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Embarking on the journey of In Vitro Fertilization (IVF) is a remarkable and often life-changing experience. It’s a path filled with hope, challenges, and countless decisions, all leading to the dream of growing one’s family. 

From the very first step of egg retrieval to the much-anticipated embryo transfer and every aspect in between, the IVF journey is a testament to human resilience, love, and the power of science. 

This is a journey that has transformed countless lives, offering renewed optimism to those who have faced infertility. 

In this blog post, we will take you on a guided tour of the final steps of the IVF journey, offering insights, guidance, and hope to those who are considering, or already undergoing this remarkable process.

  1. Egg Retrieval as part of the IVF Journey

The Retrieval

Once ovarian stimulation is complete and follicles have matured, your doctor will retrieve as many eggs as possible. 

Egg retrieval (also known as oocyte pick up or ovum pick up ) is performed under light sedation, local anaesthesia or, in some cases, general anaesthesia. 

Post-Egg Retrieval – Important Things to Consider:

Here are some helpful do’s and don’ts for our patients to consider, post-egg retrieval:

It is advised that you please do not drive for the remainder of the day, due to the after-effects of the general anaesthetic you have received.

Depending on the number of eggs we retrieve, your pain may vary from mild to moderate. The type of pain experienced is often described as being similar to menstrual cramps. Your ability to manage pain and your pain threshold also plays an important role. You will be discharged with pain medication and instructions on its use. 

*Please only use Panado/Paracetamol for pain relief if transferring an embryo in the same cycle i.e. in a few days.

Anti-inflammatories may harm the endometrial lining. If the transfer will not be in the same cycle, then anti-inflammatories may be used with caution.

It is important to remain well hydrated with plenty of fluids after your egg retrieval. Avoid carb-heavy foods and try to include plenty of fresh fruit & vegetables into your post-egg retrieval diet. 

Try adding a Brazil nut (just 1 provides you with the recommended daily dose of selenium) to your diet – their high selenium content has proven fertility benefits, including protecting the embryo from oxidation and DNA damage.

Contact one of our Fertility Specialists if you experience any of the below:

Severe abdominal pain, severe and persistent nausea and vomiting, bloating, tight-feeling abdomen or shortness of breath.

What Comes After Egg Retrieval? 

Looking at the Process of Fertilisation.

After the process of egg retrieval has taken place, we move on to fertilisation. 

The above can occur in two different ways;

Liquids and follicles melting together

IVF and ICSI  Explained in Terms of the Fertilisation Process

After the process of egg retrieval has taken place, we move on to fertilisation. This can happen in two different ways, either  IVF or ICSI.

IVF

On the day the eggs are retrieved, a semen sample is collected from the male partner and processed to ensure the selection of the strongest, most active sperm. 

The sperm are then placed with the eggs in an incubator that is set to the same temperature as a woman’s body. 

The next day, the eggs are examined under a microscope to determine whether fertilisation has occurred. If it has, the resulting embryo(s) will be ready to transfer to the uterus a few days later.

ICSI and How it Relates to IVF 

ICSI stands for Intracytoplasmic Sperm Injection (ICSI). This procedure is used in conjunction with IVF, where a highly skilled embryologist injects a single sperm directly into each egg. 

This technique is used when the sperm is unable to penetrate the egg wall during the fertilisation stage. If the egg is fertilised, the embryo is inserted into the uterus, as described previously for IVF.

Steps Taken Before Embryo Transfer – Embryo Development and Grading 

Embryo grading is a tool that helps embryologists and physicians during an IVF treatment to determine, exactly which embryos to transfer, the ideal day of transfer and the appropriate number of embryos to transfer.

Typically done on Day 3 or Day 5, grading is not used independently but is just one part of a complex process that is used along with many factors like the patient’s age, fertility history, and other information.

While embryo grading provides valuable and critical information, it is important to note that even lower-graded embryos can result in successful pregnancies.

Day 3 Embryos:

Grade A – These embryos show that there are 6-8 evenly sized cells, with no or less than 10% fragmentation.

Grade B – These embryos have more uneven or irregularly shaped cells with 25-50% fragmentation.

Grade C – These embryos show 50% or more fragmentation.

Day 5 Embryos:

Blastocysts are graded on three factors:

  1. The degree of expansion is based on how expanded the cavity is. This is graded on a scale of 1-6 with 6 being the most expanded.
  2. The appearance of the inner cell mass (the part that makes a baby) which is graded for the compaction of cells with either an A, B, or C with A being the best.
  3. Appearance of the trophectoderm (the part that makes the placenta) is also graded for the number of cells with A, B or C; with A being the best.

Each of those factors is combined to create the grade (number, letter, letter).

Embryo grading is a tool to help scientists and specialists, but it is only one part of the decision process. This is why our specialists and scientists determine the potential of an embryo by taking into account not only the grading but all of a patient’s unique medical history.

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The Last Step in the IVF Process – The Embryo Transfer

  1. Medication for Embryo Transfer

Your Estrogen and Progesterone supplements will start on the day of your egg retrieval.

Your embryo transfer will take place 3 – 5 days after your egg retrieval time, and the lab will be in touch and keep you updated on the progress of your embryos.

  1. Embryo Transfer Process

The final step in your IVF journey will be the embryo transfer. It is not a complicated procedure and does not require anaesthesia.

The embryos are placed in a tube and transferred to the uterus, using a catheter and syringe. The number of embryos transferred depends on a woman’s age, cause of infertility, pregnancy history and other factors.

However, in most cases, a single embryo transfer is recommended to reduce the risk of a twin pregnancy. If there are additional embryos that are of good quality, they may be frozen for later use.

The Aftermath of Your IVF Journey

Post-Embryo Transfer – Things to Consider

Rest and Gentle Exercise – On the day of your embryo transfer, we advise that you rest and relax for the remainder of that day. Drink plenty of fluids and ensure you stay well hydrated. Following this, we encourage gentle, light exercise. Avoid heavy, physical activity for 2 – 3 days. Your regular exercise routine may resume after this.

Medication – Please continue taking your medication (Utrogestan/ Crinone/ Estropause/ Estrofem/ Progynova) as prescribed by your doctor until you are advised to do otherwise. This is incredibly important to help sustain a resulting pregnancy once implantation occurs. Please avoid all over-the-counter anti-inflammatories at this time. 

Should you experience any pain, please use paracetamol only.

Sexual Intercourse – We would advise abstaining from sexual intercourse for 3 – 4 days following embryo transfer. This allows the pelvic area to remain relaxed. Should you experience any spotting post-transfer, we advise abstaining until the outcome of your pregnancy test.

Diet and Nutrition – Enjoy a healthy diet filled with plenty of fresh fruit & vegetables. Avoid consuming raw meat & fish from sources you are unfamiliar with. Avoid alcohol consumption. Drink plenty of fluids and get creative with fertility-boosting smoothies & juices. Try adding Brazil nuts (just 1 provides you with the recommended dose of selenium) to your daily diet – their high selenium content has proven fertility benefits including protecting the embryo from oxidation and DNA damage.

Affirmations – Positive fertility affirmations are an incredibly effective way to shift your energy from anxious and constrained to positive, relaxed and open. We’re here to encourage you and cheer you on as you embark on this 2-week wait.

You’ve got this!

What Happens While You Wait to Hear Your Result:

Taking a closer look at Implantation

In the case of in vitro fertilisation (IVF), the fertilised eggs or human blastocysts normally hatch out of their shell and start to implant about 1 or 2 days after the 5th day of the IVF blastocyst transfer. 

This means the implantation takes place about 7 to 8 days after fertilisation of the egg.

The embedding of the embryo into tissue so it can establish contact with the mother’s blood supply for nourishment.

Implantation usually occurs in the lining of the uterus; however, in an ectopic pregnancy, it may occur elsewhere in the body.

Other Elements of the IVF Process To Consider

Legalities of Egg Donation and IVF

Egg donation is a process in which a fertile woman donates an egg, or oocyte, to another woman to help her conceive.

The donor who remains anonymous must agree to relinquish all maternal rights once she has been approved as a donor. The egg donation process is a part of Assisted Reproductive Technology (ART).

The National Health Act of 2004 regulates all gamete donations in South Africa; therefore, anonymous egg donation is legal in South Africa.

The law in South Africa allows financial compensation for reasonable expenses incurred by the donor, e.g. time away from work/studies and travel expenses (public transport/petrol) to and from HART. According to South African law, an egg donor may not have more than six live-born children from their donated gametes.

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IVF Journey with Donor Sperm

In some cases, your fertility journey may need the help of a sperm donor rather than an egg donor.

IVF with donor sperm follows the same process as standard IVF. It involves the use of fertility drugs to stimulate your ovaries to produce mature eggs, which are fertilised following retrieval, in our laboratory, with sperm from the sperm donor you have chosen from our recruitment program.

As you consider or embark on your own IVF journey, remember that it’s okay to seek support, ask questions, and make informed decisions. You are not alone in this process. The science of IVF has come a long way, and there is an extensive community of individuals who have successfully navigated this path.

Your journey is unique, and your outcome may be as well, but remember that hope is your constant companion. 

You are taking a bold step towards building the family of your dreams, and as you walk this path, know that you have the unwavering support of those who have come before you and a world of possibilities ahead.