How to Prepare for IVF - A guide for IVF patients
▫️WRITTEN BY DR RAELIA LEW
IVF stands for in vitro fertilisation. The term comes from Latin, meaning the combination of sperm and eggs to achieve "fertilisation" "in glass" – a reference to the original laboratory petri dishes. However, modern IVF treatment encompasses much more than this original definition suggests.
Today, IVF refers to a comprehensive range of technologies and strategies that fertility doctors use to help patients conceive when natural conception proves challenging. While some couples find conception easy and natural, others face significant difficulties that may require medical intervention. Coming to terms with needing help to start or grow your family can bring a mix of emotions – frustration, sadness, and uncertainty are all completely normal responses.
Our role is to help you overcome these challenges and improve your chances of having a baby, whether you're trying to conceive for the first time or expand your existing family. While starting IVF can feel overwhelming, we're committed to supporting you every step of the way. At Women's Health Melbourne, working alongside our laboratory partners at Melbourne IVF, we ensure your preparation is thorough, your education process is straightforward, and a professional support team led by your fertility specialist is there to ease anxiety and optimise your treatment outcomes.
UNDERSTANDING THE IVF TREATMENT PROCESS
Before starting IVF, you'll have already had several appointments with your fertility specialist and our team to discuss various fertility treatment options and how they align with your circumstances and goals. Our WHM consent information video page provides a valuable resource for reviewing the concepts behind different fertility treatment strategies.
If IVF is your chosen pathway, getting started involves pre-treatment counselling and education.
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You'll meet with your fertility specialist to design your first IVF treatment plan at a specialist consultation appointment outside of an IVF cycle. These planning appointments take place at Women's Health Melbourne and are always accommodated to help you. Please note that IVF treatment planning appointments are billed separately by your fertility specialist and should be budgeted for in addition to IVF cycle fees.
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Your PLA acts as your personal IVF concierge, arranging everything you need to start your IVF journey. They'll book your pre-treatment counselling, your fertility nurse-guided New Patient Information Session, and provide you with pre-treatment informed financial consent relating to your specialist's plan. IVF cycle fees are only charged after you decide to activate your treatment plan.
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You and your partner (if applicable) will complete an ANZICA counselling session, available either face-to-face or online through Melbourne IVF. During this session, you'll learn about relevant Victorian legislation affecting IVF and how it relates to your treatment. You'll also understand your choices and obligations regarding the freezing and storage of eggs, sperm, or embryos during treatment.
If your treatment involves donor materials, reciprocal IVF, or gestational surrogacy, additional counselling will be arranged before treatment begins.
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Your fertility nurse will conduct a New Patient Information (NPI) session to reinforce and explain the finer details of your personalised IVF plan. You'll receive support to learn how to self-administer relevant medications, which may include injections, oral medications, and vaginal suppositories.
You'll receive comprehensive support information, including in-hours and emergency contact details, so you can reach your IVF team or alternative relevant support whenever you need help or advice. You'll also learn about the steps of IVF treatment and how to get started with your cycle, which may involve calling us on Day 1 of your menstrual cycle or booking a planned start for an embryo freeze cycle.
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The basic steps of IVF include:
Preparing eggs for collection using medications for approximately 10 days (on average), aiming to collect several mature eggs. The ideal number is 10-12 eggs, though this varies based on individual ovarian reserve and medication response.
Collecting sperm on the day of egg retrieval or from previously frozen samples.
Achieving fertilisation in the IVF laboratory under carefully controlled conditions.
Embryo culture over several days to monitor development.
Embryo biopsy for genetic testing (if recommended).
Embryo vitrification (freezing) for future use.
Embryo transfer with the goal of achieving pregnancy.
During your stimulation phase, you'll attend one or more ultrasound appointments to monitor your progress. Blood tests may also be required, though this isn't always necessary.
The egg collection itself is a day procedure taking approximately 20 minutes on average. Eggs are gently extracted from your ovaries using a fine needle via an ultrasound-guided transvaginal approach. While usually performed under light anaesthetic for comfort, the procedure can also be done with local anaesthetic if preferred.
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Embryo transfer may or may not occur in the same cycle as your egg collection. Experts worldwide agree that in many circumstances, higher IVF success rates may be achieved with natural cycle frozen embryo transfer in a future month. This is because hormonal preparation for optimal egg numbers can cause premature advancement of the endometrium (womb lining), which may adversely affect implantation potential.
We take an individualised approach with all patients at WHM and Melbourne IVF. You'll strategise with your fertility specialist to create an IVF plan that provides your best chance of success.
Once your eggs and sperm are in the IVF lab, you'll receive regular updates on their progress. It's normal and expected that not every egg will result in a viable embryo. We're pleased if one in five eggs collected results in a blastocyst embryo for transfer or vitrification. In an average IVF cycle where 10-12 eggs are collected, 2-3 blastocysts would be expected to develop.
YOUR EMBRYO TRANSFER
Where embryo transfer is planned in an IVF cycle directly following an egg collection this happens on embryo development “day 5” (5 days after your egg collection (Ovum Pick Up, OPU) procedure.
Where frozen embryo transfer is planned, this can occur in any future menstrual cycle. You may choose to have a frozen embryo transfer in the menstrual cycle directly following your OPU cycle. You may alternatively take a break and return to IVF when you feel ready.
An embryo transfer cycle can be activated simply by calling us on “Day 1” of your natural menstrual period.
Pregnancy success rates that can be expected per embryo transfer cycle are referenced here
MEDICAL PREPARATION FOR IVF
Before your fertility specialist planned your IVF treatment, you completed extensive pre-treatment investigations including:
Fertility health checks:
AMH testing
Hormone testing
Sperm analysis (may include semen analysis, sperm antibody testing, and DNA fragmentation index)
Pelvic ultrasound imaging
Reproductive genetic screening
Karyotypes
Infectious disease screening (bacterial and viral assessments of blood and genital tract)
Immunity assessment
Blood group assessment and antibody screening
Medication adjustments: Your fertility specialist may ask you to cease certain medications and rationalise over-the-counter or allied health recommended supplements that could negatively interact with IVF medications, including Chinese herbs. Conversely, you may be asked to commence certain medications or supplements to improve IVF outcomes.
Essential supplements: All patients planning pregnancy are recommended to ensure they are folate, vitamin D, iodine, and iron replete.
Vaccinations: If you're found to be non-immune to certain viruses that can cause problems in pregnancy (such as Varicella Zoster Virus and Rubella), vaccination before starting IVF treatment may be recommended.
LIFESTYLE & WELLNESS TIPS
Preparing for IVF, leverage the fact that sperm and eggs respectively take 70 to 100 days to mature – you can prepare your body during this time too.
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This helps every cell in your body feel good and perform optimally, including eggs, sperm, and their supporting cells.
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Avoiding substances that may have toxic effects on sperm, eggs, and embryos has been shown clinically to improve outcomes for patients undertaking IVF, outcomes during pregnancy, and long-term health outcomes for babies. This includes smoking, alcohol, and excessive caffeine.
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Getting on top of risk factors known to negatively affect IVF outcomes will help you achieve success faster, requiring fewer IVF treatments. For those who may be overweight or obese, taking time prior to fertility treatment to lose weight can radically improve your IVF response and outcomes. Please ask your fertility specialist about medically assisted weight management at WHM.
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Take a careful look at products you use on your skin and body, around your home, and in your kitchen. See what you can do to "go natural" and reduce exposure to plastics, as these endocrine-disrupting chemicals of modern life are thought to have negative impacts on both natural and assisted fertility.
EMOTIONAL PREPARATION FOR IVF
IVF is emotional in many ways. Even accepting and coming to terms with the fact that you may need help to conceive can be extremely challenging.
While IVF is an amazing scientific endeavour, it's usually far from a quick fix for the many real and significant challenges couples with infertility need to confront and overcome. Setting realistic expectations is key to your emotional survival.
It's highly likely that you'll need several IVF treatments to achieve your goals because most people do. There will be emotional ups and downs. You'll experience a mixture of feelings – excitement, apprehension, optimism, sadness, and from time to time, frustration and feelings of hopelessness. These emotions, all of them, are normal.
It's important to create outlets for yourself. Find someone you can talk to. Infertility is not a fault or a choice. Try to be open about how you're feeling, especially in communication with your partner.
At Melbourne IVF, we provide counselling support if you're ever in need of an objective, professional sounding board or source of advice and emotional guidance.
YOUR FERTILITY TEAM AT WHM AND MELBOURNE IVF
At Women's Health Melbourne, we work in close collaboration with Melbourne IVF. Our Collingwood Fertility Clinic is located in the Melbourne IVF 36 Wellington Street Precinct, and our Caulfield WHM Fertility Practice is conveniently co-located with our Melbourne IVF Caulfield Treatment Monitoring Clinic.
Planning appointments before IVF cycles occur at WHM (with appointment billing via WHM), while all aspects of IVF treatment during a commenced cycle occur via Melbourne IVF (with IVF cycle billing via Melbourne IVF). Our two teams work closely together and are in daily communication to arrange your care.
KEY TEAM MEMBERS INVOLVED IN YOUR IVF PROCESS
Your Fertility Specialist directs your care and makes all treatment decisions.
Our Fertility Nurses help support you in implementing your treatment plan, coordinating and arranging your treatment monitoring ultrasounds, and explaining next steps in your fertility specialist's plan for your care.
Our Administrative Support Staff ensure you have all the supports you need, arrange appointments, and coordinate procedures.
Our IVF Hospital Team cares for you on the day of procedures like your egg retrieval or embryo transfer.
Our Skilled Scientists nurture your eggs, sperm, and embryos. At Melbourne IVF, we have a world-leading team in IVF science and research, striving to achieve the best outcomes possible for you in your IVF treatment.
Our Counselling Team is here to support you at every step along your fertility journey.
Every member of your fertility team is essential. Each has a critical role to play working together to achieve your success. During your IVF treatment, you'll have an opportunity to meet and interact with many of these key team members. We'll ensure every aspect of your care is optimised as much as possible.
Not every IVF cycle goes to plan. Your fertility specialist will observe, deduce, strategise, and may need to adapt your plan based on scientific observations and initial treatment outcomes to help you reach your goals.
At WHM and Melbourne IVF, our goal is to provide you with optimal care. IVF is complicated and your journey may not be straightforward. However, please be reassured that you can always reach out at any time with questions or concerns you may have.
FINANCIAL AND LOGISTICAL PLANNING
Based on Australian data, the average patient requiring IVF will undertake three stimulated cycles. Given that infertility can be challenging to overcome, it's important to understand and plan for treatment costs in IVF.
Some treatment costs may be covered by Medicare or your private health insurance, while other treatment costs involve out-of-pocket charges. Up-to-date IVF treatment costs and eligible rebates are thoroughly and transparently outlined on our Melbourne IVF website.
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Doctor appointments are important and each consultation is unique. Due to the fact that you may be in attendance at WHM for an extended time around your appointment, it's advised to keep your schedule free or flexible around your scheduled WHM clinic appointment.
Your fertility specialist may not always run exactly to time, as her priority will be to meet the needs of every patient with various presentations, circumstances, and levels of complexity. She may also need to make accommodations for unexpected procedures or medical emergencies. We respect your time and will always endeavour to update you promptly if a delay or change of appointment time is expected.
You may need to meet with other staff members after your appointment, such as our PLA or nursing team, or attend blood tests at our onsite pathology collection facilities. We'll happily provide you with a medical certificate so that you may access medical leave entitlements to attend your appointments and associated needs.
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Parking on site is free and always available at our WHM Caulfield Clinic. Parking is more challenging around our Collingwood clinic, and allowing time to secure parking is recommended. Both our clinics are easily accessible via public transport solutions.
When you attend an IVF egg collection procedure with sedation anaesthesia, you will not be fit to drive and will be required to organise a support person to collect and escort you home.
For those who live far away, you can consider arranging accommodation for an overnight stay around your IVF procedures to avoid stress on the day. Quest apartments are located within easy walking distance of WHM Collingwood and Melbourne IVF.
FINAL ENCOURAGEMENT
It's not unusual for many people to consider IVF with apprehension, worry, even fear. Starting IVF isn't easy. It takes commitment, energy, spirit, and courage.
Having a baby, having a family can be the ultimate achievement of a lifetime. Every difficulty, every challenge, every milestone is ultimately worth it for patients who succeed. In our care, the vast majority of patients we treat at WHM and Melbourne IVF will ultimately have a baby.
There are some people for whom IVF will not be successful despite extreme efforts from all parties involved, and we acknowledge the uncertainty that this knowledge can bring.
To ensure you're not overwhelmed by the preparation and process involved in getting started with IVF, we encourage our patients to just take it one step at a time. We're committed to helping you and feel always that your success is our success.
There is no better testament than word-of-mouth recommendation from our relieved, happy, pregnant patients. We're extremely proud you have chosen us for your care and feel privileged to help you.
So please ask us anything you need to know along the way. No question is too small, and your WHM and Melbourne IVF team will always be here in your corner to support you.
Written by Dr Raelia Lew
Dr Raelia Lew is the Medical Director of Women’s Health Melbourne. Dr Raelia is a Royal Australia and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) Board Certified CREI Fertility Specialist, and is President Elect of the Australia and New Zealand Society of Reproductive Endocrinologists and Infertility Specialists(ANZSREI).