In-vitro fertilisation (IVF) In-vitro refers to glass as glass dishes were first used to achieve the first pregnancy in 1978.Fertilisation is now achieved using plastic dishes to unite the eggs and sperm to achieve a number of embryos to transfer to the mothers uterus. This technique is carried out in a laboratory using the latest technology and is used to treat infertility when previous kinds of treatments such as Intrauterine Insemination have failed. It is also a solution to infertility problems arising from the male factor, tubal factor (obstructed fallopian tubes) and unexplained infertility, among others.

The insemination of oocytes can be carried out by means of the conventional IVF technique where eggs are mixed with a specific concentration of spermor byIntracytoplasmic Sperm Injection (ICSI). The latter is recommended in cases of severe male infertility, previous fertilisation failures with IVF, previous Intrauterine Insemination treatment failures, or situations in which we have a limited number of oocytes available.

Phase 1 Your first visit

Personalised patient care

Before the start of IVF/ICSI treatment, we will perform an ultrasound scan to rule out any abnormality which could be present, and also tailor the ovarian stimulation to your needs. Extensive counselling will familiarise you with the planned treatment.

Phase 2 Ovarian stimulation (08-12 days)

Ovarian stimulation

This procedure is necessary for improving the chances of success, as in natural terms, women only produce one or two follicles, and therefore, one or two eggs, in each menstrual cycle. This treatment consists of stimulating the ovary so that it produces more eggs, allowing the creation of a greater number of embryos. The treatment lasts 08-12 days. During treatment, a series of ultrasound scans will be performed – around 3 or 4 – and the level of blood estradiol and progesterone will be determined to check that the growth and development of the follicles are normal. In case you are coming from abroad, you will be able to complete this phase in your home country under our supervision, and you will only have to come to IVI for the final ultrasound scan, follicular puncture and embryo transfer.

Phase 3 Egg retrieval and the laboratory (5-6 days)

Egg retrieval

At the ultrasound, when the follicles have reached an appropriate size (>16mm) then an injection of hCG will be given to mature the eggs in the follicles and follicular puncture will be scheduled 36 hours later.

Puncture is performed in the operating theatre under local anaesthesia or sedation, so that the patient does not experience any discomfort during the procedure, which takes approximately 15 minutes.

Fertilisation of the eggs

Once we have collected the eggs following follicular puncture and obtained the spermatozoa sample from the husband, we will proceed to fertilisation of the eggs. This process can be performed through the conventional IVF technique, which involves placing the eggs surrounded by a specific concentration of spermatozoa in the culture dish, or using the technique of ICSI, which consists of holding the egg and injecting a live spermatozoon using a fine needle

Embryo culture in the laboratory

The embryos resulting from fertilisation of the eggs are observed dailyin the laboratory and are classified according to cell number and quality. The development of some embryos may be arrested, and these will be rejected as non-viable.

NB: In certain cases, embryo culture may take place in the embryoscope. An embryoscope is an advanced embryo incubator which allows the embryo to be observed second- by-second without having to remove it from the incubator, from the point when in-vitro fertilisation takes place to the moment when it is transferred into the uterus. This leads to a substantial improvement in the results of embryo implantation, and consequently a greater number of pregnancies, while using a non-invasive technique.

Phase 4 Transfer

Embryo transfer

This involves introducing the best embryo(s) into the maternal uterus using a fine tube called a catheter, which has been specially designed for that purpose. The procedure is carried out in the operating theatre, although in this case there is no need for anaesthetic, as it is a quick and painless process. Regarding the number of transferred embryos into the womb of the wife, we follow the European guidelines in order to reduce the risk for multiple pregnancy.

Phase 5 Pregnancy test

Pregnancy test is conducted approximately 14 days post transfer.>

Phase 6 Ultrasound scan

If the test is positive, a vaginal ultrasound scan will need to be carried out one week later in order to see the gestational sac, and about 2 weeks later to see the foetal heartbeat.

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