In vitro fertilization is the union of egg and sperm in the -in vitro-laboratory in order to obtain fertilized embryos to transfer them to the uterus of the mother. The oocites fertilization can be done through convencional IVF or through intracytoplasmic sperm injection (ICSI).

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Indications

Unknown infertility cause or sterility. Fails in cycles prior to insemination.

  • Absence or injury of the fallopian tubes

  • Eendometriosis.

  • Ovulation disorders

  • Immune disorders.

  • Mild or moderate alterations in mobility, concentration or morphology of the semen

  • Inability of sperm to penetrate the cervical mucus

  • Retrograde ejaculation

  • Sperm spine damage

Development of treatment

The IVF treatment consists of 4 phases

1. Stimulation Phase

Is usually performed after “blocked” pharmacologically the natural cycle of ovulation. Once this is achieved, starts the ovaries stimulation with daily injections of hormones called gonadotropins, which are self-administered subcutaneously by the patient. The objective is to get a multiple follicular development, which allows us to obtain a reasonable number of oocytes fertilizable. This stage lasts about 10 days, and approximately every two days the patient is seen in consultation in order to perform a ultrasound control and adjust the dose of hormones. Sometimes we preform some boold work control for more information.

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2. Follicule Puncture

The oocytes are retrieve from the ovaries of women through the puncture of the follicles. This procedure is controlled by ultrasound and is usually done under analgesia so that it does not become painful. Usually is done 11 days after the cycle start. The procedure does not require hospitalization and the patient leaves the clinic in 30-60 minutes knowing the number of oocytes that was obtained, and with an approximation of the quality of these. After are prepared and classified in the laboratory.

The semen, it has to be obtained almost at the same time that the oocyte retrieval, after a period of sexual abstinence. The semen is prepared in the laboratory in order to eliminate certain components and select the most suitable sperm to fertilize.

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3. Fertilization Phase in the laboratory

Conventional IVF

We proceed to put in contact the sperm and oocytes, remaining in incubation in media and in special conditions for hours.

The semen, it has to be obtained almost at the same time that the oocyte retrieval, after a period of sexual abstinence. The semen is prepared in the laboratory in order to eliminate certain components and select the most suitable sperm to fertilize.

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ICSI (intracytoplasmic sperm injection).

ICSI is a technique that applies when the fertilization rates expected would be nule or very low with conventional IVF:

  • Low number or quality of the sperm.
  • Severe Abnormalities of sperm morphology.
  • Problems of interaction between egg and sperm.
  • Low number of oocytes.

The most appropriate sperm will be select, injecting it inside each egg. This option is used in an increasing the number of cases to optimize the results of the treatments.

Once fertilization is achieved, embryos are selected to be transferred into the uterus of the patient.

4. Embryo Transfer

Consists of transferring the embryos (three maximum) in the interior of the uterus. It is usually done between 2 and 3 days after the oocyte retrieval. The procedure is completely painless and is usually done under ultrasound control. The woman stays at rest during 45- 60 minutes and bed rest is recommended at home for 24-48 hours. Women will continue with progesterone vaginal suppositories a hormonal treatment to promote embryo implantation.

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Success Rates

IVF (percentages)

Thawed transfer