IVF
IVF was first applied to women whose infertility was due to tubal causes. Nowadays, IVF is used for whole range infertility problems, such as ovulatory disorders, endometriosis, and male factor problems.
The treatment has evolved over the years to produce better recruitment of mature oocytes, becoming more patiently friendly and less arduous for the couple.
IVF cycle
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How long is IVF treatment?
According to which protocol is used (e.g. long, short, "MAP") the treatment is usually from 7 days to 2 weeks.
The treatment does not require hospitalization. The first cause of treatment involves a series of injections to prepare your ovaries, that can be administered by yourself or by the IVF unit's staff. Egg collection and embryo transfer are performed on an out patient basis requiring a few hours at the most at the Clinic.
What Other Tests are needed?
Mock transfer- usually before treatment has commenced the accessibility of the uterus via the cervix is examined. To assure a smooth embryo transfer, a catheter (exactly like the one which will contain your embryos) is passed through the cervix into the uterus.
If the clinician observes that the cervix is narrow or any irregularities, he will dilate the canal to ensure no difficulties on the day.
Semen Analysis- it is essential before your attempt to have a recent semen analysis
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Blood Tests The law in Greeec requires both partners to have the following tests: Syphillis
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What fertility drugs are taken ?
The attempt to mature many follicles containing eggs (oocytes) the IVF cycle can be broken down into two stages:
Suppression stage
These stop the release of your LH hormone produced from the pituitary gland. These drugs prevent LH induced ovulation so we can control the maturation and time of oocyte collection.
According to protocol and preference of your doctor-these drugs are administered subcutaneously, intra-muscularly form or in a nasal spray,
Caution! You do not stop taking these drugs until the midnight injection
Super-ovulation stage
These drugs stimulate the ovary to produce several oocytes. The amount and length of administration leads to the development of multiple follicles as opposed to a single one that develops in a natural cycle.
These drugs are administered by intra-muscular or subcutaneous means.
The development of follicles are monitored by ultrasound scans and blood tests (oestrodiol levels)
On the basis of these results your next visit to the clinic will be arranged.
A change in dose may be required to increase the number of mature oocytes produced.
If an inadequate number of follicles are seen on ultrasound it may be advisable to cancel the cycle and begin a new regime in the following months. Also if your ovaries over-respond it may be necessary to abandon the cycle to avoid adverse effects.
The treatment cycle for each women is different. The protocol, dose, type of drugs used may depend on age, type of infertility and previous responses in previous IVF attempts.
The treatment cycle is tailor made for each couple to increase the chance of a successful outcome.
In some cases it may advantages to use the long protocol, in other cases the short protocol-where a shorter period of down regulation is advantageous to produced a better retruitment of follicles in women with expected poor response to the drugs.
While natural cycles (with no drug administration) where the monitoring of a single follicle will be offered to others.
Midnight Injection
The injection of HCG is your last injection!
It has a similar effect to the LH hormone and stimulates ovulation approximately 36 hours afterwards.
The injection is given at night, so that the oocyte retrieval can be arranged in the morning two days later i.e. Monday midnight injection for Wednesday morning oocyte retrieval.
The Day of your Oocyte Retrieval
You must have fasted from the previous night.
The procedure takes about 15-20 minutes and a light anaesthetic is used so you feel no discomfort.
It is preformed trans-vaginally under ultrasound guidance.
The same morning your husband will produce the sperm sample.
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During the oocyte retrieval the oocytes are visualized by the embryologist, collected and placed in culture medium specially designed to give nutrients to the developing egg (oocyte) and embryo. |
Embryo transfer
The embryo transfer is a simple and painless procedure. It is without anesthetic but sometimes a relaxant may be administered.
The embryos are placed in a catheter and introduced into the uterus vaginally.
The fertilized oocytes (zygotes) are selected and further cultured until the day of embryo transfer either a) on the 2nd day (2-4 cell stages) b) 3rd day (6-8 cell stage) or c) 5th/6th day (blastocyst stage).
The number of embryos replaced depends on their "quality", age of the patient and outcome of previous IVF attempts.
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The fertilized oocytes (zygotes) are selected and further cultured until the day of embryo transfer either a) on the 2nd day (2-4 cell stages) b) 3rd day (6-8 cell stage) or c) 5th/6th day (blastocyst stage). The number of embryos replaced depends on their "quality", age of the patient and outcome of previous IVF attempts. |
Pregnancy test
Usually 12-14 days after your oocyte retrieval a blood test will determine your HCG hormone level.
If it is positive, an appointment will be made 2 weeks later for an ultrasound scan.
It is quite common to have a little spotting of blood before your test. This is no cause for concern. The pregnancy test is still necessary.
If the test reveals you are not pregnant, consult your doctor on your cause of action. You will be asked to meet with your doctor to discuss future options.
