WHAT IS IN VITRO FERTILIZATION?
In Vitro Fertilization (IVF) is a technique whereby egg fertilization takes place outside the woman’s body. Embryos are created in the laboratory and then placed in the woman’s uterus to stimulate development and achieve pregnancy. This process involves several steps which need to be adequately coordinated. Designing made-to-measure treatment for the patient’s needs, team quality and the clinic’s technology are key to success.
PREPARATION AND STUDY OF THE PATIENTS FOR THE IVF PROCEDURE
Every patient is a unique individual. For this reason, our treatments at Alps hospitals and Diagnostics are tailored to every one of our patients. Our goal is to locate the source of infertility among couples and select the most effective treatment. The male’s sperm and hormone levels are analyzed and, if necessary, a urological assessment is performed.
In the case of women, their cervical canal and endometrial cavity are examined, as well as possible alterations in their fallopian tubes and their menstrual cycle patterns. These are accompanied by detailed assessments of the couple’s sexual health.
This process ensures that IVF is the correct solution to the patients’ infertility problems and that they are physically and psychologically ready to begin the cycle. If this is not the case, the patients are offered other treatment options.
In order to maximize the possibility of pregnancy, we need to obtain more than one oocyte, which is the number a woman’s ovary normally produces.
In order to stimulate the production of several oocytes and guarantee their quality, we administer a combination of pharmaceutical drugs. Response is monitored using vaginal ultrasound scans and timely blood analyses: ovulation induction.
The whole process lasts approximately between 8 and 12 days, depending on each case. The treatment can be cancelled if a low or exaggerated ovarian response is observed.
Once the oocytes are mature, we retrieve them with the guidance of a vaginal ultrasound scan under local anaesthesia and light sedation so that it is completely painless. This process only takes 15 minutes and does not require an operation, being hospitalized, stitches or the use of general anaesthesia.
The retrieved eggs are taken into the IVF laboratory where they are prepared for insemination.
Oocytes and spermatozoids are placed together for several hours within an incubator which provides the ideal conditions for fertilization to take place and the subsequent development of pre-embryos. The number of fertilized eggs will not be known until the next day
ICSI (INTRACYTOPLASMIC SPERM INJECTION)
ICSI is performed on oocytes when the reproduction biologist in charge deems it necessary or when it has been previously agreed upon.
The Intracytoplasmic Sperm Injection (ICSI), consists in the introduction of a single spermatozoid inside a mature egg to achieved fecundation.
ICSI proved to be a revolution in assisted reproduction techniques, as it overcomes most male infertility problems. This technique is used in fertilization when sperm suffers from low count, an abnormal morphology, poor motility or when the sperm is unable to fertilize through IVF. It can also be used with patients suffering from a blocked sperm duct. In this case, a puncture is made in order to extract sperm directly from the testicles.
This procedure is performed using a microscope. Micromanipulation equipment is also used, allowing us to stabilize the egg softly and subsequently place the sperm inside it. Sperm selection is essentially guided by morphological features, although other methods (MACS, IMSI, and PICSI) can also be used.
CULTURING THE EMBRYOS
Fertilization is followed by development in a culture medium that provides everything that is needed for growth. The embryos are assessed during development. Growth is periodically assessed because not all human embryos reach the blastocyst stage. It is important to keep in mind that not all of them will fertilise and become viable embryos. There will be good and poor quality embryos and others that will simply block.
TRANSFERRING THE EMBRYOS
Once the blastocyst stage has been reached, embryo transfer takes place. It is an essential stage during treatment. It entails placing the embryo in the mother’s uterus.
The procedure is performed using an abdominal ultrasound scan. The culture medium containing the embryo is positioned inside the uterus. It is a quick and painless procedure.
Embryos that have not been transferred and wish to be preserved, after vitrification, proceed to storage. After identification, they are deposited in an exclusive location in the cryogenic tanks of our laboratories. For complete security, this location is not shared with other samples, nor with other patients, to protect them from potential cross-infection or inaccuracies.
TESTING FOR POSITIVE PREGNANCY
13/14 days after the progesterone medication began, a blood sample is taken from the patient in order to determine if she is pregnant or not. It consists of detecting beta-hCG levels in blood since this hormone is produced by the embryo and passed on to the mother. It is the first measurable sign sent by the embryo.
If the patient is not pregnant, the medical team involved in the course of treatment assesses the causes and decides what steps need to be taken. The patient is given an appointment in order to be able to tell her about the team’s evaluation of the situation.