In vitro fertilization procedure is very complicated and should be performed by skilled specialists and using a sophisticated laboratory equipment. The process consists in :
The entire procedure lasts approximately a month. It usually begins on the third day of the woman’s menstrual cycle. After the procedure is completed there is a 20%-50% chance of a successful pregnancy.
The first step in IVF procedure is giving the female patient fertility medication in order to stimulate ovulation. It has been established that the procedure is more successful when several embryos are implanted simultaneous. Read more about fertility medication.
The second step of the in vitro preocedure procedure is harvesting the ova before the ovulation,because otherwise they will vanish in the reproductive tract. To monitor the follicles, which contain the eggs that are released during ovulation,the doctor uses ultrasound scanning. In order to measure the level of estrogen which rises once the follicles rich maturity,blood samples are taken. The patient is administrated an hCG injection with 36 hours before ovulation. A premature ovulation can be triggered with a luteinizing hormone. Once the ovulation has been triggered what follows is egg harvesting using a technique named ultrasound-guided aspiration. An ultrasound probe is inserted into the vagina,this probe emits sound and like this an image of the reproductive organs is formed. The doctor inserts a needle into the vagina and further into the follicle where he draws the ovum into the needle. The ovum can also be aspirated through abdominal wall,or with the help of a laparoscopy.
After the eggs harvesting the specialist establish their maturity level so he could know when is the perfect time for adding the sperm,that is for insemination. For the in vitro fertilization the sperm is provided by the partner or sperm donor on the day of egg harvesting or before,but at that moment it is frozen until the moment that is needed.
At this point a certain number of sperm that have been separated from the motile sperm (“sperm washing”) are placed with each egg in it’s own laboratory dish and left for 18 hours in an incubator. Once the fertilization took place the fertilized cell divides in two within 12 hours and after another 48 hours the pre-embryos are prepaired for being transferred into the uterus.
Preimplantation Genetic Diagnosis (PGD)
An extra step in the in vitro fertilization procedure is PGD and is used by couples who want to make sure they can carry a successful pregnancy to term. This procedure consists in screening each embryon for chromosomal abnormalities or inherited genetic diseases,before the implantation takes place in the in vitro process. During the procedure a single cell from the embryo is isolated and is carefully analized in order to establish whether the embryo is healthy for being transferred to the uterus. The PGD procedure can also give the patients the chance of choosing their baby’s sex. The specialist can transfer a certain amount of embryos of the sex wanted by the patients to the uterus during the in vitro fertilization process. The sex selection procedure using PGD had successful results in almost 100% of the cases. Today PGD is available only for patients whose progeny are at high risk for a genetic disease or for women who undergo in vitro fertilization. The PGD procedure is very effective,the embryos prior PGD-scanned and transferred to the uterus during the in vitro process have a very good chance of a successful pregnancy.
It has been demonstrated that the more embryos are transferred in the uterus,the bigger the chance of multiple pregnancies. The embryo (embryos) are transferred in the uterus using a transfer catheter. Even though the transfer takes 10-20 minutes it is recommended that the patient remain in the clinic for a period of time afterwards. After the IVF process is completed the patient is given progesterone injections daily for a better chance of successful pregnancy. The embryos that aren’t selected for transfer can be frozen for further use.