In vitro fertilization. IVF

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In vitro fertilization enables us to reach higher success rates than in natural conception. In many cases over 60% per attempt.

In Spain, this treatment is ruled by a legislation that forces the couple to formalize an informative consent authorizing us to proceed and to carry out analysis that allows us to reject the presence of serious illnesses for the health of the future child (syphilis, different types of hepatitis, AIDS).

An IVF cycle has different stages:

  1. Research and preparation of the couple.
  2. Ovarian stimulation.
  3. Egg retrieval.
  4. Laboratory fertilization: Ovocites, spermatozoid and embryo culture.
  5. Embryo transfer to the mother.

1. Research and preparation of the couple

It intends to assure that the IVF cycle is the correct decision to solve the infertility problem, and that the couple is physically and psychologically ready to start it. If this is not the case, the patients are directed to other treatments.

2. Ovarian stimulation

In order to maximize the possibility of pregnancy, we need to obtain more than one ovocites, which is what normally a woman’s ovary produces. In order to stimulate the production of several ovocites and guarantee the good quality of them, we provide a combination of medicines whose response is controlled by means of vaginal ultrasound scans and, occasionally, blood tests.

The whole process lasts, depending on each case, between 8 and 12 days approximately. The treatment can be interrupted in case a low or an exaggerated ovarian response is observed.

3. Ovocites collection

Once the ovocites are mature, we collect them by means of vaginal ultrasound scan, under local anaesthesia and smooth sedation; that is to say, in a totally painless way. This process only lasts 15 minutes and it does not require operation, being hospitalized, stitches or general anaesthesia.

4. Laboratory fertilization

Insemination

The gathered eggs are taken into the IVF laboratory where they are prepared to be inseminated. In parallel, the semen is activated to improve and to increase its virility. Eggs and spermatozoids are put together over a period of several hours within an incubator that provides the ideal conditions for its fertilization and development. Until the next day we will not know the number of fertilized eggs, but the fertilization rate is 60%; that is why several embryos are usually obtained.

5. Embryo transfer

The phase of embryo culture can last between two and five days. This enables us to observe the embryo development in order to select the ones with best quality. Therefore nature will reject the ones which are weaker. In general, it can be said that in a long culture we have fewer embryos, but with better quality than in a short one.

The implantation rate, that is to say, the percentage of embryos that succeed, is sometimes between 40 and 50%, therefore, in order to avoid multiple pregnancies we propose in many cases to transfer only one embryo and freeze the rest of them. Then, the embryos are placed in the uterus in a fast, comfortable and painless procedure.

Embryo criopreservation

If there are more embryos with good quality, they are cryopreserved, that is to say, they are frozen to allow future transfers, either if pregnancy does not occur in the first transfer and it needs to be done again, or otherwise, to allow the couple to have a child again, without the necessity of undergoing the IVF process from the beginning. The pregnancy rate obtained after cryopreservation reaches 40%.

The fact of receiving embryos does not mean that there is pregnancy. Unfortunately, the implantation rate in human beings is not high and not all the transfers imply pregnancy. In most of the cases it is not possible to know why the embryos have not succeeded, because in nature the number of embryos that do not implant is very high. Nowadays, there are several treatment lines studying this situation.

Our aim is not to obtain multiple pregnancies, but only to obtain the highest rate of success per cycle. However, since the embryo does not always implant, we transfer in many cases two or three embryos. Transferring more embryos does not imply a benefit, but just a risk of multiple pregnancies.

Pregnancy

Once gestation, is reached pregnancy will develop with total normality, without requiring special controls except for the usual attention paid to much wished pregnancies. On the other hand, the possibility of miscarriage, malformations, etc, is the same as the one for general population.

If the treatment is over and pregnancy has not been achieved, the Committee on Reproduction, formed by the team responsible for the case, will revaluate the situation to advise the patients of the following steps to make. For that purpose, a personal interview with the couple is carried out.

This information can be modified due to the constantly evolving law and medical changes that happen in Reproductive Medicine and due to the specific particularities in every case. Take into account that all of us, doctors, biologists, nurses, laboratory and administration staff do our best to help the couple to achieve our common purpose: having a child.

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