IVF (In Vitro Fertilization) is currently one of the most common techniques for treating fertility problems.
When IVF is conducted under optimal laboratory settings, the sperm’s fertilization of the eggs takes places externally. This alternative emulates the natural procedure usually occurring in the woman’s fallopian tubes. The procedure begins with the extraction of mature eggs from the woman’s body or from an egg donor. These are fertilized by sperm cells under strictly supervised laboratory conditions. The fetus is then transferred to the surrogate’s uterus simultaneous to the surrogate receiving supportive hormonal therapy.
IVF, initially designed to help women with obstructed or absent fallopian tubes, is now the go-to solution for a diversity of single or multiple conditions including ovulation disorders, complex sperm disorders, endometriosis, hormonal imbalances, and of course a combination of simultaneous disorders.
Preliminary Tests
Prior to treatment, a series of laboratory tests and other procedures are conducted to determine factors of risk that could disrupt the pregnancy or potentially harm the health of the fetus and/or mother. This includes immunology and antibody testing, infectious disease screening, testing the cervical surface to rule out the development of cervical cancer, viral hepatitis (B and C) antigen, HIV and more.
In addition, genetic testing is recommended to rule out hereditary diseases. The status of the uterus is examined based on hysteroscopy, or an up-to-date uterine scan should be performed. Similarly, sperm and blood tests should be performed to evaluate initial hormonal levels.
How Treatment is Carried Out
Ovarian stimulation and egg extraction. In vitro fertilization begins with ovarian stimulation. This leads to the production of multiple eggs suitable for fertilization. The eggs retrieval procedure will then be performed in an operating room located near the IVF laboratory. Retrieval will be performed under local cervical anesthesia or, rarely, under general anesthesia. The operation can cause discomfort and may require several hours of recuperative rest.
Fertilization of the eggs in the laboratory and growth of the embryos. – the eggs are then transferred to the laboratory and placed in a cultured medium and incubated. At the same time, the male sperm samples are retrieved and fertilized with the eggs after careful preparation.
Transfer of embryos to the uterus. The final stage in IVF is the transfer of embryos to the uterus. This stage is neither painful nor does it require anesthesia. It is performed by injecting the embryos into the uterine cavity through the cervix using a very thin catheter. This procedure should be followed by a day of rest.
Micromanipulation or ISCI (Intra Cytoplasmic Sperm Injection) is a common medical procedure when it comes to in vitro fertilization. The primary difference relates to the stage at which the mature egg becomes fertilized. In this procedure, a single sperm cell is injected directly into the egg. It bypasses the need of fertilization being performed in the Petri dish under laboratory conditions.
Micromanipulation treatments are usually used in circumstances where the fertility complication is in the male. Causes may be due to low sperm count, a problem with the vas deferens (sperm duct) or sperm motility, and morphology (problems related to sperm structure). The ICSI procedure is similar to in vitro fertilization (IVF), with the main difference being the stage at which fertilization is carried out.
Micromanipulation also begins with preliminary treatments to enhance ovulation and eggs retrieval, and procedures to improve the quality of sperm cells. On the day set for eggs incubation, the sperm cells will undergo a process to identify the highest quality sperm cell based on movement, structure, and shape. An option also exists for accessing sperm cells directly from the testicles: performing this kind of biopsy helps locate normal sperm cells. The selected sperm cell is directly injected into the egg using a microscopic device (micromanipulator) having a syringe that penetrates the egg’s protective layer to ensure the sperm’s successful entry.
Success rates using ICSI tend to be the same as for IVF procedures. This may be an excellent solution for completely infertile couples where the cause of infertility relates to very low sperm count, oddly shaped sperm, or no sperm at all.
