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FIVThe In Vitro Fertilisation treatment comprises five steps: Ovarian stimulation, egg retrieval, fertilisation, culture and selection of embryos and embryo transfer.

Ovarian stimulation

By stimulating the ovaries it is possible to control ovulation and the retrieval of several follicles. This means we can obtain a greater number of eggs than in a normal menstrual cycle in order to achieve a suitable number of embryos, thus increasing the possibility of pregnancy. During this process, which usually lasts between one week and ten days, the woman is supplied hormones to stimulate the growth of a greater number of eggs. In order to control that growth, tests and scans are carried out.

Egg retrieval

When the size of the follicles is right, a hormone is administered to produce a controlled ovulation. It is administered 36 hours before the egg retrieval. The retrieval is carried out in an operating room under sedation and is therefor painless.

We retrieve the oocytes using a special needle which collects the fluid contained in the follicles inside the ovaries. This follicle fluid contains the oocytes, we obtain them in the lab by separating them from the fluid. After this procedure, we place the oocytes in a culture medium inside an incubator.

After one or two hours, the patient can go home.

Fertilisation

Once we have a sperm sample, it is processed to fertilise the eggs. On a culture plate we prepare several micro-drops where we will place the right concentration of sperm. Later, we place an egg in each of these micro-drops and, within hours, one of the sperm will penetrate the egg producing fertilisation. (This is the classic In Vitro Fertilisation method). This plate is left in the incubator at 37º C, a concentration of 6% of CO2 and high relative humidity (95%), wich are the same condiotions of the womb. 18-20 hours after insemination we check under the microscope if the eggs have been properly fertilised, in wich case they will be called embryo´s.

Culture and selection of embryos

The now embryo´s will spend one or two more days in the incubator, where their evolution will be observed in order to determine their quality. This way, we select the best embryos for their subsequent transfer.

Embryo transfer

After these days in the incubator, one, two or three embryos are transferred. This depends on each specific case, medical advice and the wish of the patients.
The total process takes no longer than half an hour. The embryos are introduced in the uterine cavity with a very fine cannula, guided by ultrasound.
We then wait for implantation to take place.

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Written by: Sabrina Camara