IVF (in vitro fertilisation) means that fertilisation takes place outside the body in a laboratory.

About four percent of all children are born through IVF. If you cannot conceive naturally and are seeking care, an investigation will be carried out at first to try to determine the reason why you aren’t getting pregnant. Usually, you can seek help after trying to conceive naturally for one year, although it can take considerably longer to conceive naturally. But after a year, it is recommended that an investigation be carried out, and it may show, for example, that there is damage to the fallopian tube or that the pregnancy is complicated by endometriosis. Sometimes underlying diseases in the woman or man are detected and can sometimes be treated with medication to improve fertility. In some cases, it may be an issue of reduced function of sperm or eggs. Or that you, as a same-sex couple or single person, do not have access to sperm. It is possible to donate your eggs or sperm.

Sometimes it is also not possible to determine the cause of involuntary childlessness.

IVF may be covered by health care insurance in your respective country, and in Sweden you will go through a regional queuing system. The length of the queue depends on which region you are in. You have the right to seek care in another region, and you will then be placed in their queue. The number of attempts you are allowed will vary. If you instead choose to go directly to a private clinic, you will pay according to their fees. In order to get your IVF financed through your region, women must be under 40 years old and men must be a maximum of 55 years old. If you, as a woman, have your eggs frozen, you can use them before your 45th birthday. If you are a couple and already have children together (biological or adopted), or if you as an independent woman already have children, IVF may not be covered by health care insurance and you may have to pay privately.

There are different ways to do IVF and a plan for IVF will be drawn up after an individual medical assessment. You may need medication to induce a menopause-like state, and then receive medication to stimulate the follicles. You may also be given medication during your natural cycle to stimulate your follicles – while also receiving medication that prevents ovulation from occurring. Both methods are designed to try to stimulate the formation of as many follicles as possible. Once enough follicles have formed, you will again receive medication for the eggs to mature and a few days later the egg will be retrieved. The egg can then be fertilised by allowing the sperm to swim into the egg. If there are too few sperm or if they are of poor quality and are unable to enter the egg on their own, the laboratory can help the sperm enter. Sometimes there is no sperm in the seminal fluid, and the doctor can examine whether there are sperm in the testicle or the epididymis and whether it is possible to extract them directly from there.

When the eggs have met the sperm in the laboratory dish, they are left to develop into embryos for a few days. The laboratory staff look at the dishes and sees how the cell division is going and if it looks normal. After about 5-6 days, the embryos that have developed normally are returned. In Sweden, only one embryo is returned because of the risks entailed in a potential multiple pregnancy. Only in exceptional cases are two embryos transferred. If there are any left over, they may be frozen for any potential future attempts.

The transfer of the embryo takes place through a short procedure where the embryo is inserted into the uterus through a thin plastic tube. At the same time, the doctor checks with an ultrasound to see that it is in the right place. Two weeks after the transfer, you can take a pregnancy test. If the test is positive, you will usually come back to the IVF clinic for a vaginal ultrasound about three weeks after taking the test to make sure everything is going well. You decide for yourself when you want to contact the maternity healthcare services that you want for your pregnancy. Please bring the paper provided by the IVF clinic to your antenatal clinic when you register.

Undergoing fertility tests and treatments can be an emotional roller coaster. Hope and despair are emotions that can easily follow on from each other. Some want to take a break and catch their breath after a negative pregnancy test, while others want to try again right away. If you want to try again, you can book a meeting through your health care provider, or you can apply privately.