In-Vitro Fertilisation (IVF)
In-Vitro Fertilisation (IVF) is an assisted reproduction technique that enables us to fertilise eggs with sperm outside of the uterus in a laboratory setting. Embryos obtained with this method are later placed in the uterus.
Types of In-Vitro Fertilisation
The Treatment step by step
1. Stimulation of the ovaries
In vitro Fertilisation and Intracytoplasmic Sperm Injection usually begin with the stimulation of the ovaries through the use of medication, the action of which is similar to that of certain hormones produced by women. The purpose of this treatment is to obtain the development of several follicles, inside which the eggs can be found. In order to avoid spontaneous ovulation, other drugs with hormonal action will be prescribed.
2. Follicular puncture and egg retrieval
The eggs (or oocytes) are extracted by a puncture of the ovaries and vaginal aspiration of the follicles under ultrasound supervision. This intervention is usually performed on an outpatient basis and requires anaesthesia and subsequent observation for a variable period.
The eggs (or oocytes) obtained are prepared and classified in the laboratory. The number of eggs that are extracted during the egg retrieval, their maturity and quality cannot be accurately predicted, and there is even a possibility that no or no viable eggs are obtained.
2.1 Preparation of the semen
Couple’s semen: The male collects the semen sample in the same room his wife is assigned to. Later, it is collected by a nurse to take it to the laboratory and process it.
Donor semen: The semen sample comes from our sperm bank where the most suitable donor will be selected in accordance to current legislation.
The cryopreserved semen is thawed in the Andrology Laboratory and will be processed for later use in in vitro fertilisation.
The Intracytoplasmic Sperm Injection (ICSI) is performed, the sperm is microinjected, so that one sperm is introduced into each egg.
4. Embryonic Culture
16-18 hours after IVF or ICSI, the number of fertilised eggs will be determined, and they will be left in the incubator for observation during the following days of culture with special monitoring. Every day the number and quality of embryos that continue to develop will be assessed. The embryos will be kept in the laboratory for a period of 2 to 6 days, after which they will be transferred and / or frozen in some cases.
At the Tambre Clinic we use Time-Lapse systems for evaluating embryonic viability through morphokinetics.
The Embryo transfer is a simple and painless procedure that is performed with the help of an abdominal ultrasound. It consists of inserting the embryo in the uterine cavity, with a very fine cannula. In order to promote embryonic implantation. Hormonal treatment is also prescribed.
It is important that you have previously drunk a couple of glasses of water and have a full bladder, which will make it easier to see in the ultrasound where to place the embryos exactly. After the transfer, you will rest for approximately half an hour in the room until you can go home. For this, it is recommended that you bring a nightgown or robe. This will make the wait more comfortable.
The embryo transfer can be done on day +2 (48 hours after puncture), on day +3 (after 72 hours), or 5 days later if a long culture and blastocyst transfer is performed. The day of the transfer depends on each personal circumstance of the cycle and the patient.
The Spanish Assisted Reproduction Law allows a maximum number of 3 embryos to be transferred. In order to avoid multiple pregnancies, at Tambre we usually transfer a maximum of two embryos and in many occasions, it is advisable to transfer only one.
Finally, if there are viable embryos left from a previous In vitro fertilisation cycle, they will be preserved by freezing or vitrification.
6. Pregnancy test
The pregnancy test is performed 10 days later. It consists of the determination of a hormone: the beta hCG in the blood. Its level will be examined to know more precisely how the pregnancy is developing.