycle IVF. It is cheaper, and does not run the risk of over-stimulating the ovaries, but it is much less likely to be successful. The vast majority of IVF treatment involves the use of drugs to stimulate the ovaries so that they produce a number of eggs, giving more chance that some will fertilize and develop. Some doctors are now looking at the possibility of milder stimulation using fewer drugs, which is known as 'soft IVF'.
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| Unexplained Infertility IVF |
Your clinic will normally arrange some kind of introduction to the IVF process. This may be a chat with a doctor or nurse who will explain it to you as a couple, or it may be a much larger affair. It is important to understand as much as you can about what is going to happen during the cycle, as this will make the process easier.
You will usually begin your IVF treatment with a period of 'down-regulation' where you are given drugs that switch off your own hormonal cycle and stop the ovaries producing eggs. This allows the medical team to have closer control over your ovaries. The down regulation drugs are generally taken either as a nasal spray or an injection. Some women experience menopausal symptoms during down-regulation, which can be unpleasant, ranging from hot flushes to headaches. Sometimes a shorter treatment plan may be used where the down-regulation drugs are not taken so early on.
Once the body's natural cycle has been switched off, drugs are used to stimulate the ovaries so that they will produce a number of eggs - a process known as superovulation. Gonadotrophins (FSH and LH) are used for this purpose. Some drugs have just FSH, some have LH and FSH, Originally the drugs used for superovulation were made using the purified urine of menopausal women, which is why you may have heard stories about lorry-loads of urine being collected from convents where there were concentrations of menopausal women all excreting FSH.
Now, many of the drugs are made in the laboratory without the need to extract the hormones from human urine. They are known as recombinant drugs, and are, rather bizarrely, sometimes produced using Chinese hamster ovaries.
There are large differences in the cost of the different types of drugs used for superovulation, but little evidence to suggest that the more expensive drugs are any more effective. There are not usually too many unpleasant side effects with the drugs, although many women do feel bloated as their ovaries respond, and it is common to feel very emotional at this time.
'When the drugs start kicking in, you do start getting a little bit emotional. I think my husband saw me becoming more and more stressed. I felt I was holding things together pretty well, but I think he felt that I wasn't a lot of the time. I did let things affect me a lot more. It was only looking back on it that I realized how weird I must have been at that time, really obsessing about things.' Heather, 48
One of the things many couples find most alarming about starting IVF is the fact that the drugs are given by injection, which they are expected to do themselves at home. Some women get their partners to do it, and find it helps them to feel involved, others prefer to do it themselves. The clinic will give help, advice and practice at injecting before they send you off home with a pack of syringes and drugs, and self-injecting kits are now available which make it much easier. Most couples find they cope with it all surprisingly well, but it is often a source of worry.
'It was kind of terrifying. My husband is a bit phobic about needles, but there was no way I could do it myself. The nurse did the very first injection. He watched her do it and he said he thought he could do that. We got into a kind of routine. I'd prepare it and load up the syringe and he would do it. I think it brought us closer together, that he would do it for me and that I trusted him to do it.' Gillian, 30
Sometimes it is the day-to-day practicalities of the injections that can be the most difficult thing to deal with.
'I didn't actually mind the injecting. You have to do it at a particular time of day, and I was never sure I was going to be at exactly the right place. I was injecting in my office and keeping all sorts of injection equipment under the desk and not being able to figure out how to get the syringes home and into my sharps box. I was injecting in the library, injecting on a railway... None of it really did me any harm, but it was stressful.' Naomi, 39. To find out more, you can check out Unexplained Infertility Ivf.
