In vitro fertilisation (IVF)

In Vitro Fertilisation (IVF-ICSI) is recommended in the following cases:

• Tubal factor infertility. Abnormalities in the Fallopian Tubes which prevent sperm and eggs from meeting and joining together naturally.
• Severe male factor infertility. If the number or quality of spermatozoids is inadequate for a cycle of artificial insemination (REM < 5 million).
• Cervical factor infertility. Cases of endometriosis and polycystic ovaries, illnesses which lead to functional abnormalities that complicate processes such as ovarian stimulation, egg quality, fertilisation of eggs or embryo implantation; advanced maternal age, ovarian failure and diminished ovarian reserve.
• Unexplained infertility. This generally results in fertilisation abnormalities or poor quality during embryo development.
• Previous failed artificial insemination cycles. When, after undergoing 3 cycles of insemination, a pregnancy has not been achieved.
• Patients who previously had eggs frozen through a cycle of Fertility Preservation.

Generally speaking, all of the mature eggs obtained following the ovarian stimulation and egg retrieval procedure will be fertilised so that the best embryos can be selected for transfer, thus optimising treatment and increasing the likelihood of a pregnancy in the shortest amount of time.

In certain cases, some of the eggs obtained can be frozen for the future while the rest will be fertilised.

In Vitro Fertilisation (IVF) is an assisted reproduction technique in which the egg is fertilised by a spermatozoid in the laboratory rather than inside the woman’s body. The purpose is to create embryos which will later be transferred to the woman’s uterus.

This requires an ovarian stimulation process in order to mature several eggs which will be collected during the egg retrieval procedure while the patient is sedated. Following fertilisation, the embryos that have been created will remain in the laboratory until it’s the best time to transfer them to the uterus.

The In Vitro Fertilisation process normally begins on the second or third day of the menstrual cycle. That’s when an ultrasound scan will be performed to confirm that both ovaries are inactive before starting the process of stimulation. The treatment protocol to be used will be personalised and will be dependent upon the gynaecologist’s assessment of your case. The stimulation will last about 10-12 days, and during this time 2 or 3 ultrasound scans will be performed until the follicles have reached the optimal size.

The embryo transfer will be carried out 3 or 5 days following egg collection. Following transfer, the patient will need to wait 10-12 days before taking the pregnancy test (BhCG blood test) to confirm a pregnancy.

Success rates with In Vitro Fertilisation mainly depend on the reasons behind the patients’ infertility and the treatment that is prescribed, as each patient case is unique as is each treatment cycle.

The age of the female is one of the most important factors given that a woman’s fertility declines as she ages. The chances of achieving a pregnancy with own eggs after the age of 42 is less than 10%.

At Ginemed, our success rates surpass the national and international averages and are audited externally. You can view our annual results here or find out your chances directly by contacting us.

During in vitro fertilisation treatment, as the ovaries are stimulated and several follicles mature and develop causing them to increase in size, it’s possible for the patient to note abdominal swelling, a feeling of heaviness, swelling in the legs, etc. These symptoms can appear beginning around the fifth or sixth day of stimulation and disappear after the egg collection has been performed. The symptoms are generally mild and temporary.

You can continue with your usual activities and there are no restrictions, though you should avoid stress to the extent possible and make sure to get enough rest. In addition, you should avoid contact with toxins and get at least 30 minutes of physical activity daily, such as walking. What’s good for our health is good for reproduction.

The day of the embryo transfer is one of the most exciting days of assisted reproduction treatment. On this day, the embryos which will make the future pregnancy possible are transferred to the woman’s uterus.

Choosing the best time for the transfer largely depends on embryo development in the laboratory. In a natural pregnancy, the embryo implants in the uterus after 5-6 days of development. This means that Day 0 is the day that the egg is fertilised by the spermatozoid, which in IVF translates to the day of egg collection and the sperm sample. That’s why when an embryo continues developing properly until Day 5 and reaches blastocyst stage, the chances of pregnancy increase due to the fact that:

• The best quality embryos can be selected for transfer.
• This improved selection process makes it possible to transfer the best embryo and just one at a time, avoiding the risk of a multiple pregnancy.
• The uterus is more receptive.

A delayed embryo transfer is one in which the embryo transfer is performed using embryos that were frozen directly after the In Vitro Fertilisation (IVF) cycle for either personal or medical reasons.

The vitrification (freezing) process generally takes place on day 5 or 6 of embryo development, which is when the embryos have reached blastocyst stage. According to embryologists, this is the best time to carry out the embryo transfer as the embryos which correctly reach this stage are of the best quality and, in turn, have better survival rates post-thawing.

This type of treatment makes it possible to transfer good quality embryos that were frozen after the IVF cycle rather than being transferred in a fresh IVF transfer cycle, in turn increasing cumulative success rates.