Reproductive Medicine

Treatments

In Vitro Fertilisation (IVF)

This technique basically consists of placing the eggs in contact with the sperm in vitro in the laboratory, outside the female body. The fertilised eggs grow into embryos and are introduced into the uterus where they should continue to grow.

There are different methods of carrying out this procedure, depending on the origin of the reproductive cells that are used:

IVF with eggs and sperm from the couple.

IVF with donor eggs and sperm from the couple.

IVF with donor eggs and sperm.

IVF with eggs from the couple and donor sperm.

Stages:

Ovarian stimulation:

For in vitro fertilisation, it is important to have several eggs to give a greater possibility of obtaining quality embryos and improving the pregnancy.

The procedure involves the intramuscular or subcutaneous injection of hormones that act on the ovary. Various ultrasound scans are needed to check the response. When the hormonal levels and the number and size of the follicles are satisfactory, preparations are made to extract the eggs.

Egg extraction:

Extraction is carried out in the operating theatre with ultrasound scan control. The eggs are extracted by puncturing the mature follicles and aspirating the follicular liquid.

The average length of time taken by this procedure is 15 minutes and it is carried out under anaesthetic (sedation) to avoid discomfort and inopportune movements.

The patient recovers very quickly and can be discharged after one or two hours.

The risk of complications arising in the egg extraction procedure is one in every 2,500 cases and can therefore be considered negligible.

Egg identification

The follicular liquid is taken to the in vitro fertilisation laboratory where the eggs are located and harvested.

 

Semen preparation

The sperm sample is processed in the Andrology Laboratory using the most suitable Spermatic Preparation Technique for the quality of the sample. This allows us to isolate and select the sperm samples with the greatest mobility.

If the sperm sample comes from a sperm bank, it will be provided by Embriogyn after prior verification of the physical characteristics, blood groups and Rh factor of the patients.

If the sperm sample is from the partner, it may be obtained fresh or may previously have been frozen (see first visit)

Fertilisation Technique

There are currently two techniques for facilitating gamete (reproductive cell) fertilisation: 1) Conventional Insemination and 2) Intracytoplasmatic Sperm Microinjection (ICSI).

Conventional Insemination. In this procedure the eggs are placed into contact with the previously treated sperm, in order to allow the gametes themselves to carry out the fertilisation.

ICSI. Intracytoplasmatic Microinjection (Intra Cytoplasmic Sperm Injection) consists of introducing the sperm directly into the mature egg by means of micromanipulation.

This technique can be used with very low quality sperm samples and even allows the use of sperm from the epididymis or testicle (obtained through aspiration or testicular biopsy in those cases where there is no sperm in the ejaculate).

Evaluation of the fertilisation

The validation of the fertilisation is carried out 16-20 hours post ICSI or Conventional Insemination. In order for the egg to be correctly fertilised it is essential that the embryo present its own fertilisation structures.

Embryonic Culture

The fertilised eggs, now termed embryos, are kept in an incubator for a maximum of seven days after the eggs were obtained, allowing the in vitro development of the embryos.

Based on different morphological criteria, the embryologist may select the embryos that are considered viable, reserving them for transfer to the uterus or for freezing and rejecting those considered to be unviable.

Embryonic Transference

Depending on the characteristics of the embryos, the embryologist will advise on the most suitable moment to do carry out the transfer.

The transfer is not a painful procedure and normally requires no anaesthetic. The embryos are placed at the end of the uterus with the help of a catheter. This process is controlled with an abdominal ultrasound scan.

Only two or three embryos are transferred, as the high rate of implantation makes it advisable to limit the number of embryos transferred to reduce the risk of multiple gestation.

EMBRIOGYN | Estanislau Figueres 8, baixos, 43003 Tarragona (Spain)| Tel. +34 977 24 24 51 | Fax. +34 977 92 06 13