In Vitro Fertilization

The process of an In Vitro Fertilization Treatment consists of the following steps:

Ovarian Stimulation:

Gonadotropins are used to stimulate the growth of multiple ovarian follicles. The term “gonadotropins” refers to medications that contain follicle-stimulating hormone (FSH) and Luteinising Hormone (LH). During this process, we closely monitor the growth of the ovarian follicles by transvaginal ultrasound scans and blood tests.

When applying the short protocol, the one most commonly used in the In Vitro Fertilization process, ovarian stimulation commences on the 2^nd or 3^rd day of your cycle and takes about 10-12 days to complete. During this period, your response to medication will be assessed on 3 to 4 time points via sonography and hormone blood tests. Should you leave Greece and return to your country of residence, the progress of the ovarian stimulation can be remotely monitored by sending us your reports for review.

The ovarian stimulation process step is extremely important since the number of oocytes retrieved is directly related to the number of embryos available for transfer. Once the size of the follicles is optimal, a trigger injection is administered to induce ovulation and finalise oocyte maturation. Oocyte retrieval takes place 36 hours after the trigger injection is administered.

Oocyte retrieval (egg collection):

Egg collection is performed under transvaginal ultrasound guidance. A fine needle is advanced into the ovarian follicles through the vaginal wall. The fluid from all follicles inside both ovaries is aspirated and, then, examined by an embryologist to identify the eggs under the microscope. Next, any extracted eggs are placed in culture plates with nutrient media and, then, in the incubator. The whole procedure is performed under light sedation, and, generally, takes less than 10–15 minutes to complete.

Sperm retrieval:

On the day of the egg retrieval, a fresh sperm sample from the male partner is assessed. In case of obstructive azoospermia, sperm is surgically retrieved in Fertilia’s Operating Room.

Fertilization:

If the sperm is of good quality and no medical concerns have been raised, classic In Vitro Fertilization is applied: sperms and eggs are introduced in a culture dish, which is then placed in the incubator. If there is a male infertility factor or any other medical issues (e.g. history of low fertilization rate), Intracytoplasmic Sperm Injection (ICSI) is applied. ICSI involves the injection of a single sperm directly into the oocyte.

Embryo culture:

The morning after the insemination, all eggs are examined to determine whether fertilization has occurred. The embryo(s) will be cultured in the lab for 3 to 5 days. You will be continuously updated by Fertilia’s team about the process of the embryo culture.

Embryo transfer:

The embryo transfer can take place either on Day 3 or Day 5, depending on patient status and history, and is performed by your physician under abdominal ultrasound guidance.

An echogenic catheter is inserted through the cervix into the uterine cavity, and the fertilised egg (embryo) or eggs (embryos) are placed 1-2 cm from the top of the cavity. Extra good quality embryos may be frozen for future use. A pregnancy test is performed 10 to 12 days after the embryo transfer.

The whole process of IVF may be performed either on a stimulated cycle or a mildly stimulated cycle or on a natural or totally natural cycle. The latter treatment approaches are typically preferred in cases of low ovarian reserve and a history of poor response.

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