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In Vitro Fertilisation (IVF)

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Definition

In Vitro Fertilization (IVF) was the first assisted reproduction technique (ART) applied and which is still the most widely used. Within the framework of an IVF cycle, the eggs (which usually result from controlled ovarian stimulation with the aid of hormonal drugs) and the sperms are collected and placed in a petri dish where the fertilization is effectuated. If the eggs are successfully fertilized in the laboratory, they are transferred to the uterus. Ideally, one of the fertilized eggs will be implanted in the uterus and will grow, as it naturally happens. In vitro fertilization (IVF) is divided in four stages:

Ovarian Stimulation – Ovulation monitoring & induction

The success rates increase according to the big number of mature eggs, available for fertilisation. Considering that naturally female body develops and releases a mature egg every month, the growth of more follicles is possible only with the use of hormonal preparations provoking controlled ovarian hyperstimulation and therefore growth of more follicles. Follicles are sacs full of fluid wherein eggs grow and mature. For the rupture (ovulation) of the follicle in the final stage of maturation and release of eggs hormonal preparations are also used.

Woman is regularly submitted to ultrasound imaging to monitor the number and size of growing follicles. Provided that growing follicles secrete increasing quantities of oestrogens, biochemical examination is also required for the assessment of hormonal levels with a view to determine the perfect timing for the administration of hCG preparation in order to achieve final maturation of eggs before the egg collection.

Egg collection

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After the completion of the ovarian stimulation and the maturation of the follicles, it will follow the collection of the grown eggs. This process is known as egg collection; this process is short and takes places under light general anaesthesia. The mature follicles are located by ultrasound imaging and then a needle is introduced in the vagina and then to ovary to collect the liquid from mature follicle with slow suction. The fluid is immediately examined with the aid of a microscope to confirm the egg collection. This process is repeated for each one of the mature follicles in both ovaries. The eggs that are collected from the follicular fluid are placed in an incubator.

For the better preparation of the lining of the uterus for the fertilised egg, it is often suggested to take progesterone – oestrogen and children’s aspirin, after egg collection.

Egg fertilisation

At about two hours before egg collection it is taken sample of sperm from the partner or from the partner. This sample undergoes special processing so as to activate. Then, sperms are mixed with eggs in an incubator settled in the appropriate temperature, pressure etc. conditions. The following day, eggs are examined with the use of a microscope in order to check for signs of fertilization. Then, the fertilized eggs will remain for some time in the laboratory until they will be ready to be transferred in the uterus within about 2-6 days.

Embryo transfer

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Embryo transfer (transfer of embryos fertilised in the laboratory) is not a complex procedure and may be effectuated without anaesthesia. The embryos are placed in a tube – catheter and they are transferred in the uterus from 2 to 6 days after egg collection. When the embryo transfer takes places on the 5th or 6th day after egg collection embryos have reached the stage of blastocysts (120-150 cells).

The number of transferred embryos depends on:

  • the age of the woman
  • the reason of infertility
  • possible previous pregnancies
  • other factors

Any remaining embryos of perfect quality may fulfil the conditions of preservation under freezing (cryopreservation) for future use.

Other techniques of in vitro fertilisation

At the in vitro fertilisation centre we manage with consistency and responsibility for many years, we provide you specialised services regarding:

  • Intra-cytoplasmic sperm injection (ICSI)
  • In Vitro Maturation (IVM)
  • Egg donation
  • Preimplantation genetic diagnosis
  • Specific laws of each country

FAQ

What are the success rates of in vitro fertilisation?

As you know, in order to address the issue of infertility modern medicine has developed during the last 30 years advanced treatment methods of assisted reproduction techniques.

Infertility treatment with these methods leads to success rates between 35-50% for every attempt, always depending on the type of problem, the age of the patient etc. Cumulatively this rate increases a lot and amounts to 70-80% after 3 consecutive treatment cycles; this means that most of the couples who will turn to a special infertility centre will finally return at home with a child.

Especially if we take into account the fact that the average conception probability of a fertile couple is about 15-20% for every month of their life, it is understood that modern assisted reproduction techniques have very significant success rates close to those naturally offered to couples without fertilisation problems.

How many times may a woman undergo the treatment of in vitro fertilization?

The number of the treatment cycles that a woman can undergo is not determined. It is certain that in Greece there are highly qualified obstetricians – gynaecologists and organised infertility treatment centres providing perfect medical services at this level.

If there are appropriate indications (e.g. ovaries corresponding to stimulation treatment, good quality of endometrium etc.), the success rate, especially with the use of modern techniques and biotechnological medication presenting increased bioactivity in comparison to conventional medication from urine, cumulatively amounts about to 65-70% after 3 treatment cycles.

40 years after the birth of the first IVF child what are the significant evolutions and what are predictions for the scientific treatment of the problem?

By default, infertility treatment is multifactoral. Significant steps have been made in all subsectors, such as:

  • in the diagnostic approach of the couple, where the implementation of endoscopic techniques has been generalised and the assessment of immunological problems if more adequate.
  • in technical issues, e.g. improvement of culture materials required at the laboratory, as well as the quality control of embryological laboratory
  • in adoption of new practical methods such as preimplantation diagnosis, blastocysts, cytoplasm transplantation, in vitro maturation etc.
  • in medication and preparations used, where truly leaps forward and evolution has been succeeded.

Do the insurance funds cover the cost of IVF treatment?

The state has started recently facing positively the infertility issue so it has improved the access of infertile couples to modern medical Assisted Reproduction Techniques. So, now, most insurance funds cover satisfactorily the cost of medication for limited treatment cycles. For further information ask your insurance fund or your insurance advisor.