In Vitro Fertilization
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WHAT IS IN VITRO FERTILIZATION?
Consists in the union of the egg of a woman with a man's sperm in the –in vitro– laboratory, in order to obtain embryos of good quality that can lead to a pregnancy after their transfer to the uterus.
In the in vitro fertilization, the eggs are extracted by using a simple process which requires no wounds in the abdomen, called ovarian puncture. This procedure consists of making a puncture in the ovarian flocs to suck your content – the follicular fluid - and thus retrieve the eggs.
TYPES OF FERTILIZATION IN VITRO
1. Own eggs:
The IVF with own eggs and sperm of the couple is known as an own In Vitro fertilisation since it does not interfere with genetic material from a third party and only involved two members.
2. Egg donor
IVF with egg donation is an assisted reproduction treatment in the same IVF with an egg from an anonymous donor and the sperm of the recipient couple. This procedure makes possible the miracle of having a child to patients who are unable to conceive by themselves, or that they could not otherwise have children.
3. Genetic Preimplantation Diagnosis:
In Vitro Fertilization (IVF) with preimplantation genetic diagnosis, is the combination of both procedures for the presence or absence of certain genetic abnormalities or alterations in the number of chromosomes in the embryos before their transfer into the uterus. Detecting chromosome problems in the embryo that is transferred, decreases the risk of miscarriage and increase the odds of having a healthy and free of diseases baby such as Down syndrome, Turner or Klinefelter
PROCESS OF IN VITRO FECUNDATION
Step 1
Ovarian Stimulation
This involves daily injections that the patient may put herself. Naturally, the woman produces a single egg each month, but thanks to this hormone treatment, which lasts between 15 and 25 days, causes a growth multifolicular that develops several of them. This will allow us to later get several eggs, which will fertilize and give rise to embryos.
Step 2
Ovarian puncture or follicular
It is a simple procedure that lasts between 15-20 minutes and is performed in the operating room under sedation. We access to the ovaries from the vaginal cavity and puncture each of the follicles. The fluid aspirated from each follicle is the one that contains the eggs that later may be fertilized in the IVF laboratory.
Step 3
Preparation of semen
The semen sample is prepared in the laboratory to optimize its characteristics and thus increase the possibility of obtaining a pregnancy.
Step 4
In Vitro Fertilization
This procedure can be carried out using two different techniques:
The first is the technique of conventional IVF, in which are deposited each of the eggs obtained from the puncture in drops of semen previously prepared, in a way that simulates in the culture plate by the process of natural fertilization. The second technique is using the intracytoplasmic sperm injection (ICSI): it is a technique of high accuracy, that is that our embryologists individually selected the best sperm and introduce one-to-one on the inside of each egg.
Step 5
Embryo culture
The cultivation of embryos lasts between 5 and 6 days. The embryologist is responsible for providing the culture conditions necessary for the embryos in each phase and simultaneously observe and analyze their development to be able to evaluate their quality.
Step 6
Embryo transfer
To make the embryo transfer, you must prepare in advance the uterus of the patient, ensuring that the endometrium has the proper thickness to receive the embryo. During the transfer, we introduce the best embryo in the uterus with the help of a cannula. This is performed in the operating room, but it is a quick and painless procedure, so it is outpatient and does not require any type of anesthesia.
Step 7
After the procedure
After the embryo transfer, the woman may be asked to rest for the rest of the day to resume their normal activities the next day. Women who undergo IVF should use progesterone vaginal or oral route after the embryo transfer. More or less 12 to 14 days after the embryo transfer, the woman should take a pregnancy test.
IN WHAT CASES IS INDICATED IN VITRO FERTILIZATION?
In vitro fertilization can be performed with a sperm donor or the partner's sperm and enables us to facilitate the process of fertilization when there are other causes that make it difficult. This treatment is recommended for:
Women after several artificial inseminations without success.
Women with advanced endometriosis, with a probable condition in the tubes and in the oocyte quality.
Women of advanced agewith eggs of poor quality.
Women with injury in the fallopian tubes or the absence of them.
Women with hydrosalpinx.
Couples in which the it is necessary to make a genetic pre-implantation study.
Couples in which the man have poor sperm quality (male factor moderate or severe).
WHAT RESULTS ARE OBTAINED WITH IN VITRO FERTILIZATION?
The chances of achieving pregnancy with a treatment of In Vitro Fertilization are very high, thanks to the technical advances and the latest technology developed. In addition, depending on the cycles that occur, increases the chances of pregnancy. For example, after four cycles of IVF, the pregnancy rate can reach 60%.
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