Since the first IVF baby, Louise Brown, was born in England in 1978 more than 5 million children have been born using this technique.
We are going to explain in plain language each step of the IVF process.
1. Once medical histories have been studied, ovarian stimulation is the first step. Starts from the onset of menstruation and lasts about 9 days. Its purpose is to obtain an adequate number of good quality oocytes or eggs.
– In order to adapt the medication to the body’s response, which varies even within each cycle, we continue the ovarian follicle development through ultrasound scans and the occasional blood test.
– To achieve this we follow the medication timetable outlined and prescribed by the gynaecologist which is designed for each patient.
2. When the time comes, we will use an injection of HCG (Ovitrelle) (drug name country) to provoke the final maturity of all the eggs that have been developed and monitored. This will be synchronized 36 hours beforehand.
3. The eggs are collected in about 10 minutes in an outpatient basis. The procedure is completed under light sedation and with the help of vaginal ultrasound and with minimal discomfort and risk to the patient.The gynaecologist aspirates follicular fluid which is then immediately studied by the biologists who then prepare the retrieved eggsfor fertilisation.
4.At the same time, a biologist prepares and capacitates the semen to increase its fertilising abilities
5.Whenever possible we prefer to be as natural as possible and thus apply classic IVF. That is, we leave thousands of spermatozoids around the egg so that the strongest among them fertilises it.
6.If semen quality is reduced, we apply the ICSI technique which gives Nature a helping hand. It involves putting a single pre-selected sperm inside the egg.
7.We also know that, just as it happens in Nature:
1. Only 60-70% of eggs retrieved are normal and mature.
2.Only 60-70% of these are fertilised.
3.Not all fertilized embryos develop normally
Throughout the process, which can last up to five days, we evaluate the characteristics of embryonic development and transfer one or two of the embryos which have the best chance of achieving pregnancy.
What are the advantages?
Firstly as it represents natural selection of the best embryos as the weaker ones will not survive the days following fertilisation and so the survivors are the most likely to succeed.
Secondly it allows for the possibility of being able to freeze suitable embryos for future transfers, using a technique called vitrification. This avoids all the previous process of stimulation, collection and embryo culture for a new attempt in the event of the first cycle failing or indeed if you would like other children in the future.
8.After 18 hours we find out the number of eggs showing the first signs of fertilisation.
9.Progesterone is then prescribed and taken in order to prepare the endometrium where the embryo is implanted.
10.48 hours later, on day 3, the embryos now have between 7 and 9 cells and, depending on their quality, number and quantity, the time of transfer is decided.
11.From the 4thday, the embryos are called blastocysts. They cells are already compacted and can even be seen to move. The 5th day is the maximum amount of time the embryos can be outside the womb.
12.Now the most anticipated and desired event takes place- the transfer. There is no need for sedation. It is a painless process where the gynaecologist transfers the resulting embryo into the womb using a thin ultrasound-guided catheter which allows him or her to see the uterus and the best site to deposit the embryo.
13.After about 10 or 11 days a maternal blood test is performed to confirm the success of the procedure. This looks at the presence of BHCG in the blood. This is the hormone that early embryos produce. Its value helps us evaluate the pregnancy as well as the possibility of having twins.
14.Pregnancies and future children conceived through assisted reproduction techniques develop in the same way as those achieved naturally.