IVF TRAVEL s.r.o.

Appropriate patients are offered IVF, after some initial testing such as a sperm count, a few hormone tests and an evaluation of the uterine cavity to establish the cause of infertility. The first stage involves stimulating the woman's ovaries so that several eggs mature. Normally, a woman produces one egg in each menstrual cycle, but with IVF, many ovarian follicles are produced by hormone stimulation and several eggs are obtained (usually 7-15) and a number of embryos are produced after oocyte fertilization. Two or three embryos are replaced into the woman's uterus to increase the chance of getting pregnant the first time.

To achieve this, a woman will need to take drugs to suppress her own hormones. This phase lasts about 21 days. The drugs have the effect of putting the body into a temporary low hormone state (similar to a short-term menopause), along with all of the side effects that might be expected such as hot flashes and mood swings.

Once the woman's own hormones have been suppressed, she can begin taking the medication that will stimulate the ovaries and egg production. She may need to have injections daily for 8-12 days, but this will vary according to the way her body is responding. The response of the ovaries will be carefully monitored using ultrasound scanning to show the size and number of developing follicles and frequently a blood test.

Monitoring of the woman during this stimulation period is essential, because a woman's ovaries sometimes respond too strongly to these medicines. This may result in the ovarian hyperstimulation syndrome, which can cause a range of symptoms from mild abdominal pain to severe pain, vomiting, nausea and dehydration. Sometimes a treatment cycle has to be abandoned because of hyper stimulation. On the other hand some cycles are canceled if not enough follicles are produced or the follicles grow very poorly. If all goes well, however, the next stage of the procedure is egg collection. This takes place when the ultrasound scan shows a sufficient number of large follicles. The woman is given an injection late at night to give the ovaries containing the eggs their last 'push' towards maturity. Ovulation normally occurs 37-40 hours after this injection, so egg collection is scheduled to take place just before ovulation occurs (at about 34 hours).

The eggs are usually collected using a fine, hollow needle guided by ultrasound. Around the same time of the oocyte collection in the woman, the man produces a semen sample. The sperm is assessed and prepared for fertilization. As soon as the eggs are extracted from the woman, they are placed into a nutrient "embryo culture" medium with the sperm and then placed in an incubator overnight. The next day, the eggs are observed through a microscope to see if fertilization has occurred. The next day cell division will have started and the embryo might now have two or four cells.

The embryos will be checked by our expert CRM embryologist to ensure that they are developing normally and, if all is well, embryo transfer can take place. The embryos, together with a tiny amount of nutrient fluid, are put into a catheter and placed into the woman's uterus through her cervix with a special ultrasound guidance. By transferring one or two embryos we reduce the risk of a multiple pregnancy. Occasionally in older patients we transfer three embryos. If there are 'spare' embryos of good quality these can be frozen and stored for use in a future treatment cycle if needed.

The embryo transfer procedure is critical. The procedure is short and generally painless. Afterwards, the woman will be advised to rest for a short time and then go home and "carry on as normal". It will be about two weeks before a pregnancy test can be done, and this waiting is one of the most stressful times of the cycle. During this time, the woman will be prescribed progesterone, which is needed to provide hormonal support to any potential pregnancy.

If the pregnancy blood test is positive we will confirm this with a couple more blood tests. Then an ultrasound scan a couple of weeks later will identify a normal pregnancy in the uterus and the heartbeat of the new embryo.If all is developing normally, the newly pregnant woman will be referred back to her obstetrician to make the transition to antenatal care.

However, one of the most important things to remember about IVF is that it only works about half the time in the best couples. So sometimes the patient needs to repeat the cycle. Other times, a woman who is older or has "premature aging" of her ovaries might not have a successful IVF cycle. In these cases, which are not that uncommon, patients are offered the opportunity to use eggs from a donor. These donor egg cycles allow the woman who otherwise would have no chance for pregnancy carry and deliver her own baby using the sperm from the husband. Donor egg cycles are usually less expensive than adoption. CRM also uses an embryo adoption program that has been very successful.

 

 

For more IVF information please feel free to contact us.