IVF or in vitro fertilization is a method used to help fertility and prevent genetic problems.
IVF is the most effective fertility treatment. This method can be done with paired eggs and sperm or through donated eggs and sperm.
In the continuation of this article, we will review the infertility treatment by IVF method and its stages Moj Aramesh Amitis Health Tourism Company, so stay tuned until the end of this article.
IVF Procedure in Details
During IVF infertility treatment, the patient must first take medications to strengthen and mature the eggs. In the next stage, mature eggs are collected from the ovaries, which is called egg retrieval. The eggs are then fertilized by sperm in a laboratory, which is called in vitro fertilization. At this stage, it takes 3 to 5 days for the created fetus to reach a suitable position and grow well. On the third day, the fetus is usually mature enough to be ready for transfer to the uterus.
In the last stage, the fetus is transferred to the mother’s uterus. A full IVF cycle takes about three weeks, and sometimes different IVF methods may be used during these stages, depending on the patient’s condition and the doctor’s diagnosis, in which case the treatment process will be a little longer.
IVF infertility treatment includes several different stages, including:
- Tests and screenings
- Ovarian stimulation
- Ovulation
- Sperm recovery
- In vitro fertilization
- Embryo transfer
Each cycle will last about two to three weeks and may require more than one menstrual cycle.
- Tests and screenings before infertility treatment by IVF
Before starting the IVF cycle, couples should have various screenings to check their overall health and further treatment success. These screenings include the following:
- Ovarian reserve test
During this test, the doctor checks the quality and quantity of the eggs. This test involves checking the levels of the hormone estradiol, follicle-stimulating hormone, and antimullerian hormone in the blood. This test is done in the first few days of menstruation. The result of this test is usually checked with an ultrasound of the ovaries to determine the condition of the ovaries in response to fertility drugs.
- Examination of the sperm sample
If a sperm test is not done, your doctor will take a sperm sample test to check your sperm quality before starting IVF infertility treatment.
- Infectious disease screening
Couples should be screened for infectious diseases, including HIV, before starting IVF infertility treatment.
- Checking Embryo transfer
This procedure is done to check and determine the depth of the uterine cavity and a fake embryo transfer is done by a doctor. Because the uterus must be prepared to hold the fetus.
- Examination of the uterus
Before starting IVF infertility treatment, the doctor examines the lining of the uterus.
In this procedure, an ultrasound hysterography is performed, during which fluid is injected into the uterus through the cervix to take pictures of the patient’s uterus using ultrasound.
Another method of examining the uterus is hysteroscopy, in which a small, thin camera is sent into the uterus to store images of the patient’s uterus.
- Induction of ovulation (ovarian stimulation)
The first stage of IVF infertility treatment begins with stimulating the ovaries with synthetic hormones (taking ovarian-stimulating hormone drugs) to produce multiple eggs. In this method, single eggs that grow each month are not enough and several eggs are needed to transfer the embryo. Because many eggs are unable to fertilize or grow normally after fertilization.
Several different medications may be used to stimulate ovulation, including:
Ovarian stimulation drugs
In this method, injectable hormonal drugs must be used to stimulate the ovaries. These drugs can stimulate several eggs at once.
- Ovulation puberty drugs
After the follicles are ready to retrieve the egg, which takes 8 to 14 days, gonadotropin injections or other drugs are used to mature the eggs.
- Medications to prevent premature ovulation
These drugs prevent the ovaries from ovulating prematurely and allow the growing eggs to be released at the right time.
- Uterine preparations
On the day of egg retrieval or embryo transfer, your doctor may recommend that you start taking estrogen-containing medications to help your uterus prepare for implantation and embryo acceptance.
Sometimes the patient is in a situation where the doctor has to stop the IVF cycle before retrieving the egg. Conditions that lead to the cancellation of IVF are:
Premature ovulation
Overgrowth of follicles, followed by ovarian hyperstimulation syndrome
A low number of growing follicles and other medical issues
If the IVF cycle is stopped, the doctor will consider changing the medication or changing the dose, or the patient will have to use donated eggs to continue the process.
- Oocyte retrieval
Usually, the ovaries should be stimulated for one to two weeks before the eggs are ready for recovery, and various tests are performed to determine when to collect the eggs, such as:
- Vaginal ultrasound
During this ultrasound, the condition of the ovaries can be detected through a monitor screen. Vaginal ultrasound is done to look at the growth of follicles and sacs filled with ovarian fluid to make sure the eggs are mature.
- blood test
A blood test is done to check the condition of the eggs after taking ovarian stimulants.
The process of egg retrieval
During egg recovery, the patient first receives analgesics and analgesics. This step is done through transvaginal ultrasound.
In the first stage, an ultrasound probe is inserted into the vagina to identify the follicles. A thin needle is then inserted through the guide into the vagina to access the follicles to retrieve the egg. If access to the ovaries is not possible through vaginal ultrasound, abdominal ultrasound is used to guide the needle into the vagina.
In the next step, the eggs come out of the follicle through the suction device. Several eggs can be separated from the follicle in 20 minutes. You may feel a slight tightness in your abdomen after the egg is recovered.
The mature eggs are then placed in a nutrient fluid and stored in good condition. In the next step, the fertilized eggs are fertilized by sperm to form an embryo. The remarkable thing is that not all eggs may be fertilized. About 12 days or a week after egg retrieval, the patient should have a blood test to determine if she is pregnant. If the test is positive, the doctor will refer the patient to a gynecologist for prenatal care. But if pregnancy has not taken place, the doctor recommends that the patient stop taking progesterone and a period occurs a week later. If the patient does not menstruate or has abnormal bleeding, he should inform his doctor immediately.
- Sperm recovery
After the egg is recovered, a sample of male sperm must be obtained in the laboratory, where semen is usually collected through masturbation. But other methods, such as testicular aspiration or direct extraction of sperm from the testicle, are also performed surgically. Donated sperm can be used if necessary and depending on the couple’s condition.
- Laboratory fertilization
Fertilization is done through two common methods, conventional fertilization and cytoplasmic injection of sperm. In the first method, which is conventional fertilization, healthy sperm are mixed with mature eggs and incubated (kept in proper conditions). In the second method, healthy sperm is injected directly into each egg. This method is used when the quality or quantity of semen is not acceptable or the fertilization performed in the previous period has failed.
- Embryo transfer
If egg retrieval is successful, the embryo is transferred about 6 to 10 days later.
Embryo transfer is usually done two to five days after egg retrieval in a doctor’s office. During this procedure, a mild sedative is first injected into the patient. Although this method is painless; however, the patient may feel slight cramping during fetal transfer. In the first step, the doctor inserts a thin tube into the cervix. A syringe containing several embryos suspended in some fluid is then attached to the end of the tube and, using a syringe, guides the embryos into the uterus.
IVF infertility treatment in Iran
Iran is currently one of the most successful countries in the world in terms of IVF infertility treatment, which with more than thirty years of experience in infertility research and treatment, has become one of the pioneers in infertility treatment in the world. There are more than 80 specialized infertility clinics in Tehran, Isfahan, Urmia, Yazd, and other cities of Iran, which offer the highest quality infertility treatments with the latest science and the most advanced equipment. The very high quality of services and the low cost of infertility treatments in Iran have led many international patients to choose Iran as a destination for infertility treatment.
Concluding remarks
If the patient has certain conditions such as follicle overgrowth, premature ovulation, and an insufficient number of follicles, the doctor will stop the IVF cycle. If IVF is stopped, changing the medication or changing the dose of the medication is recommended by your doctor. But in more specific circumstances it may be necessary to use donated sperm. If the patient develops severe or moderate pain after the transfer of the fetus, he or she should contact his or her doctor immediately to check for ovarian hyperstimulation, infection, and ovarian torsion. If more than one fetus is transferred to the mother’s uterus, it can lead to multiple pregnancies. Embryos that are in excess during in vitro fertilization can be frozen so that they can be used for later periods. Dear ones, you can contact the experts of Moj Aramesh Amitis Health Tourism Company and leave it to this group through every stage of the IVF infertility treatment.
Author: Sh. Khazaei
Translator: N. Rahimifar
