What is In Vitro Fertilization?
When is In Vitro Fertilization Recommended?
- Previous unsuccessful attempts at Artificial Insemination Techniques.
- Unknown causes of infertility or sterility.
- Absence or damage to the fallopian tubes.
- Decrease in the number or motility of sperm, and/or defects in the sperm.
- Ovulation and/or immunological disorders.
When is In Vitro Fertilization with Donor Sperm Recommended?
- Severe male factor infertility.
- Previous failed attempts at conception with the spouse or partner’s semen.
- Single women.
- Female homosexual couples.
The In Vitro Fertilization Procedure
PHASE I: STIMULATION
IVF generally begins with the female undergoing a hormone therapy to guarantee multiple follicle development by taking certain medications. We need to obtain more than one egg – which is what normally happens during the female’s natural cycle – in order to be able to work in the Lab and obtain an acceptable number of embryos. This phase tends to last between 10 and 12 days depending on protocol and how the female responds to the process, and is monitored with ultrasounds and hormone testing.
PHASE II: FOLLICULAR ASPIRATION AND EMBRYO CULTURE
Once the doctor has checked how the female is responding to the medications and has similarly made sure that the follicles have reached an appropriate size and quantity, we will schedule a procedure called follicular aspiration in order to retrieve eggs from the woman’s ovaries. This intervention is performed in the Operating Room under sedation in order to prevent any discomfort. The procedure is ultrasound guided and lasts approximately 15 minutes. The patient will be able to go home on the same day after about 3 hours.
The semen (either from the partner or donor) is also prepared in the Lab in order to select the most appropriate sperm for fertilization. Insemination with the eggs can be carried out either by Conventional In Vitro Fertilization, or by Intracytoplasmic Sperm Injection (ICSI). The latter involves introducing a pre-selected sperm directly into the cytoplasm of a mature egg.The day after the follicular aspiration has taken place we will be able to determine the number of fertilized eggs, or pre-embryos, that we have. The embryos are cultured for three to five days either in conventional incubators with controlled CO2 and temperature levels, or in a Time-Lapse EmbryoscopeTM incubator. Throughout every step of the process, the patient will be in direct contact with the lab personnel in charge of her case in order to keep her informed about the evolution of the process.
PHASE III: EMBRYO TRANSFER AND PREGNANCY TEST
The embryo transfer consists of the introduction of the best embryos into the uterine cavity. This is a painless, outpatient procedure that does not require sedation or hospitalization. It is carried out in the Operating Room and lasts about 10 minutes. Following the procedure, the patient will continue taking a hormone therapy to encourage a viable pregnancy. If any more good quality embryos are left remaining after the treatment is finished, they will be cryopreserved by means of vitrification (flash-freezing). This technique will allow us to transfer the extra embryos during a later cycle, without needing to undergo the phases of ovarian stimulation and follicular aspiration again. A pregnancy test will be performed 16 days after the follicular aspiration has taken place.