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In Vitro Fertilisation (IVF) / ICSI
The miracle of life happens in our laboratories.
What does it consist of?
In Vitro Fertilisation (IVF) is the technique most used in assisted reproduction centers. It is a more complex procedure than artificial insemination and consists of fertilizing the ovocytes with the sperm in the laboratory in order to generate an embryo. The embryos are cultivated for a few days and then transferred to the woman’s uterus to continue its natural evolutionary process.
Fertilization is conducted using a technique called ICSI (intracytoplasmic sperm injection). Our embryologists select the best sperm and inject them one by one directly into each egg. It is a very precise technique that allows to increase the possibilities of fertilization of the ovocytes.
Depending on the source of the semen sample, the process can be:
- IVF with couple sperm. The sperm comes from a semen sample of the patient’s partner.
- IVF with donor sperm. The sperm comes from a gamete bank.
When is it indicated?
- Injury or absence of the fallopian tubes.
- Severe alterations in sperm quality.
- Use of testicular sperm (TESE).
- Previous treatment failures.
- Hereditary genetic disease (PGT-M).
- Need for Pre-implantation Genetic Diagnosis (PGT-A).
- Use of vitrified ovocytes after fertility preservation.
- ROPA.
- Others.
Ovarian stimulation
Treatment begins with ovarian stimulation of the woman. To do this, drugs are used to stimulate the development of follicles (the place where future ovocytes mature). Normally, a woman only matures one ovocyte in each menstrual cycle, whereas this way it is possible to obtain several mature ovocytes in a single cycle. The medication is administered subcutaneously, using “self-injection” devices.
Control of follicular development
During the ovarian stimulation treatment, we will carry out regular controls, through vaginal ultrasounds and, if necessary, hormonal tests; all this to check follicular maturation and schedule the ideal time for puncture. This phase lasts between 10 and 12 days.
Puncture
The removal of the eggs is a very simple procedure that is performed in the operating room, by means of the vaginal puncture guided by ultrasound and the aspiration of the follicles. The process does not last more than 15 minutes and is performed under sedation for your comfort and well-being.
It does not require hospital admission, only a rest of several hours is prescribed in the room of our clinic. After this time, you can resume your usual activity.
Preparation of the semen sample
It is necessary to prepare the semen sample so that it has the ability to fertilize the egg, in addition to achieving an optimal concentration of mobile sperm.
The sample can be collected on the same day or previously cryopreserved, either from a donor or from the couple’s own male partner. In cases where the use of donor semen is indicated, this sample will always be frozen and stored in our semen bank.
In both cases, our embryologists will treat the sample in the laboratory with a process known as sperm capacitation, so that we can select the sperm with the best mobility.
Fertilization and culture
Our embryologists perform fertilization through a technique called ICSI (Intracytoplasmic sperm injection). It consists of the selection of a single sperm for each egg that is microinjected into it. It is a very precise technique that favors the fusion of the nuclei of the male gamete with the female. Fertilized embryos must be kept in culture for 5-7 days. And during this time, they will develop until they reach the blastocyst stage.
In Next Fertility, we use time-lapse technology, which allows real-time monitoring of the evolution of embryonic development. In this way, we evaluate in a very exhaustive way the morpho-kinetic changes that take place and this allows us to select the embryos most likely to get a pregnancy.
Embryo Transfer
In the embryo transfer we will deposit the embryo inside the uterine cavity; this can be done in “fresh” or in “deferred”.
The transfer is done with an embryo in blastocyst stage (5-7 days of embryonic life), is called in “fresh” when it is done with a blastocyst without having been frozen previously, during the same cycle of ovarian stimulation and follicular puncture; and in “delayed” when a thawed blastocyst is transferred, in a cycle after the in vitro fertilisation treatment cycle.
The transfer is made “deferred” when: a) there is a risk of “Ovarian hyperstimulation syndrome”, b) endometrial conditions are not adequate for embryonic implantation, c) it is necessary to perform embryonic genetic diagnosis techniques, d) there is some reason why gestation in the same IVF cycle is not advisable.
In both cases, the transfer is done with a transfer tube or catheter, using an ultrasound guide. This procedure is completely painless and does not require hospital admission.
Pregnancy Test
A blood pregnancy test will be carried out 14-15 days after insemination. It will look for the presence of the hormone β-hCG (human chorionic gonadotrophin), which is the hormone produced by the embryo after its implantation in the endometrium.
If the test result is positive, an ultrasound will be carried out around 2 weeks later to confirm the presence of the ‘gestational sac’ inside the uterus and to observe the heartbeat of your future baby. From this point on, your regular gynaecologist can monitor the pregnancy.
Any more questions? We will be happy to help you.
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