10 steps you need to complete as a couple following an IVF procedure
In vitro fertilization (FIV) is a procedure used to treat fertility issues and to help conceive a child. During the in vitro fertilization, mature ovules are retrieved from ovaries and fertilized with sperm in a laboratory. Subsequently, the fertilized egg (embryo) is implanted in the uterus.
Which are the steps every couple must follow, in order to use in vitro fertilization?
For the in vitro fertilization to be as efficient as possible, each couple must undergo the following 10 steps:
- The first discussion: The first step to obtaining a pregnancy via in vitro fertilization is a detailed discussion between physician and couple – the so called infertility consultation. Your physician will examine you during this consultation and check your medical documents – analyses results, previous consultations, and based on this discussion the physician decides if additional investigations are necessary or not. Once all the investigations requested by the physician were performed and collected, it is established, if in vitro fertilization is appropriate or not in your case.
- Preparation of the IVF file: In order to prepare your IVF file, a meeting with the person in charge of your case is necessary, during which your analysis results will be checked again and certain steps will be explained which you need to follow, to insure a smooth running of the entire process.
- Preparation for IVF: An appointment is made for a consultation during the menstrual cycle prior to the one for which the treatment is scheduled. This consultation must take place no later than 14 days after the start of your menstrual flow. During this menstrual cycle you will need to use barrier contraception methods (condom, diaphragm, hood, etc.) in order to avoid getting pregnant.
- Preliminary consultation: During this consultation the new investigations performed and added to your file will be checked and possibly missing investigations will be completed, the physicians will explain the stages of the IVF process to you. On this occasion, the type of protocol is established for ovarian stimulation, according to the situation of your couple and the effective treatment starting date.
- Ovarian stimulation: On the date set by the physician, you will start an injection treatment in one of the following variants, as recommended:
- Long protocol
- Short protocol
- Short protocol with Gn RH antagonists
- Harvesting oocytes and sperm: 35 to 36 hours after administration of the hCG oocytes and sperm are harvested. Oocyte harvesting is performed by ultrasound guided transvaginal punction, with or without anaesthesia. This intervention requires short term hospital admission. Sperm harvesting can be made at the clinic (preferably) or at home, after a sexual abstinence time of 2-5 days (no more, no less), in a special recipient, on the same day as the oocyte harvesting. Sexual activity is prohibited 3 days prior to the oocyte aspiration punction.
- After sampling oocytes and sperm: What happens in the embryology lab:
- DAY 0 – Day of the punction for oocyte harvesting; fertilization is performed in the embryology lab, either via classic IVF technique or by ICSI technique. During the IVF procedure, oocytes and sperm are brought into contact, in a special culture medium, and in case if the ICSO procedure, each oocyte is injected with a single sperm, by means of a needle, under special microscope control.
- Day 1: Some egg-cells are fertilized, however, others are not. The embryologist checks their evolution and you are informed.
- Day 2: Fertilized oocytes are already divided into 2-6 cells, and depending on their number and aspect the decision is made to implant the embryos to the uterus on day 3 or to wait until day 5.
- Day 3: Fertilized oocytes with a good development may already have divided into 6-10 cells. On this day, the implantation of the embryos into the uterus can occur (embryo transfer), but in some cases we wait until day 5.
- Day 4: The embryo is the morula stage.
- Day 5: The embryo has already reached the blastocyst stage.
- Embryo transfer: Transfer of embryos to the uterus is a relatively simple and painless procedure which usually occurs 72 or 120 hours after the harvesting of oocytes, if valid embryos are generated during the laboratory fertilization. The technology consists of inserting a thin catheter which holds the embryos and the growing medium through the cervix and its complete evacuation inside the uterus.
- Monitoring after embryo transfer. In two weeks’ time after embryo transfer, laboratory investigations may confirm or deny the success of the procedure.
- Pregnancy monitoring: The pregnancy will be monitored by your gynaecologist just like any other pregnancy would be.
The physicians at the Columna Medical Center and IVF Academy will be happy to inform you in more detail about the IVF procedure during a consultation.