FIV /ICSI – Intracytoplasmic Sperm Injection
It consists of the injection of a single sperm into the cytoplasm of each egg.
Step by Step explanation: How the stimulation for In Vitro Fertilization (IVF) is performed.
How is the puncture performed to obtain your eggs? We explain it step by step.
The last step of In Vitro Fertilization (IVF)/ ICSI in which the embryos are transferred after being fertilized.
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To carry it out, a series of steps must be followed that are key to maintaining the chances of a successful pregnancy:
Ovarian stimulation
Necessary to obtain an ideal number of follicles with mature eggs. In the ovary, in a natural cycle, a certain number of follicles are recruited every month, of which only one will be selected to ovulate.
What advantages does it bring?
The more follicles, the more eggs and, therefore, more embryos to be able to select the best quality ones at the time of transfer. Therefore, we will give you a personalized FSH ovarian stimulation, based on your age and ovarian reserve, regularly monitored by ultrasound in order to avoid hyperstimulation.
We recommend a 24-hour rest after the puncture.
Egg Retrieval
The follicles are punctured and the eggs are collected vaginally, under sedation with ultrasound control, and in the presence of an anesthetist. The fluid obtained from the puncture is sent to the laboratory, where it is examined for the eggs.
Egg Fertilization
Once selected, the mature eggs (Metaphase two, MII) are placed in a plate with an appropriate culture medium. ICSI fertilization is performed by selecting an egg, with a single sperm. 24 hours later, they are looked at under a microscope for signs of fertilization (where the nucleus will have divided into two pronuclei). In 90% of cases, the sperm will fertilize the eggs and embryos are generated.
In Vitro Embryos Development
The embryos are observed daily to see how they divide and to note characteristics of normality, quality, and number of cells. These generate a degree of embryonic quality. During this time, the embryos remain closed in special incubators, until the day of transfer. It can be two, three, or five days post-puncture.
Today, all embryonic development can be monitored in real-time (Time Lapse) without having to move it from the incubator.
Transfer
Before transferring the embryos to the uterine cavity, the doctors will comment on the number of embryos available, their quality, and if they wish to cryopreserve any. The Law of Assisted Reproduction limits embryo transfer to a maximum of three.
In FIVMadrid, in order to reduce the number of multiple pregnancies, we recommend the transfer of a single embryo for women under 35 years old, when conditions are favorable, and without compromising gestation rates. In women over 38 years of age, two embryos are usually transferred, or three in very exceptional cases.
The transfer is a simple procedure that does not require sedation, which is performed with a full bladder and under ultrasound to control the release of the embryos into the uterine cavity.
We recommend a relative rest of two or three days after the transfer, and taking Progesterone to help the implantation of the embryos. Two weeks later you have to take a pregnancy test and contact the clinic to notify the result.
If you do get pregnant, consider your pregnancy a normal one and tell your obstetrician that you have been subject to In Vitro Fertilization (IVF).
