In Vitro Fertilization (IVF)

How is performed?

With In-Vitro Fertilization (IVF), the union of the egg and sperm (fertilization) does not occur within a woman’s fallopian tubes, but within a specialized laboratory. IVF has been performed since 1978 and its success rates have improved substantially as technology advances and specialists gain more experience.

IVF can help couples with conditions that, until recently, had prevented them from achieving their dream of being parents:

• Ovulation problems 
• Blocked fallopian tubes 
• Endometriosis 
• Poor sperm quality 
• Advanced maternal age

This procedure consists on five basic steps:

Step 1: Ovarian Stimulation

This procedure lasts about 10 days, during which women are given medications to stimulate egg production. Typically, a woman produces one egg per month, but fertility medications help the ovaries to generate multiple eggs.

Medications are administered either orally or by injection and it is important to mention that, if a woman is not carefully monitored by an experienced specialist, this medications can entail certain risks such as multiple pregnancies and ovarian hyperstimulation syndrome, which can have serious consequences.

Around every three days the patient must submit to a transvaginal ultrasound and blood tests to confirm her reaction to the medication, verify her hormone levels and follow the growth of her follicles, which contain the patient’s eggs.

Step 2: Egg retrieval

Transvaginal egg retrieval is the extraction of a patient’s eggs by means of an ultrasound probe adapted with a thin needle. With the patient under sedation, this needle gently crosses the vaginal wall and is carefully guided trough ultrasound to reach the ovaries, where it will begin aspirating the follicular content in order to obtain the egg growing inside them.

If performed by skilled personnel using the appropriate technology, egg retrieval is a very simple ambulatory procedure, allowing the patient to resume normal activities after one day of relative rest. Ingenes’ operating rooms are completely equipped with the best technology, which is used by our experienced team to perform our patient’s egg retrievals.

It is important to point out that the number of eggs recovered is directly related to the chance of success via In-Vitro Fertilization. An ideal egg retrieval is a procedure in which between10 to 20 eggs are obtained, but every case is different and must be managed accordingly.

Step 3: Fertilization

The semen sample is processed through a technique known as sperm capacitation, which aims to increase the sperm sample fertilization potential. In this procedure, a series of washing and centrifugation techniques are used to eliminate cell debris, bacteria, leukocytes, poor quality spermatozoa and seminal secretions.

Once processed, the best sperm are placed along with the best quality eggs in a special cell culture dish to allow fertilization to take place. Generally, the sperm takes a few hours to fertilize the egg.

Step 4: Embryo culture

Once fertilized, the eggs become embryos, which are kept in special incubators within the Assisted Reproduction Laboratory. The embryos are carefully monitored by our qualified team to follow their growth and, after a few days of supervised culture, the best embryos are selected to be transferred back into the maternal uterus.

Step 5: Embryo transfer

The embryos are placed inside the maternal uterus using a thin catheter introduced vaginally. This technique (which is known as embryo transfer) is painless, lasts only a few minutes and is performed under abdominal ultrasound guidance.

During this procedure multiple embryos are usually introduced into the patient’s uterus to increase the chances of pregnancy, which can result in a multiple pregnancy.

About embryo transfer

Thanks to our IVF specialists’ experience, at Ingenes we have developed advanced embryo culture and selection techniques that allow us to select an adequate number of embryos to transfer, reducing the risk of multiple pregnancies. With this in mind, the best option is to transfer of embryos in the blastocyst stage, that is, five or six days after fertilization.

Until a few years ago, embryos were usually transferred on the third day after fertilization, as it was very difficult to keep them alive under laboratory conditions.

Nowadays technology allows us to perform extended embryo culture, allowing us to take them to the blastocyst stage. This enables a better embryo selection to distinguish those with higher quality and greater implantation potential. 

Thanks to this technique it is thus possible to transfer less embryos instead of the three or four day three embryos that are usually transferred. While this doesn’t completely eliminate the risk of multiple pregnancies, it does reduce it considerably without compromising In-Vitro Fertilization success rates.

The blastocyst stage embryo transfer (five or six after fertilization) is also concordant to the natural process inside a woman’s body since it is around the fifth day when a naturally fertilized embryo usually reaches the uterus from the fallopian tubes.

Final steps of the procedure

Once the In-Vitro Fertilization (IVF) procedure is concluded, the patients must wait about two weeks to have a pregnancy test done. However, she must use a progesterone supplement administered vaginally or intramuscularly up to the day of the pregnancy test, continuing for 8 to 10 weeks if the test is results are positive. This hormone helps thicken the uterine lining, enabling a correct embryo implantation.