The IVF ICSI cycle timeline

What is IVF?

In Vitro Fertilisation (IVF) can be described in the very simplest terms as “eggs are extracted, fertilized in a laboratory and placed in the uterus to hopefully implant and develop into a pregnancy”.

A more detailed description begins to reveal the complexity of this treatment process. During IVF treatment, eggs are surgically removed from the female partner’s ovary. In a glass dish (“in vitro”), outside the body, it is mixed with sperm to be fertilized. The fertilized eggs, called embryos, are then placed in the women’s uterus three to five days later.

What is ICSI?

ICSI stands for “Intra Cytoplasmic Sperm Injection” and it is a revolutionary medical process that makes it possible for nearly every man to have his own biological child, even in the case of severe sperm problems. Practised safely around the world, ICSI has helped thousands of couples to have their own biological offspring.

ICSI is a medical procedure used in specific circumstances when the fertilization of the eggs takes place in the lab during IVF treatment, and it is very effective.

The IVF ICSI timeline

The brief descriptions of IVF and ICSI make the process sound quite simple.

However, a full overview of the steps and procedures involved in a typical 28-day IVF ICSI plan at Cape Fertility, as detailed below, provides a realistic picture of the full process.

Timeline: Day 1

Clinics in Cape Town that Offer AI, IVF and ICSI

In Cape Town

Nestled at the foot of the iconic Table Mountain – one of the New7Wonders of Nature and a Unesco World Heritage Site – Cape Town is a destination to experience! It was just recently named “Leading City Destination for 2021” in the 28th annual World Travel Awards, which also named Table Mountain as “Africa’s Leading Tourist Attraction”. In fact, Cape Town is regularly voted by international travellers as the greatest city in the world and for good reason.

With spectacular beaches, magnificent mountains, unique floral kingdoms, some of the world’s finest wine routes, the iconic Robben Island and the famous V&A Waterfront, the accolades Cape Town receives are not over-stated.

Clinics in Cape Town

Cape Town is home to many advanced medical facilities, ranging from private specialist clinics to the world-famous Groote Schuur Hospital – probably one of South Africa’s premier hospitals – known worldwide as the location of the world’s first successful human heart transplant. Locally, it is renowned as the training ground for some of South Africa’s best doctors, surgeons and nurses.

In the Claremont Medical Village at the back of Table Mountain, under the eaves of the picturesque Constantia Mountains, you will find Cape Fertility, one of the top fertility clinics not only in Cape Town, but also in South Africa and in the world.

Male Fertility Challenges… What Are The Causes?

Today we know that the female partner is not automatically responsible for infertility in a couple.

In fact, in about a third of infertile couples, the infertility is due to a male factor, most often a problem with the sperm. In a further third of couples struggling with infertility, it is due to fertility challenges in both partners. In the remaining third of infertile couples, the challenge lies with the female partner.

Given this reality, it is important for couples who have not fallen pregnant not to make any assumptions but to have all the proper fertility tests done for both partners before making any decisions.
While the statistics confirm that male infertility is really a significant issue affecting increasing numbers of couples, male fertility is not spoken about as publicly or as much as female fertility. This contributes to a widespread lack of awareness of the fact that male fertility issues are a significant contributor in many infertility cases.

What forms do male infertility take?

Male infertility can take various forms, for example, a complete absence of sperm, a low sperm count or problems with the shape or movement of the sperm.

When a sperm analysis is done, there are various factors that are investigated.

The first is the volume of the sperm. A normal volume is at least 1.5ml and if there is less, it may point to an obstruction somewhere between sperm production and ejaculation.

Cape Fertility Supports Endometriosis Awareness Month

Reproductive Cancers in the Spotlight on World Cancer Day

One of the greatest challenges

According to the WHO, cancer is one of the world’s leading causes of death, and its burden is growing.

In 2021, the world crossed a sobering new threshold – an estimated 20 million people were diagnosed with cancer, and 10 million people died of cancer. These numbers will continue to rise in the decades ahead.

And yet all cancers can be treated, and many can be prevented or cured.

Care for cancer, however, like so many other diseases, reflects the inequalities and inequities of our world. The clearest distinction is between high- and low-income countries, with comprehensive treatment reportedly available in more than 90% of high-income countries, but less than 15% of low-income countries.

Similarly, breast cancer survival five years after diagnosis now exceeds 80% in most high-income countries, compared with 66% in India and just 40% in South Africa. For all of these reasons, the theme for this year’s World Cancer Day is “closing the care gap”.

WHO’s efforts are focused on breast cancer, now the most common cancer; cervical cancer, that can be eliminated; and childhood cancer.

Reproductive cancers

This year, Cape Fertility adds its voice to cancer awareness efforts by highlighting reproductive cancers – including cervical cancer, and the other cancers that affect women, as well as reproductive cancers that affect men.

February is Reproductive Health Month in South Africa

What is reproductive health?

Reproductive health is a broad topic that implies that every person:

* has a responsible, satisfying and safe sex life;
* has the capability to reproduce;
* has the freedom to decide if, when, and how often to reproduce.

This means that both men and women have the right to:

* be informed of safe, effective, affordable, and acceptable methods of fertility regulation;
* have access to the method of fertility regulation of their choice;
* access to appropriate health care services to enable a woman to safely carry a pregnancy and go through childbirth, to provide couples with the best chance of having a healthy infant.

Unfortunately, for both men and women, there are many issues that can negatively impact reproductive health and the ability to have children, or infertility. The most common causes of infertility in women are ovulatory disorders, endometriosis, fibroids and fallopian tube problems, as well as advanced maternal age (35+). Few people realise that when it comes to fertility, age does matter. After age 35, a woman’s fertility declines rapidly, while the chance of abnormalities and miscarriages increases exponentially.

There are also many possible causes of male infertility such as sterilization or vasectomies, spinal cord injuries, erection or ejaculatory dysfunction, medical conditions, medications and sexually transmitted diseases.

In both men and women, poor lifestyle choices, such as smoking, drinking and being overweight, can also negatively affect reproductive health.

Female Fertility After Forty

At Cape Fertility, we support women empowerment. It is a woman’s right to be allowed to decide when to start a family. Women must empower themselves with financial independence, because one of the main reasons gender-based violence exists is that women are financially dependent on their male partners.

Women who want to further their careers before starting a family can fully count on Cape Fertility’s support. We believe women deserve the same reproductive freedom as men.

However, when making this decision, women should also be fully aware of the impact of their age on their fertility, their pregnancy, labour and birth, as well as the treatment options that are available.

Age-related infertility

The reality is that women have a prime fertility window that extends to around age 35. One of the barriers to falling pregnant naturally in your 40s is infertility.

With increasing age, a woman’s fertility decreases. This is due to the fact that from the age of 35 onwards, women not only produce fewer eggs than at a younger age, but these few eggs produced are also of lower quality.

Of course, some women have no issues getting pregnant well into their 40s, and most healthy women who get pregnant after age 35 and even into their 40s have healthy babies.

But, statistically speaking, a woman is less likely to get pregnant and more likely to need fertility treatments the older she is when trying to conceive.

Technology Advances In Fertility Treatment

Very simply stated, during in vitro fertilization, the female partner’s eggs (or eggs from a donor) are collected and fertilized with sperm in a laboratory. The resulting embryo is then implanted into the mother-to-be’s uterus.

Several technology advancements have enhanced the success rate of IVF and other fertility treatments. These include automatic sperm analysis, ICSI, laser biopsy, time lapse technology, Pre-Implantation Genetic Screening (PSG) and Pre-Implantation Genetic Diagnosis (PGD), all of which are very exciting developments that have improved IVF pregnancy rates.

Automated sperm analysis

A significant innovation in terms of the treatment of male infertility is automated sperm analysis. Traditionally, sperm samples would be analysed under a microscope, based on visual information. Today, thanks to automated sperm analysis, sperm samples are now checked and automatically analysed by a computer.

Since 2017, Cape Fertility has provided our patients with access to a Sperm Class Analyzer CASA System. The computer analysis is more accurate than an analysis done by a person, and this improves the chances of a pregnancy.

ICSI

Intra Cytoplasmic Sperm Injection or ICSI revolutionised male infertility treatment. Before ICSI, it was very difficult to treat male infertility. But now, nearly every man can have his own biological child, as long as there is sperm.

Top Four Common Causes of Female Infertility

Endometriosis

Endometriosis is a benign condition in which the lining of the uterus is growing where it is not supposed to be – outside of the uterus, often at the back of uterus or around the ovaries or on other organs.

Endometriosis is a very common disease and it can start at any age. Up to 10% of all women have this disease.

There are different stages of the disease, ranging from minimal to severe. Most women have minimal or mild endometriosis, characterised by superficial implants and mild adhesions. Moderate and severe endometriosis is characterised by chocolate cysts and more severe adhesions.

A very common symptom of endometriosis is infertility – endometriosis affects between 25 and 40% of women facing fertility challenges.

This is because endometriosis can cause inflammation and scar tissue. Endometriosis is an inflammatory disease, and the inflammation it causes can interfere with a woman’s ovulation.

Endometriosis can also cause anatomical abnormalities such as scarring that can reduce the chances of conceiving. For example, endometriosis adhesions may prevent the fallopian tubes from picking up the egg from the ovary during ovulation.

Endometriosis can also grow on the surface of the ovary as implants or invade the ovary and develop a blood-filled cyst called an endometrioma, or a “chocolate cyst” (so called because over time the blood they contain darken to a deep reddish-brown colour). These cysts may be as small as a pea or grow larger than a grapefruit.

Infertility – When To Get Treatment and What It Entails

There is currently an epidemic of obesity in South Africa. Fertility treatment is also less successful in women that are overweight than among women with a normal body mass index.
Chronic diseases also affect couples’ chances of conceiving.

In men, the testes are the most sensitive organ in the body. So, any serious chronic health disorder will have an effect on sperm cell production and on sperm quality, including hypertension and diabetes.

While chronic diseases like diabetes, hypertension, asthma or heart disease, do not always have an effect on a woman’s ability to conceive, it can come into play during pregnancy, when there may be more complications.

Certain common pelvic diseases can also influence fertility. Fibroids of uterus is one common example in South Africa. This is a disease of the uterus, with abnormal growth of the muscle of uterus, that is known to cause infertility in women.

Another chronic condition of the pelvis, called endometriosis, refers to the lining of uterus growing outside uterus on the fallopian tubes or ovaries, on the bowel or on the bladder. It can lead to pain, but is also a very common cause of infertility.