IVF requires the coordinated efforts of not just doctors, nurses and embryologists, but also the couple undergoing treatment. Expectations are very high and this contributes to the stress and anxiety experienced by the couple. Concerns of this nature have recently been shown to adversely affect treatment outcome (Klonoff-Cohen & Natarajan, 2004).

Simplification of the IVF programme is important to shield you from the complexities of the programme, so as not to add to the pressures you already feel. Rationalization of the processes improves efficiency and also reduces the risk of communication errors.

Simplification is part of the overall philosophy of holistic patient-centered management at Thomson Fertility Centre. The Clinical philosophy is not one of blind pursuit of the latest advances, but selecting and integrating the appropriate ones to achieve the dual goals of excellence with simplicity for patients. It is, therefore, not related to any particular procedure or protocol.

The IVF programme at Thomson is divided into 4 phases.

￭	Phase 0 The stage of ‘Preparation’ and spans 1 month. The first consultation is usually scheduled on one of cycle days 2-4 to assess the clinical situation and to allow final discussions and fine-tuning before embarking on the programme. A course of oral contraceptive pills (OCP) is usually prescribed to ensure hormonal stability as well as to facilitate scheduling of the IVF programme. Phase 0 may be omitted if certain conditions are fulfilled, whereupon couples can go straight into Phase 1.
￭	Phase 1 The stage of ‘Egg Growth’. You return on day 2 or 3 of the cycle following OCPs to ensure that all is ready to commence hormone treatment. Daily injections with hormones such as FSH, Cetrorelix and hCG are used to stimulate the growth of about 10 eggs. Pen injectors have simplified injections so that many patients are able to self-inject. Blood tests are rarely needed as you are assigned an IVF clinician who will perform all your scans and procedures. Phase 1 typically takes 10 to 14 days and ends when enough eggs are fully grown.
￭	Phase 2 The stage of ‘Procedures’. The first procedure is egg extraction or Oocyte Pick-up (OPU). OPU is typically a 10 – 20 minute procedure performed under a mild, short-acting anaesthetic. The presence of your husband is encouraged to provide emotional support. You are usually well enough to leave the Centre after 2 hours. The eggs in the meantime will be combined with your husband’s sperm in the laboratory. ICSI, where individual sperm is injected to each egg, is performed if the sperm count is very low. Otherwise the sperm and egg are allowed to fertilise naturally. The second procedure is Embryo Transfer (ET) where fertilised eggs are cultured for 3 days after which the ‘best’ 2 or 3 embryos are transferred back into your womb in a simple 10 minute procedure.
￭	Phase 3 The phase of ‘Womb Stabilisation’. Various hormones are administered for a 2 week spell to keep the womb stable until the pregnancy test.