In vitro fertilization (IVF) is an advanced reproductive technique that is more complex than artificial insemination. To undergo IVF, a medical laboratory with the necessary technology and a biologist are required to combine an egg with a sperm.
What is In Vitro Fertilization?
IVF involves fertilizing eggs with sperm in a laboratory, resulting in embryos that are later transferred (usually 1-3) into the uterus.
IVF Treatment Steps:
IVF is recommended for endometriosis, failed artificial insemination, male factor infertility, unknown infertility, and diminished ovarian reserve.
The success factors include maternal age, ovarian reserve, prior reproductive ability, and embryo quality.
The IVF treatment consists of several stages:
- Ovarian stimulation
- Egg retrieval
- Fertilization of the eggs
- Embryo transfer
- Embryo vitrification
1. Ovarian Stimulation:
By administering gonadotropins and gonadotropin-releasing hormone (GnRH) agonists or antagonists, multiple follicles develop in both ovaries. This controlled ovarian hyperstimulation is typically done through subcutaneous injections and lasts 10-13 days.
2. Egg Retrieval:
After the ovarian stimulation protocol is completed, the eggs are retrieved through a procedure called ovarian puncture. This is done in the operating room under sedation and guidance from ultrasound. The eggs are aspirated from the follicles using a fine needle connected to a suction system. The collected fluid containing the eggs is then sent to the embryology laboratory for evaluation.
3. Fertilization of the Eggs:
In IVF, there are two possible techniques: conventional IVF and intracytoplasmic sperm injection (ICSI). After the eggs have been retrieved, they are given time to rest and then fertilized. In conventional IVF, the eggs are placed in contact with a sample of sperm and the sperm naturally fertilizes the eggs. If conventional fertilization fails, ICSI is used to inject a single sperm directly into an egg.
4. Embryo Transfer:
Once the eggs have been fertilized, the resulting embryos are cultured in the laboratory to monitor their development. Depending on the number and quality of the embryos, the transfer can take place on day 2 (D2), day 3 (D3), or day 5 (D5). The choice of transfer day is based on the evaluation and development of the embryos.
5. Embryo Vitrification:
Any remaining embryos after the transfer can be cryopreserved through a process called vitrification. Vitrification involves freezing the embryos at a very low temperature (-196ºC) to maintain their quality. These frozen embryos can be used in future cycles if the first IVF attempt is unsuccessful. The law provides four options for the fate of cryopreserved embryos: utilization by the couple, donation to other couples, research purposes (currently unused), or discontinuation of storage.
In conclusion, personalized care is essential for IVF success. Each case is unique, and tailored treatments increase the chances of a positive outcome.
