Fresh Embryo Transfer

In vitro fertilization (IVF) is a procedure in which a embryologist fertilizes gametes in a culture medium outside the body. It is possible to carry out the procedure using the couple’s own eggs and sperm. It may also include anonymous donor eggs, sperm, or embryos. The embryo is then transferred to the female partner’s uterus for implantation. The whole procedure takes about three weeks.

Why Is It Done ?

IVF is usually recommended to a couple who has been unsuccessful in conceiving despite attempting less invasive methods such as intrauterine uterine insemination, in which sperms are inserted directly into the uterus at the time of ovulation.

However, IVF is recommended as the primary treatment option in the following situations:

The woman is over 40 years old.
Blockage of the fallopian tube : which makes it impossible for sperm to enter the egg and fertilize it, as well as for the embryo to reach the uterus. If a woman has already had tubal ligation and wishes to conceive again, IVF is a possible alternative to tubal ligation reversal surgery.
Ovulation disorder : which occurs when the amount of eggs produced is insufficient or when ovulation does not occur.
Endometriosis: As uterine tissue develops outside the uterus, it interferes with function of the ovary and tubes, rendering fertilization and embryo transport to the uterus for implantation difficult.
Problems with sperm production and motility: It is difficult for sperm to fertilize an egg if sperm counts or motility are low, or if sperm shape and size are irregular. The best sperm are chosen and used to fertilize eggs in the IVF process.
Unexplained infertility : which occurs when no cause is identified during the infertility assessment of both spouses.

How Do You Get Ready?

The first move is to seek the advice of a qualified reproductive endocrinologist. Both partners are likely to undergo multiple screenings before beginning an IVF cycle.

For females: 1.Ovarian reserve testing determines the quality and quantity of eggs produced. In the early days of the menstrual cycle, blood levels of Follicle-stimulating hormone (FSH), Estradiol, and Anti Mullerian hormone are measured. Ultrasonography is often used to assess the amount of eggs in each ovary and how the ovary will respond to fertility drugs.
2.The lining of the uterus will be tested before the IVF procedure. A hysteroscopy is a procedure in which a small, flexible, lighted telescope (hysteroscope) is inserted into the uterus through the vagina and cervix.
For males: sperm analysis is performed as part of the initial fertility assessment.
For couples: HIV, Hepatitis B, and Hepatitis C are among the infectious diseases that can be detected by screening.

What can you expect ?

Since there are several steps to the operation, it will be explained to the patient:

1.Stimulation of the ovaries :

injection FSH/HMG are given to stimulate the ovaries to produce several eggs instead of the single egg that forms normally each month. Since certain eggs will not get fertilize or grow normally after fertilization, multiple eggs are needed.
Monitoring: The growth of follicles is monitored using vaginal ultrasound of the ovaries. Blood tests are also used to assess how well ovarian stimulation drugs are functioning — estrogen levels rise as follicles grow, while progesterone levels remain low until just after ovulation
Oocyte Maturation Medication: Human chorionic gonadotropin (HCG) or other drugs are provided to help the eggs mature when the follicles are ready for egg retrieval, which usually takes eight to fourteen days.

2.Collection Of Eggs

The egg retrieval procedure is usually scheduled 34 to 36 hours after the final injection and before ovulation. To render the treatment painless, it is performed under sedation.
The most common form of retrieval is transvaginal ultrasound aspiration. A thin needle is inserted into an ultrasound guide to go through the vaginal canal and into the follicles to extract the eggs under ultrasound guidance.
A needle attached to a suction system is used to separate the eggs from the follicles. In around 20 minutes, you can extract several eggs. The more the number of eggs retrieved, the better the chances of conceiving.
The patient may experience cramping, fullness, or fullness after the egg retrieval procedure.
Incubation is performed on mature eggs in culture medium. Healthy fertile eggs will be combined with sperm in an effort to produce embryos.

3.Retrieval of sperm

If a partner’s sperm is used, he will have a semen sample the morning of ovum retrieval via masturbation. Other methods include testicular aspiration, which involves extracting sperm directly from the testicle with a needle or surgical procedure, are often used, or donor sperm may be used.

4.Fertilization.

Fertilization can be accomplished in one of two ways:

Traditional insemination: In this process, mature eggs & healthy sperms are combined in a culture medium, where the sperm uses its natural motility to fertilize the egg.
ICSI : single healthy sperm is inoculated directly into a mature egg in intracytoplasmic sperm injection (ICSI). When the quality or quantity of sperm is a concern, or fertilization attempts during previous IVF cycles have failed, ICSI is often used.

5.Embryo Transfer

Medications to prepare the uterine lining: Progesterone supplements are provided on the day of egg retrieval in order to allow uterine lining more responsive to implantation. The embryo transfer procedure normally takes 2 to 5 days after the egg retrieval.
The number of embryos transferred is usually determined by the age of the patient and the number of eggs collected. Since older women have a lower rate of implantation, more embryos are normally transferred. Extra embryos may be preserved and held for many years for potential use.
Although the operation is usually painless, the patient may feel mild cramping. A catheter is a long, thin, flexible tube that is inserted into the vaginal canal, then passed through the cervix and into the uterus. The catheter’s end is attached to a syringe holding one or more embryos suspended in a small volume of fluid. The syringe’s contents are then injected into the uterus.

Post-Procedure Results

The patient will resume regular daily activities after the embryo transfer. However, since the ovaries may still be swollen, physical exercise may be uncomfortable and should be avoided.

If you notice any of the following side effects, you can see a doctor right away:

Pain in the abdomen
Heavily bleeding
Urinary complaints
A blood test (beta-hCG) is used to determine if the patient is pregnant 12 days to 2 weeks after embryo transfer.

If the woman is pregnant and has a positive b-HCG test, the doctor will begin or refer her to prenatal care. If the woman is b-HCG negative, which means she is not pregnant, she should stop taking progesterone and expect to have her period within a week. If she still has some frozen embryos, she will be given frozen embryo transfer in subsequent cycles.

What Are the Consequences ?

Ovarian Hyperstimulation Syndrome : which is a condition in which the ovaries are overstimulated. Ovulation stimulation is a procedure in which women are given injectable hormone drugs to help them produce more eggs. The issue occurs when the body has an excess of hormones, which may lead to Ovarian Hyperstimulation Syndrome (OHSS). It’s a disease under which the ovaries swell up and cause excruciating pain. Abdominal pain, vomiting are associated problems.

Multiple pregnancies: If more than one embryo transfer occurs, there’s a chance of multiple pregnancies, which may lead to early labor and low-birth-weight infants. When a fertilized egg implants outside of the uterus, normally in a fallopian tube, it is known as an ectopic pregnancy. The fertilized egg is unable to survive outside of the uterus, and will lead to termination of pregnancy. Birth defects: The mother’s age is the most important risk factor for the occurrence of birth defects.

Start your Parenthood Journey with Goodwill IVF

We have highly experienced team of fertility experts, including obstetricians and gynecologists, pediatricians, embryologists, andrologists, ultrasonologists, counselors, nurses, and other healthcare professionals always dedicated to help you.