IVF (in vitro fertilisation) is the fertility treatment that is most well-known. It means "fertilisation in glass", hence the expression "test tube baby". In the UK, one baby in every 50 born is conceived through IVF.
There are various stages involved in IVF treatment:
You will be prescribed drugs that will help to control when your eggs are produced. You will also take drugs to increase the number of eggs you produce. This means that more eggs can be fertilised and the clinic will have a greater choice of fertilised eggs to use in treatment.
The clinic will carry out vaginal ultrasound scans to monitor your developing eggs. They will also do blood tests to chart the rising levels of oestrogen produced by your eggs. This helps to track how your eggs are maturing. 34-38 hours before your eggs are due to be collected, you will have a hormone injection to help your eggs mature.
Eggs are usually collected by ultrasound guidance, which takes around 30 minutes. Your doctor will insert a thin needle through your vagina into each ovary. The eggs will be sucked into the needle. Very occasionally, eggs will be collected by laparoscopy (a small telescope with a light attached). This procedure involves making a small cut in your stomach and extracting the eggs with a fine needle, as before.
Around the same time that the eggs are collected, the male partner will produce a sperm sample. This will be stored for a short time, and the sperm washed and spun so that the healthiest sperm can be used to fertilise the eggs. If you are using donor sperm, this will be taken from the freezer and prepared in the same way.
The eggs and sperm are mixed and left in a laboratory dish for 16-20 hours. They are then checked to see if any have fertilised. Those that have (now called embryos) are left for another 24-48 hours before being checked again.
Two days after egg collection, the woman will be given progesterone to help prepare the lining of the womb for pregnancy. This is given with pessaries, injection or gel.
Two to five days after the eggs fertilised, the healthiest ones are selected to be put back into the woman's womb. For women under the age of 40, one or two embryos can be replaced. If you are 40 or over, a maximum of three can be used. Remaining embryos can be frozen in case you have further IVF treatment.