In vitro fertilization (IVF) is the most complex of the assisted reproduction techniques that are used to treat infertility and assist conception. During an IVF treatment, a number of different protocols can be used for the stimulation of the ovaries and the creation of multiple follicles instead of just one that occurs during a natural menstrual cycle. Following follicle tracking via regular ultrasounds and when the number and size of follicles permits a trigger injection is given and the mature eggs are collected from the ovaries 36 hours later during a procedure called oocyte retrieval (egg collection). The oocytes are then fertilized by the sperm in the embryology laboratory. Subsequently the fertilized eggs (embryos) are allowed to grow in the lab and are transferred in the uterus 2,3 or 5 days later. A cycle of IVF takes about two weeks and is the most effective form of assisted reproduction. The procedure can be done using the female partner’s own eggs and male partner’s own sperm or it may involve eggs, sperm or embryos from an anonymous donor.
IVF is often offered as a primary treatment for infertility in women around or past the age of 40 with no other infertility factors due to the higher success rates compared to other assisted reproduction techniques.
However IVF is indicated when there are certain medical conditions. It may be the only or optimal option in cases of:
* Fallopian tube damage or blockage or previous tubal sterilization.
* Anovulation or various hormonal and ovulation disorders.
* Premature ovarian failure.
* Impaired sperm production or function associated with male partner infertility.
* Unexplained infertility.
* Genetic disorders.
* Fertility preservation for cancer or other health conditions.
For some women, a stimulated IVF cycle is inappropriate for a number of different reasons. This could be due:
• A health condition that is a contraindication to controlled ovarian stimulation (history of DVT or Estrogen receptor positive breast Ca)
• Advanced maternal age or poor ovarian reserve which is often associated with low egg quality can be often made worse with aggressive stimulation protocols.
• Some women cannot tolerate the stimulation medication or simply want to avoid it for other reasons.
For these women, IVF without stimulation or with minimal stimulation may actually be the best option. The patients natural hormonal cycle is used to mature the eggs and egg collection is carried out to retrieve 1-3 eggs that would otherwise ovulate spontaneously. IVF/ICSI fertilization and subsequent embryo transfer is carried out in the same way as for conventional IVF.
Artificial insemination (IUI) is an assisted reproduction technique that involves the injection inside the uterine cavity of sperm that has been prepared in the laboratory to improve its count and motility. This is done via a thin catheter that the doctor passes through the vagina and the cervix of the uterus. The timing of the procedure is critical as it has to be synchronized with ovulation. IUI can be performed generally either during a natural menstrual cycle or a medicated/stimulated one.
The idea behind IUI is that couples who experience difficulty to get pregnant can benefit from the exact timing and placement of a more potent sperm inside the endometrial cavity. IUI can be of particularly benefit in cases where there is a cervical factor such as cervical scarring, cervical stenosis, or thick cervical mucus, or mild male factor of reduced sperm count and motility, as well as in cases where there is a problem achieving or synchronizing intercourse with ovulation. This method is also used for single women using donated sperm.
For some women egg production and/or egg quality is too weak for normal fertilization and development. This can be caused by various reasons such as advanced maternal age, endometriosis, premature menopause, chemotherapy or congenital chromosome anomalies.
The above problems can be overcome using donor eggs. At Serum we offer a large pool of carefully selected egg donors. We take pride in our donation program as all our donors are young, beautiful and proven aged 18-30.
In some cases male infertility cannot be treated. In these cases (azoospermia, severe oligo-teratospermia etc) sperm donation can be a solution. At Serum we have the first and largest Sperm Bank established in Greece in 1991. We provide a wide variety of top quality proven sperm donor options for our patients. For more information CLICK HERE
For couples or single women who need both donor eggs and donor sperm, we offer fresh double donation, or frozen embryos made with donor eggs and donor sperm.
Once the oocytes are fertilized, they are placed in a special culture medium where they are allowed to grow. Monitoring the embryo’s progression, symmetry and fragmentation allows the embryologist to assess their quality (and hence the chance of a successful pregnancy). Culturing to blastocyst (day 5 of embryo growth) enables the embryologists to select the embryos which are more likely to be euploid (have the right number of chromosomes) and hence have a higher chance of a clinical pregnancy and live birth.
(Freezing) & Frozen Embryo Transfer (FET) – Embryo cryopreservation involves the freezing of embryos for later use. This is most often done with excess embryos remaining after the transfer of fresh embryos.
Sometimes a woman cannot carry a pregnancy. There are many reasons for that such as lack of uterus ( previous Hysterectomy or Rokitansky syndrome), severe endometrial adhesions, multiple fibroid uterus, significant medical problems (ie aortic stenosis, severe renal disease etc). In these cases, she may choose to have another woman carry the pregnancy and deliver the baby for her.
The process is allowed in Greece following an application to the courts. Based on the current legislation the baby is born under the name of the intended parents making Greece a very attractive destination for surrogacy.
ICSI (intra-cytoplasmic sperm injection) is an in vitro fertilization technique in which a single spermatozoon is injected directly into an oocyte. This procedure is most commonly used to overcome male infertility problems, although it may also be used where an oocyte cannot be easily penetrated by a spermatozoon.
We are one of the few clinics globally that don’t charge extra for this procedure.We believe every couple, regardless of their infertility problem, deserve the most suitable treatment and our embryologists will use all their expertise and knowledge to determine whether ICSI is likely to be a suitable option for you.
Is a technique which allows the embryologist to imitate nature in selecting a spermatozoon capable of fertilization. This is based on the hyaluronan, a biopolymer found in the gel layer around the oocyte. In PICSI an “ideal” spermatozoon binds to the hyaluronan hydrogel that is contained in the disk and is selected and used for ICSI.
Is a technique that involves the selection of a spermatozoon which has external as well as internal normal morphology. This is feasible by using an inverted microscope that provides a magnifying power around 6000 times more than those which are usually made for ICSI. The above fact allows the detailed observation of the inner content of the spermatozoon. After the selection, the most suitable spermatozoon is used for ICSI.
Some patients may have a family history of an inheritable genetic disorder, such as cystic fibrosis. In these cases in order to reduce the risk of having a child with such a disease, the patients might opt for pre- implantation genetic testing of embryos. In this way only embryos with normal genetic layout would be transferred.
Assisted hatching may improve pregnancy rates in some women undergoing IVF. In assisted hatching, an opening is formed in the shell (the zona) surrounding the embryo before the embryo is transferred to the uterus.