In Vitro Fertilization takes place in five steps: ovulation induction, oocyte retrieval, fertilization, embryo culture and embryo transfer.
In Vitro Fertilization (IVF)
Ovulation induction
With ovulation induction we obtain control over ovulation and the recruitment of several follicles, that is to say, we will obtain a greater number of eggs than in a normal menstrual cycle, in order to obtain an adequate number of embryos, thus increasing the possibility of gestation. During this process, which normally lasts between one week and ten days, hormones are administered that will allow the growth of a greater number of eggs. To control this growth, analytical and ultrasound controls are performed.
Oocyte collection
When the size of the follicles is adequate, a hormone is administered that will produce a controlled ovulation. It is administered 36 hours before oocyte retrieval. This collection is performed in the operating room under sedation, using a special needle, which through the vagina, collects the fluid found in the follicles, which in turn contain the eggs. In the laboratory is where they will be separated from this fluid and placed in culture medium in an incubator. After one or two hours, the patient can leave the hospital.
Fertilization
Once we have the sperm sample, it is processed to inseminate the eggs. Several microdroplets are prepared in a culture plate, in which we will place an adequate concentration of spermatozoa. Later, we place an egg in each of these microdroplets, and in this way, in a few hours, one of the sperm will penetrate the egg, producing fertilization or fecundation (this is in vitro fertilization). This plate with the eggs and sperm is left in the incubator, in conditions similar to physiological conditions, i.e. 37º C, with a concentration of 6% CO2 and high relative humidity (95%). At 18-20 hours after artificial insemination, we verify whether fertilization has taken place by observing them under the microscope.
Embryo culture
The embryos obtained (which are the previously fertilized eggs) will spend one or two more days in the incubator, observing their evolution, to determine their quality and thus be able to select the best quality embryos for later transfer.
Embryo transfer
After these days in the incubator, the transfer of one, two or three embryos is performed, depending on the number of embryos in each particular case, according to medical advice and patients’ wishes. The whole process takes no more than half an hour. The embryos are introduced into the uterine cavity by means of a very fine cannula, guided by ultrasound, to place the embryos in the most appropriate place. Implantation is then expected to occur, which may result in pregnancy.
