In Vitro Fertilisation (IVF)
IUI is not always an option for some couples, and this can be due to various factors, however in these cases IVF can be used as an alternative.
IVF is an Assisted Reproductive Technology (ART) procedure that is used to treat a range of fertility problems. In IVF process, the fertilization occurs outside the female’s body and takes a place in a laboratory setting.
To start, the female’s eggs are surgically removed from her ovaries using an egg collection procedure. Eggs can then be used right away for the procedure; this is referred to a fresh cycle. Some women choose to have their eggs removed, frozen and stored until they are ready to have the procedure, this is called a frozen cycle. The male is required to provide a sperm sample for the procedure. The sperm sample must be provided on the day of the procedure as only live, fresh sperm can be used for successful fertilization.
The retrieved and egg and sperm are placed in a petri dish in the laboratory to allow for fertilization to take place.
Once fertilization has successfully taken place, the fertilized egg, now called an embryo, is implanted into the female’s womb. The egg settles into the female’s uterus for growth into a fetus and eventually a baby.
Despite being a complex procedure, since 1990 IVF treatment and fertility specialists at Bedaya hospital have successfully achieved some of the best IVF success rates in Egypt and the Middle East for both fresh and frozen cycles.
How does in vitro fertilization process work?
In IVF process, fertility medication is given to the female in order to stimulate the ovaries to produce multiple eggs. These eggs are contained in follicles in the female’s ovaries. Ultrasound scans and blood tests are used to monitor the progress of the treatment. The specialists are looking for growth of the follicles as this indicates the eggs are multiplying causing the follicles to expand.
When the follicles reach 17-22 mm, this indicates the eggs are ready to be extracted. The extraction procedure first involves giving the female a hormone injection approximately 36 hours before the egg collection. At this stage the eggs in the follicles have multiplied but are still in their immature form. In order for effective fertilization to occur the eggs must be in their mature stage. To achieve this, a hormone called human chorionic gonadotropin (hCG) is injected into the female. This hormone is used to stimulate the eggs to develop into mature stage.
The next step is to collect the eggs from the follicles. To perform this procedure females are normally given a light form of sedation to make them feel more comfortable. An ultrasound guided vaginal probe is inserted into the female and is used to locate the follicles. Once the follicles are located, the contents including the eggs and surrounding fluid is collected. The retrieved eggs are then placed in a dish in the laboratory until ready for use.
Despite close monitoring of the development of the follicles using ultrasound and blood tests to determine hormone levels it is still difficult to determine the number of eggs that will be collected until the eggs are extracted from the follicles. In rare cases, follicles are seen on the ultrasound scan and the hormone levels are elevated in the blood tests but the follicles are empty when the specialist goes in to retrieve the eggs.
In the laboratory our embryology team places the eggs into a petri dish with the collected sperm to allow for fertilization and development to occur. The embryologists closely monitors the activity of the egg and sperm.
Once the egg is successfully fertilized and the embryos have developed, the embryologist will select the healthiest, most developed embryos to be transferred back to the uterus. Multiple embryos are used for transfer as this increases the chance that an embryo will be successful in inducing pregnancy. On average approximately 2-4 embryos are used for insertion. The embryos are inserted into the female using an embryo transfer procedure. This procedure is quick and painless and does not require any form of sedation. The embryologist inserts the embryos into a fine catheter which is placed into the female’s uterus. There is no recovery period required following the procedure and the female can resume her usual activities afterwards. It takes approximately 2 weeks for the embryo to settle and develop therefore a pregnancy test can be completed after 2 weeks for an accurate reading.
What happens to embryos that are not transferred?
As indicated above, only the healthiest embryos are used in the transfer, so what happens to the embryos that are not used? All remaining, good quality embryos that are not transferred will be frozen and stored.
These frozen eggs can be used later on at the discretion of the couple for future use. we have a very high pregnancy rate for frozen embryo transfers. The advantage of freezing good quality eggs at this point is that it offers a very high chance of getting pregnant in a subsequent cycle without having to go through the whole IVF procedure again.