In Vitro Fertilization (IVF) involves a wide range of techniques, aiming at helping infertile couples conceive a child. It is a process of fertilization, where an egg is combined with sperm in a laboratory, outside of a woman’s body, under controlled laboratory conditions. Since the birth of Louise Brown in 1978 -the first Preparation During IVF treatment, drugs designed to stimulate ovarian function are administered (follicle stimulation hormones), in order to retrieve more eggs than the one produced by the female naturally. Monitoring is performed by ultrasound examination and blood sampling, usually every 2 to 3 days. The drug doses are individualized. As the eggs mature within the follicles, the size of the growing ovarian follicles is closely monitored by vaginal ultrasound. The goal is to achieve development of multiple follicles larger than 18 mm. At this size, it is considered that the eggs in them have matured enough and are ready for retrieval The increase in endometrial thickness is also monitored. The endometrium is the tissue lining the uterine cavity, where embryos will be later transferred. The levels of estradiol are also monitored by blood tests; Estradiol is a hormone produced by the follicles and is also an indicator of egg maturity. When a sufficient number of follicles larger than 18 mm are achieved, as well as a satisfactory endometrial thickness and adequate estradiol levels, the final stages of egg maturation are triggered by administering beta-chorionic gonadotropin and about 36 hours later, the eggs are ready for retrieval. Egg collection Fertilization Embryo transfer Pregnancy test A pregnancy test is performed 12 days after ebryo transfer. Blood is drawn to measure the concentration of beta-chorionic gonadotropin. If the test is positive, 2 to 3 weeks later an ultrasound scan is scheduled in order to detect the presence of gestational sac(s) of the embryo(s) in the uterus. If the test is negative, the medication is stopped and the possible causes of failure are being analysed in order to make further decisions. Embryo Cryopreservation In case a “fresh” IVF cycle is not successful, cryopreservation of supernumerary embryos allows for a new embryo transfer and possible pregnancy without having to submit the patient again to the ovarian stimulation and egg collection procedures. The success rate of this procedure is slightly lower than that of a “fresh” cycle. According to studies children born after cryopreservation are perfectly healthy, even if the embryos have been kept in cryostorage for several years. The freezing process includes placing the embryos in special cryoprotectant solutions and storing them separately in liquid nitrogen, bearing the names of the couple. The technique of cryopreservation used is that of ultra-rapid freezing – vitrification. Vitrification has gained universal acceptance because of its advantages. Vitrification avoids destruction caused by ice crystal formations within the cells and significantly increases the survival rate of embryos upon thawing.In Vitro Fertilization (IVF)
The egg collection procedure takes about 10 to 15 minutes and is done under light sedation. The specialized gynecologist aspirates the follicular fluid using a needle, under ultrasound guidance, in each ovarian follicle. The follicular fluid is taken to the embryologist, who identifies the eggs under a microscope.
After collection, eggs are placed in culture medium. The insemination is then performed with the sperm of the partner / donor that has already been processed with special techniques. The next morning, eggs are checked for fertilization and their development is monitored in the following days. In cases where the sperm cannot fertilize the egg normally (e.g. due to low sperm count, poor quality or low motility) the same preparatory procedure with the conventional IVF process is being followed, however, in this case fertilization is performed by the technique of Intracytoplasmic sperm injection (
This is a simple procedure that does not require sedation. It is usually performed 3 to 5 days after egg collection. The embryos are placed inside the endometrial cavity by means of a thin plastic catheter introduced through the cervix. The decision on how many embryos should be transferred is made together with the couple. If there is a large number of embryos available, some of them may be frozen to be used in future attempts.
