The embryo replacement (embryo transfer) procedure is quite simple and usually pain free. It may cause minimal discomfort and no anesthetic is used, although some women may need sedation or occasionally a general anesthetic. The male partner is usually invited to attend the procedure. The couple may also be able to view the embryos through a monitor before the embryos are replaced.

The patient lies on a table or bed, usually with her feet in stirrups, some times the embryo transfer is performed with the patient in the knee-chest position. Using a vaginal speculum, the doctor exposes the cervix. The cervix is then cleaned with a little of culture medium or sterile water. One or more embryos suspended in a drop of culture medium are loaded in a fine plastic catheter so-called “embryo transfer catheter” with a syringe on one end. Gently and carefully, the doctor guides the tip of the catheter through the vagina and cervix, and deposits the embryos into the uterine cavity.

The number of embryos transferred depends upon the age of the patient, the quality of the embryos and the stage of their development. The procedure may sometimes be guided by ultrasound scan to check the position of the catheter. The use of ultrasound scan during embryo transfer appears to increase pregnancy rates. After the catheter is removed, it is handed over to the embryologist who will check it to ensure that no embryos remain. All the embryos replaced are transferred at the same time. Implantation begins three to four days later.

Successful pregnancy is related to the ease with which the embryos are transferred into the womb. Occasionally the position of the womb can make the transfer difficult. This may be overcome, to an extent, by a full bladder. A tenaculum may be applied to the cervix to straighten the uterus. If this fails, the doctor may use a stylet to negotiate the cervical canal..

Once the embryos have been replaced, you may be asked to rest for a short while before going home. Prolonged bed rest of more than 20 minutes following embryo transfer has not been shown to improve pregnancy rates.
Occasionally, your doctor may advice you against having a fresh embryo transfer instead recommend freezing all embryos for later transfer. This may occur if you have one of the following:

After egg retrieval, patients are given progesterone and estrogen medications to help create a uterine lining that is optimal for embryo implantation. Two weeks after the egg retrieval, a pregnancy test (hCG level) tells us if we were successful. Pregnant patients have a repeat hCG test after 2 days to ensure that the hormone is rising appropriately. An ultrasound study is performed approximately 4 weeks after the egg collection to document fetal number and viability.

Embryo grading

Embryos are assessed by their appearance under the microscope for the number of cells, the characteristic of cells and the presence or absence of fragmentation. Good quality embryos divide rapidly, have equal cells with clear cytoplasm, and have only few fragments. Some IVF clinics classify the embryos into grade one, two, three and four.
Grade one are the best quality embryos, these have a higher chance of implantation than those of grade 4. Research has shown that up to one third of embryos are genetically abnormal. There is no guarantee that a normal looking embryo will be genetically normal. How embryos attach and implant into the womb remains a mystery

Donor Egg Program

Egg donation is recommended in women who have:
1.    Primary ovarian failure
2.    Become menopausal, either naturally or as a result of surgery, radiation or chemotherapy
3.    Undergone repeated failed attempts at IVF due to poor embryo quality or failed fertilisation
4.    Failed to respond adequately to fertility drugs during IVF stimulation
5.    A history of repeated miscarriages
6.    A genetic disorder which could be passed on to their child

Donor Sperm

Treatment using donated sperm may be undertaken for several reasons. Azoospermia, or absence of sperm, which may be as a
result of surgery, drug or radiation therapy, or a genetic problem that has stopped the cells in the testes working. Donor sperm may also be used if the sperm is of poor quality, there have been problems with fertilisation in previous IVF cycles or there is a risk of passing on an inherited disease.  Donor sperm may also be used for single women. Counselling is provided throughout this process so you are fully informed of all the factors involved in donation.

Sperm donors are men aged between 18 - 45 years with a good quality sperm. Usually these are not known to you (anonymous),  All sperm donors undergo a series of tests and quarantining to ensure that they are medically suitable to donate.

If you are a couple, we will try to match the physical characteristics of the male partner.

Treatment involves fertilising donor eggs with sperm from the recipient’s partner and transferring the resulting embryos into the recipient’s womb. The recipient is put on hormone replacement therapy (HRT) to allow her cycle to be synchronised to that of the donor and for the womb to be prepared to receive the embryos.

We would usually be able to find a suitable donor within 1 – 3 months of your first appointment. The Finney Hospital will liaise with a clinic in your  region and carry out all the necessary blood tests and scans required for your treatment to minimise the number of trips to Accra.

Their pregnancy rates are as high as 60% on the first attempt and feedback from our patients who have received treatment here has been very positive. The ACU will also provide all the counselling required before embarking on egg donation.