Instituto Bernabeu · Fertilidad y Ginecología



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Higher success rates have already been reached than in natural conception, being considered around 40% the probabilities of obtaining a pregnancy. This data, that could seem low at first, is very similar to the one reached by couples without reproductive problems during a cycle. Let us imagine that in a month, 100 couples without gestating difficulties decide to look for pregnancy: of these 100 couples, around 30 will obtain it in that month.

In Spain, this treatment is regulated by a legislation that forces the couple to formalize an informative consent that authorizes us to proceed and make analyses that allows discarding the presence of serious virus for the health of the future child (different types of hepatitis, HIV).

The IVF cycle consists in different stages:

1. Study and preparation of the patients.
2. Ovarian stimulation.
3. Egg retrieval.
4. Laboratory fertilization: Culture of oocytes, spermatozoa and embryos.
5. Transfer of embryos to the mother.

1. STUDY AND PREPARATION OF THE PATIENT

It intends to assure that the IVF cycle is the correct decision to solve the infertility problem, and that the patient physically and psychologically prepared to initiate it.

If it is not the case, oriented to other treatments.

2. OVARIAN STIMULATION

In order to increase the possibilities of pregnancies, we need to obtain more than one oocyte, that is what habitually produces a woman’s ovary. For this purpose, we stimulate the production of several oocytes of good quality, with a drug combination, whose response is controlled by means of vaginal sound scanners and blood analysis.

The whole process, depending in each case, lasts between 8 to 12 days approximately. If a deficient or exaggerated ovarian response is observed, the treatment can be interrupted.

3. OOCYTE COLLECTION

When the oocytes are mature, we gather them by means of vaginal sound scanner, under local anesthesia and smooth sedation; that is to say, in a totally painless way.

The process lasts only 20 to 30 minutes, and it does not require operation, hospital admission, stitches or general anesthesia.

4. LABORATORY FERTILIZATION

Insemination

The gathered oocytes are taken to the IVF laboratory where they are prepared to be inseminated.
Parallel to this, the sperm is activated to improve and to increase its capacity.
Oocytes and spermatozoa are mixed, during several hours, in an incubator that provides the optimal conditions for its fertilization and development.
Until the following day the number of fertilized oocytes is unknown, but the fertilization rate is around 60%; reason why it is habitual to obtain several embryos.

5. EMBRYOS’ TRANSFER

Although in certain cases the phase of embryonic culture can extend for several days, it is usually carried out two or three days after the collection. The number of embryos to transfer is determined by taking into account several factors: patient’s desire, duration and cause of sterility, maternal age, embryo quality... The final objective is to have the biggest number of single pregnancies, not multiple pregnancies.

They are deposited in the uterus or the Fallopian tubes in a painless procedure that lasts few minutes, followed by one or two hours of rest in our clinic.

Embryo Criopreservation

If more embryos exist, they are criopreserved, that is to say, frozen to allow future transfers. Given the case that pregnancy is not achieved, these embryos would be used to retry the procedure, or on the contrary, to get pregnant again in a near future.

Unfortunately, the pregnancy rate obtained after criopreservation is of 15%.

The fact of receiving embryos does not mean pregnancy.

Regrettably, the rate of implantation is not high and all the transfers are not followed by a pregnancy. In most cases it will not be possible to know why the embryos have not nested, since in nature the number of embryos that do not implant is very high. At the moment there are several experimental treatments to correct this situation.

We do not follow the attainment of multiple pregnancies to only obtain a greater success rate. But since the human embryo does not implant often, we transfer in many occasions two or three embryos. Transferring more embryos does not suppose a benefit, just a bigger risk of multiple pregnancies.

Pregnancy

Once gestation is achieved, it will evolve with total normality, without requiring special controls except for the habitual monitoring that is practiced to very wished pregnancies. On the other hand, the possibility of miscarriages, malformations, etc, is the same one as that of the general population. Multiple pregnancy is what changes in rate.

When treatment is over and pregnancy has not been obtained, the Committee of Reproduction, formed by the team responsible of the case, will revalue it to advise on the future steps to follow. This is made arranging a personal interview with the patients.

This information could be modified by the incessant changes that take place in the Reproductive Medicine field and by the specific peculiarities of each case. Finally, it must be clear that all of us, medical, biology, laboratory, infirmary and administration staff, offer our total best to help obtain the couple our common objective: having a CHILD.

Multimedia Files

Fecundación In Vitro
Video Fecundación In Vitro.

Video