What exactly is involved in IVF and how much does it cost?

We all know that infertility is a major issue in Ireland.

In our recent poll, almost one third of you told us that you or some you knew had struggled to conceive. Lots of you are interested in looking for solutions too - 83 per cent of you said you'd consider fertility treatments if necessary. IVF (In Vitro Fertilisation) is one of the most common treatments used in Ireland. Here's all you need to know about it.   How does IVF work? IVF involves harvesting eggs from the woman, fertilising them with sperm in a lab and then implanting the resulting embryos in her womb a few days later. The process begins when the woman starts taking hormones via medication over a period of days to stimulate her ovaries to develop multiple follicles, the sacs where eggs are produced. The follicles are monitored by your doctor using an internal ultrasound and when they're mature enough, the woman is injected with a hormone to trigger ovulation. The eggs can be retrieved 36 to 38 hours after this. The retrieval is done in theatre under local anaesthetic. A doctor will use a needle attached to a transvaginal ultrasound probe to draw fluid from the follicles. This fluid is examined for eggs and any eggs are washed and incubated in a special medium in a lab. Meanwhile, the man provides a sperm sample and the strongest, most motile concentration of the sample is extracted. This concentration is added to the eggs and they are incubated together overnight. In some cases, another form of insemination called ICSI (Intra-Cytoplasmic Sperm Injection) is required. This is where doctors insert a single sperm into each egg using a very fine needle and a strong microscope. The next morning they are checked to see whether any eggs have been fertilised. Fertilised eggs are then cultured in the lab for three days. Sometimes, the embryos will need to be cultured for five days to develop to what's called blastocyst stage. Up to three of the best embryos are then implanted into the woman's uterus in a procedure that doesn't require any anaesthetic. The doctor inserts a catheter through the vagina and cervix and into the uterus. The woman can take a pregnancy test two weeks later and find out whether the cycle of IVF has been successful.   How much does it cost? If you know anything about IVF, you'll know it's not cheap. A single round of IVF at Sims Clinic starts at €4,600. At Cork's Waterstone Clinic, it's €4,750 while at both Merrion Fertility and at Repro Med it's €4,500. Couples need to be aware of add-ons too. When ICSI is needed, it can add a few hundred euro on to the cost. Blastocyst culturing (letting the embryo develop for two extra days before implantation) can also cost €600 or €700 more. Couples can require multiple rounds of IVF to get pregnant. There's also a cost if couples want to freeze and store their unused embryos for use in the future.   How effective is it? It can be difficult to say. 2016 data from Sims Clinic shows a clinical pregnancy success rate of 53.4 per cent for women in the 35 to 37 age range. That falls to 24 per cent after the age of 40. Success rates vary slightly between different clinics (most publish theirs on their websites) but what's consistent throughout is that age is the most important factor in whether IVF will work. Simply put, it will be more effective the younger the couple, and especially the woman, is but there is no guarantee that it will definitely work for anyone.   This October is Fertility Month on Her, when we’ll be talking all things reproductive health and having babies.  You can check out all of our Fertility Month articles here. Want to get in touch? Email me at anna@her.ie.