In Vitro Fertilization
Today there are multiple indications to undergo in vitro fertilization.
Today there are multiple indications to undergo in vitro fertilization.
It is a treatment that consists of collecting a woman’s eggs and fertilizing them with sperm in a laboratory to obtain the most ideal conditions for the development of embryos.
Intracytoplasmic sperm injection is a technique within the in-vitro treatment that consists of the microinjection of one sperm into each egg.
This treatment is recommended in multiple clinical scenarios although the most common include severe male factor, when there is an alteration in the Fallopian tubes or when patients have had several treatments with artificial insemination without success.
In this first phase the ovaries are stimulated through hormone administration to obtain the highest number of eggs with the best quality. The patient will have to come to the clinic for transvaginal ultrasounds so we can see the number and the size of these follicles. Hormone levels will also be determined through a blood test.
The extraction of the oocytes is done through follicular aspiration. The oocytes are extracted through an ultrasound guided needle that is introduced in the vagina. The patient is under sedation and the procedure usually lasts 30 minutes. After 3 to 4 hours under observation in our clinic, the patient will be able to go home and continue with their normal daily activity.
The oocytes obtained during the egg retrieval are transferred to the laboratory where they are processed in culture media and placed in an incubator.
This step consists of putting the oocytes in contact with the sperm. Fertilization of the oocyte can be observed 17-20 hours post insemination. This is manifested by the presence of two pronuclei in the cytoplasm of the oocyte and two polar bodies in the perivitelline space of the oocyte.
The fertilized oocytes start their first embryonic divisions 12-14 hours post fertilization. Embryos are analyzed individually and each is distinct. They are classified by their morphological characteristics such as number of cells, the size of each cell, the presence of nuclei and cellular fragmentation as well as the rate at which they divide.
The day of the transfer, after having consulted with your gynecologist and embryologist, you will decide the number of embryos to be transferred. This of course depends on the quality and development of the embryos. According to Spanish law, the maximum number of embryos transferrable is three. This number is set to try to avoid multiple gestations. The egg transfer is done in the surgery suite but you will not need any type of anesthesia. Before the transfer, our embryologist will identify you asking you for your first and last names, date of birth and national identity card number. The embryos are transported from our laboratory to the surgery suite in the most optimal conditions. The embryos are then introduced into the uterus through a catheter by the gynecologist.
In the event that the patient should have embryos left after the embryo transfer, they would be vitrified and preserved in our bank with prior consent from our patients.
These embryos can be used in future cycles if that is what the patient decides. This can be due to a failed first try or because our patients desire another pregnancy. The cycle used when there are cryopreserved embryos is called (Frozen embryo transfer) and it is evidently a much simpler cycle as far as patient preparation is concerned. This is due to the fact that the patient does not have to undergo preparation for an egg retrieval procedure.