IVF aims at the creation of embryo in a laboratory, created from a couple’s genetic material, aiming at a successful pregnancy, after embryo-transfer to the woman’s uterus.
IVF aims at the creation of embryo in a laboratory, created from a couple’s genetic material, aiming at a successful pregnancy after embryotransfer to the woman’s uterus.
Process consists of the following steps:
- Causing ovulation: it is the process, during which, the woman receives injection treatment in order to stimulate ovaries and produce more than one ova, as naturally produced in her menstruating cycle. Reception of special hormones takes place daily, starting from the first or second menstruation day, until the day follicles are shaped in size, approximately 18 to 22 cm on average. This process is monitored every two days with ultrasound and by calculating a special hormone, oestradiol, which overall is calculated 4 to 5 times until the day of ovum collection.
- Ovum and sperm collection: It is the process when we collect ova from ovaries through the vagina, with a simple procedure. We provide mild sedation and effective painkillers, and with the help of ultrasound, we suck the fluid from ovaries through the vagina with a very thin needle. Inside this fluid we have the ovum which we give to our embryologists. At the same time, the spouse provides us with their sperm, through ejaculation, either in their own place or in a special chamber in the unit.
- In vitro fertilization:This process is purely laboratorial, and takes place by embryologists in a designated laboratory, where we have all the necessary equipment for the best result. After ovaries are cleaned and sperm is processed to isolate the most appropriate sperms, all of them are put together in special dishes with culture agents, where we accomplish fertilization.(Simple IVF)
In some cases, when the sperm is weak, or when we have a small number of ova, embryologists choose microfertilization technique-ICSI, where, under a special microscope, we choose the best sperm cell and there is a direct ovum fertilization. After that, embryos are developed under the appropriate circumstances in the lab, until they are ready to be transferred back to the woman’s uterus. This process takes place inside designated mini- incubators with the help of special growing agents.
- Embryo transfer: It is the final part of IVF, and is the transfer and placement of the selected embryos inside the uterus cavity. This action takes place usually 48 to 72 hours after ovum reception (second or third day of culture). If embryos have reached the stage of blastocyst, embryo transfer takes place on the 5th or on the 6th day.
The process is very simple, short in time and doesn’t require sedation or painkillers. After the procedure is completed , the woman receives hormonic support through the mouth, and we anticipate the positive successful test after 12 days.
IVF in natural menstruating cycle
The first successful IVF was in 1978 , and it was performed with the method of natural cycle, but since then, the process of IVF was mostly done with ovaries stimulation. And this specific method dominated, because the use of exogenic gonadotropins, increased significantly the number of ova, which also led to a larger number of embryos and as a result to higher percentages of successful pregnancies.
When we say IVF fertilization in a natural cycle we mean the following procedure:
- monitoring the developing follicle during menstruation
- paracentesis of the follicle
- retrieval of the ovum
- ovum fertilization by spouse’s sperm
- transfer of fertilized ovum to the uterus
This procedure addresses all women who cannot, or do not wish,for any reason, to be subjected to ovary stimulation. At the same time, it also addresses women who have already been subjected to a great number of IVF attempts, having received large doses of hormones without any success. For this reason, such women may resort to IVF with the method of natural cycle, since ovary stimulation has been proven unable to bring the desirable result to them.
As far as successful pregnancy of such a process is concerned, one out of three women, according to recent studies, achieve a successful pregnancy through this method.
That happens, either because that specific month, a woman doesn’t ovulate, or because the ovum cannot be fertilized, or because the ovum may not be of good quality, so as to allow the couple to move on to embryo transfer.
On the other hand, the chances for each embryo transfer may reach even 40%, which comes as a very good percentage, considering that the chance of a successful pregnancy through the classic method of IVF, ranges between 25 and 35%.
Apart from the above, another important advantage of IVF in a natural cycle, is the fact that , to patients with poor feedback, this specific method could generate ova of better quality, coming from the naturally selected follicle, achieving embryo transfer in a uterus that hasn’t been affected by high estrogen levels, something which stands as a prerequisite for classic IVF.
Concluding with the issue of the advantages of IVF in a natural cycle, apart from the absence of hormone reception for ovary stimulation, we must also stress the cost, which is significantly lower, as well as the minor, to zero, chance of multiple embryos.
However, the most important and invaluable advantage for a woman, is that in this case, they can get pregnant in a more natural way, without the complicated, stressful and, often, painful, especially emotionally, process of classic IVF.
Infertility and IVF: a couple’s emotional situation
IVF therapy is very effective for a very common issue in our days. Yet, it is escorted with great emotional stress for each of the two aspiring parents, and if emotions are not processed, they may have a very negative effect on each one of them, on the couple, let alone on the result of the whole process itself.
Evaluations of world health organisation, mention that almost 15% of the overall population, refer to infertile couples, whereas 10% of them, are in a reproductive age.
Assisted reproduction techniques have provided a solution, offering outstanding success rates to a very big number of couples who had little or no hope of becoming parents.
Infertility rates show that this is nowadays a very common medical issue and is treated according to the organic part of it. Infertile couples though, go through a very big emotional distress, not only until the moment they take the decision to go for IVF, but also during the whole procedure.
Before a couple goes under fertility treatment, they have been through a very painful period of attempts, without getting any results. Each one of them has dealt with frustration, anger, guilt, low self-esteem. Both spouses’ identity has been threatened, as well as their expectations and anticipations from their marriage and their life, in addition to their personal and social status, the relationship between each other and among all the people surrounding them.
However, also during IVF treatment therapy, according to most research, the couple and especially women, face a lot of stress and depression, fear, agony, impatience, guilt, and an emotional and also sexual gap between the couple may be developed.
Especially in cases of one or more failing attempts, the relationship of the couple is critically challenged, as well as their commitment, so it is in some cases difficult to maintain both parts of the existing family.
Therefore, it is absolutely clear that emotional support, before but also during IVF treatment, is of utmost importance. By getting support, the couple will process the plethora of emotions, they will accept the issue they are facing, they will feel that they are still in control of the situation, and their fears and stress will be diminished and replaced with optimism and realism. Simultaneously, they will improve their relationship, restoring their communication and assisting in effective conflict solution and maintaining the cohesion of partnership and emotional flow.
It is urgent that support be received by both partners. Nevertheless, if one of them refuses to join in the process, then support may take place individually.