In vitro fertilisation

                                                                   In vitro fertilisation

In vitro fertilisation (IVF) is a process by which an egg is fertilised by sperm outside the body: in vitro. IVF is a major treatment for infertility when other methods of assisted reproductive technology have failed. IVF success rate is usually higher than in any other of ART treatment. There are over 3 million people born with the help of IVF.

IVF procedure consists of different stages:

  1. Controlled ovarian hyperstimulation and maturation of the follicles – an induction of multiple follicle growth with medications, used to get approximately 10 – 20 oocytes. Different schemes of stimulation can be chosen according to patient’s health status and ovarian reserve. 35 hours before oocyte retrieval a special medication is injected to perform a final maturation of the oocytes.

  2. Puncture of the ovaries and oocyte retrieval - The eggs are retrieved from the patient using an ultrasound-guided needle piercing through the vaginal wall to reach the ovaries. Through this needle follicles can be aspirated, and the follicular fluid is passed to an embryologist to identify ova. It is common to remove between ten and thirty eggs. The retrieval procedure usually takes between 20 to 40 minutes, depending on the number of mature follicles, and is usually done under conscious sedation or general anaesthesia.

  3. Fertilisation of the eggs – The eggs retrieved are fertilized in the lab with the semen of a husband or a donor sperm. Embryos then are cultivated in a special media for 3 to 6 days. For fertilization a simple IVF or ICSI can be used. Woman by that time is prepared for the embryotransfer.

  4. Embryotransfer – putting embryos in the uterus.

The whole procedure lasts about 4 to 5 weeks.

Additional features of IVF cycle.

ICSI – intracytoplasmic sperm injection. Injection of a single sperm directly into an egg in order to fertilise it. The fertilised egg (embryo) is then transferred to the woman’s womb. ICSI is often recommended if: 1. the male partner has a very low sperm count  2. other problems with the sperm have been identified, such as poor morphology (abnormally shaped) and/or poor motility (poor swimmers) 3. at previous attempts at in vitro fertilisation (IVF) there was either failure of fertilisation or an unexpectedly low fertilisation rate 4.  the male partner has had a vasectomy and sperm have been collected from the testicles or epididymis (sperm reservoir) 5.other situations where the sperm count is zero and donor insemination is not wanted 6. the male partner does not ejaculate any sperm but sperm have been collected from the testicles 7. the male partner has had problems obtaining an erection and ejaculating. This includes men with spinal cord injuries, diabetes and other disorders.

To ensure a high efficiency of ART cycle ICSI technology is used in 100% of IVF.

Cryoconservation and vitrification – preservation of the embryos be means of freezing them with different techniques. These techniques allow to save 50 to 95 % of embryos when unfreezed, thus allowing to preserve embryos for future pregnancies.

Oocyte donation – closer observed in the corresponding topic.

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