IVF – In Vitro Fertilization

WHAT IS IN VITRO FERTILIZATION?

In Vitro Fertilization is an assisted reproductive technology (ART) used for infertility treatment and that involves collecting eggs from the woman and retrieving a male sperm sample to combine them in a laboratory. Subsequently, the embryo resulting from this procedure is transferred into the uterus. At the ReproART Reproductive Center, 57-86% of the In Vitro Fertilization cases result in a positive pregnancy test.

In Vitro Fertilization consists of the following stages: ovarian stimulation, egg aspiration (retrieval), fertilization and embryo development. The cycle is completed by embryo transfer, while the remaining embryos are frozen.

IN VITRO FERTILIZATION (IVF) STEPS

OVARIAN STIMULATION

Normally, women produce one egg per cycle.  To achieve better success in IVF (In Vitro Fertilization) treatment, however, we attempt to collect multiple eggs. Ovarian stimulation is performed to prepare multiple eggs. To stimulate ovarian follicles, doctors prescribe injected gonadotropins (Puregon; Gonal F; Menopur, and others). Medicated ovarian stimulation is known as Controlled Ovarian Stimulation (COS).

The patient is medicated over 7-13 days. The dosage and precise duration depend on her response to medications which can depend on her age, weight, and other relevant factors. To monitor the growth of follicles, ultrasound (sonography) and blood tests are conducted.



EGG RETRIEVAL

Eggs develop in ovarian follicles, and follicular growth is indicative of egg ripening. After the ovarian follicles have grown sufficiently follicle retrieval is scheduled by doctor. To trigger ovulation relevant medications are administered and egg retrieval takes place 34-36 hours after this final injection. Follicle aspiration (retrieval) is performed under light anesthesia, a simple harmless procedure, which lasts only 15-30 minutes, and to which patients respond very well. Using a special needle, follicular fluids are retrieved from the ovary under ultrasound monitoring. The patient spends several hours in recovery under doctor’s supervision. Subsequently, the patient is free to go home and resume normal everyday activities.




FERTILIZATION AND CULTIVATION

The embryologist identifies eggs in follicle fluids aspirated from the ovarian follicles, examines them for maturity, and adds sperm in amounts necessary for fertilization. This process is called standard IVF (In Vitro Fertilization). If necessary, egg fertilization may involve Intracytoplasmic Sperm Injection (ICSI). ReproART founder Lika chkonia, performed the ICSI that led to birth of the first child in Georgia resulting from this technique. Successful egg fertilization is confirmed 18 hours after the procedure, followed by its development monitored by the embryologist in the course of 24-72 hours.

In cases of successful in vitro fertilization (IVF), culture of the embryo continues in the laboratory for a period of between 2 and 5 days, sometime even 6 or 7 days. On the 5th day the most advanced embryos become blastocysts. The superb quality of blastocyst allows for transferring only one embryo, thereby mitigating the risk of multiple pregnancy.

EMBRYO TRANSFER

The most suitable embryo is transferred into an intended mother’s uterine cavity using a fine plastic catheter on the 3rd-5th day after fertilization, under ultrasound monitoring. The procedure is painless and lasts only a few minutes.

After embryo transfer, the patient must continue with administration of some medications. A pregnancy test is performed on the 9th-11th day after embryo transfer.

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