In Vitro Fertilisation (IVF)
Description and indications
In Vitro Fertilisation is an Assisted Reproduction technique that consists of the extraction of eggs and their fertilisation in the laboratory with previously capacitated sperm. The process ends with the transfer of the resulting embryos to the uterus. It can be performed using two different procedures: conventional in vitro fertilisation (IVF) and sperm microinjection (ICSI).
Patients for whom this technique is indicated:
- Absence, obstruction or injury of the tubes.
- Decreased sperm count and motility or increased morphological alterations of spermatozoa.
- Ovulation disturbances.
- Failure of other treatments.
- Advanced age or for Preimplantation Genetic Diagnosis (PGD).
In vitro fertilisation usually begins with the stimulation of the ovaries through the use of drugs, whose action is similar to that of certain hormones produced by the woman.
The purpose of this treatment is to obtain the development of several follicles, inside which the eggs are found. The medication is administered by the patient herself with the appropriate instructions from the gynaecologist.
The process of ovarian stimulation is usually monitored with vaginal ultrasound scans that report the number and size of the developing follicles. This process usually lasts about 10-12 days but can vary depending on the circumstances of each woman.
The eggs are extracted by puncture of the ovaries and aspiration of the follicles, guided by ultrasound and vaginally. It is performed under sedation to avoid discomfort.
Once the eggs have been obtained, the laboratory must have the sperm from the couple or from an anonymous donor, as the case may be. The semen is prepared in the laboratory in order to select the most suitable sperm for fertilisation.
If in vitro fertilisation (IVF) is performed, the eggs and sperm will be cultured together in the laboratory under favourable conditions for them to unite as they would inside the woman's body.
If Sperm Micro Injection (ICSI) is performed, one sperm is injected into each of the mature eggs that have been retrieved.
The day after IVF or ICSI, the number of fertilised eggs will be determined and the number and quality of the embryos that continue to develop will be assessed on the following days of culture.
Embryo transfer consists of depositing the embryos into the uterine cavity through the vagina. The embryos will be transferred after a period of 5 days normally from the puncture. The procedure is absolutely painless and is performed under ultrasound guidance.
The maximum number of embryos to be transferred will be three, so if there are surplus embryos of good quality, they can be cryopreserved to be used on subsequent occasions.
From this moment on, the patient will continue to receive treatment during the waiting phase, will rest for 2 days and the pregnancy test will be carried out 12 days after the transfer.