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The steps of the classic In Vitro Fertilization Procedure

The whole step by step procedure of the IVF cycle

Εργαστήριο εξωσωματικής διάδικασίας

1. Identifying the causes of the infertility

The whole procedure begins by determining the causes of the infertility. The team’s gynecologist prescribes specialized medical examinations which will reveal the causes of the inability to achieve pregnancy. Detailed analysis both of the male and female factor, play a vital role in the selection of the most suitable treatment.

Click here to find out more about the male examinations
and here to read about the female examinations.

2. Causing and monitoring ovarian stimulation

Our team of Fertility Specialists together with the couple, mutually decide on the IVF therapeutic approach. Then, the gynecologist administers an individualized treatment protocol to the woman.

This is how the stage of inducing and monitoring the ovarian stimulation begins.
In order to increase the number of follicles, sponsored hormonal drugs are administered, which in turn cause controlled ovary hyperstimulation

3. Egg Collection

The next step is the egg collection, a procedure in which the oocytes are retrieved from the follicles. This procedure takes place in the clinic after mild sedation, it’s completely painless and has a duration of about 10 – 30 minutes.

The embryologist’s role is very important in this step too because his experience and specialization will ensure the successful collection of even the most obscure eggs (without nebulous cells) while at the same time preventing any damage to the eggs’ cell structure which would in turn affect the embryos.

4. Sperm Collection

This procedure takes place on the same day as the egg collection and is achieved with masturbation.

Ωάρια

5. Embryo culture

After the egg and sperm collection, it’s time for the clinical laboratory to take action. The collected eggs and sperm are placed in such a way so that fertilization can take place and create new embryos. This is achieved by using either the classic IVF method or the ICS method.

The classic IVF method is selected in cases where:
– The collected sperm is in perfect condition
– This is the woman’s first attempt at In Vitro Fertilization
– The collected eggs are abundant

The embryologist leaves the eggs and the spermatozoa together for the whole duration of the night and in the morning, he checks to see how many of them have been fertilized. Nature has already selected the sperm that will create life by fertilizing the eggs.

IntraCytoplasmic Sperm Injection (ICSI) is selected when sperm is prevented from penetrating the egg due to male infertility and also in cases where:
– the quality of the sperm is poor
– the amount of eggs available is low
– there have been previous attempts at IVF
– there is a low percentage of fertilized eggs

In this procedure, the eggs are cleansed and the most mature and suitable ones are selected and separated from the surrounding granulosa cells. It takes place 2-10 hours after the egg collection. A small hole is made in the egg’s outer shell to allow the sperm to enter. The embryologist uses a special microscope in order to magnify the spermatozoa and select the most suitable one.

In this critical moment, the embryologist’s experience in combination with a well-equipped laboratory can achieve the much-desired pregnancy.

Read more interesting facts about IntraCytoplasmic Sperm Injection (ICSI) here

6. Fertilization check and embryo development

The embryologist analyzes the embryo results and suggests the transfer of either “fresh” 3-day-old embryos or 5-day-old blastocysts. The Greek Legislation regarding In Vitro Fertilization specifies the permitted amount of transferred embryos, taking into account factors like the woman’s age, previous pregnancy attempts and the cause of the couple’s infertility.

7. Embryo Transfer

The final but very critical stage which can determine the positive outcome of the whole IVF procedure is the embryo transfer stage. The embryos are placed in the uterine cavity with the help of a thin, flexible catheter. It is a painless procedure and no special preparation or sedation is required.

If there are any remaining excess embryos of exceptional quality, they are cryo-preserved in case the couple wishes to use them in the future.

Γονιμοποίηση ωαρίου σπερματοζωαρίου

The embryologist and the

couple’s DNA

The embryologist comes in contact with the couple’s DNA as well as the collected sperm and eggs. The follicles conceal eggs that have a unique genetic structure, separating them from the rest and granting them a special fertilizing dynamic. On the other hand, spermatozoa have different composition, form, features and strengths in relation to egg fertilization. So we can easily reach the conclusion that every embryo is different because it is the result of the union between a single sperm and an egg both of which that have different DNA.

The goal of the In Vitro Fertilization procedure is a healthy baby and the embryologist plays a huge part in achieving that goal

IVF & Success Rates

In Greece, IVF success rates range from 25% to 45%

In Vitro Fertilization is both therapeutic and diagnostic in nature. It’s a process that allows us to monitor and explain the fertilizing capability both of the egg and the sperm while bypassing any obstacles.

We can create an embryo, evaluate its quality depending on its architecture and therefore select the best possible samples to be used for the procedure. What we cannot do is to know its genetic direction.

This method can solve infertility issues in women (blocked fallopian tubes, fibroids, endometriosis, etc) and in men (reduced mobility, low sperm quantity, abnormal sperm morphology).
Many factors can determine the success rate of each attempt with the most important ones being the woman’s age and the infertility cause. The success rate can actually reach 60% – 65% in young ages.

You can watch a related video about the causes and treatment of endometriosis.
You can also read this very useful article about the success rates of In Vitro Fertilization (IVF) and Intrauterine insemination (IUI)

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Dimitris Papadopoulos, Clinical Embryologist, REA