Day 0 - Your egg collection
Day 0 - Your egg collection
On the morning of your egg collection, you’ll arrive at Cambridge IVF and be admitted to our ward area ready for your trip to theatre. While you are having your eggs collected we will be preparing the sperm sample from your partner or donor which will be used to inseminate your eggs later in the day.
We use a microscope to identify the eggs, which are surrounded by a cloud of cells called cumulus, in the fluid the doctor collects from your follicles. We then wash the eggs and place them in the incubator in a culture medium which is designed to give them the nutrients they need until we are ready to inseminate the eggs the same afternoon.
After your egg collection
After your egg collection, a member of our laboratory team will come and see you and confirm with you the number of eggs we collected, the quality of the semen sample and the insemination method we intend to use (IVF, ICSI or MACS-ICSI) to fertilise your eggs.
Before your treatment starts, your semen will have been analysed. If you are using a donor, we will have the information we need from them too. Based on this, we will already have a good idea of what the best treatment option is. Sometimes things can change on the day, so we are always flexible in our approach. We want to ensure that you get the very best chance of a successful outcome from your treatment cycle.
We will also let you know the arrangements for the next few days and what contact we will be making with you and when.
The next step is to inseminate your eggs. The way we do it will depend on the best treatment option chosen for you:
If you’re using standard IVF, we’ll mix the prepared sperm sample with the eggs in a petri dish. This process is controlled using our electronic witnessing system which prevents errors occurring in the lab. It won’t let us use any sperm with your eggs except the one we’ve prepared for you. The procedure is fast and within five minutes your eggs are back in the incubator and the fertilization process has begun to take place.
- ICSI takes the insemination process a little further. Here we inject a single sperm into each mature egg using a very fine pipette. We carry out this procedure when we believe that there is a significant chance that the sperm and eggs may not fertilise well using the IVF technique. Following the injection procedure, we return your eggs back to the incubator. Or into the EmbryoSccope if you have elected to deploy that technology as part of your treatment plan.
- Magnetic-activated cell sorting (MACS) is a variation from the ICSI technique used to select functional sperm in cases in which the spermatozoa have high DNA fragmentation. The sperm cells in the semen sample are separated using a suspension of magnetic nano-particles and a magnetic field. The sperm that are DNA fragmented bind to the magnetic nano-particles and when they are passed through the magnetic field they are retained, whilst the healthy functional sperm pass straight through and are collected. These healthy sperm are then used for the ICSI procedure as previously described and the eggs are returned to the incubator or EmbryoScope. MACS-ICSI improves embryo quality and reduces the change of miscarriage in patients with high DNA fragmentation. If we believe you are going to benefit from it, we will have discussed this with you.
What should I expect?
We can only perform ICSI on mature eggs. We can easily spot an egg which is mature using the microscope. Immature eggs would not fertilize, and it is not legal for us to inject immature eggs. It is not unusual for some of your eggs to be immature, so you need to be prepared for this when we call and let you know how the fertilisation procedure has gone.
On average we would expect approximately 65% of all injected eggs to fertilise normally from ICSI. The average may be lower if you are using surgically recovered sperm or if we know your egg quality is variable.
You now face a wait of up to six days. For you, these are very tense days of waiting and not being able to do anything. For us they are full of activity, making sure that things are progressing as they should.