The different stages of in vitro fertilization


professional holding a test tube

What is In Vitro Fertilization? Literally, this technique consists of collecting a maximum number of mature oocytes and putting them in the presence of a large number of mobile spermatozoa. Thus, fertilization can occur in the laboratory with a greater probability of success than in the female organism.

The four stages of in vitro fertilization:

1. Stimulation of the ovaries

Most often, treatment is started at the end of a spontaneous menstrual cycle in order to obtain not one, but several oocytes per cycle. Stimulation of ovulation promotes the selection and development until maturation of several follicles in the woman's ovaries. Most often, ovarian stimulation combines the simultaneous or sequential administration of hormones in order to obtain several mature oocytes at the same time.

The first hormone will stimulate the ovaries and therefore the growth of the ovarian follicles: this is FSH. Sometimes another hormone is added, LH.

The second hormone (GnRH Antagonist) will block the production of pituitary hormones. The aim is to avoid spontaneous ovulation, which would prevent the collection of oocytes for the second phase of IVF.

The response of the ovaries can vary from one woman to another, which is why it requires very careful monitoring in order to adapt the treatment and determine the precise moment when follicular maturation will be optimal to trigger ovulation.

2. Oocyte puncture

Oocyte retrieval is performed when the ovarian stimulation parameters are optimal. This takes place 36 hours after the gonadotropin injection, by ovarian puncture. In fact, the doctor directs a needle deep into the vagina and crosses the wall to reach the ovaries using an ultrasound probe. The contents of the follicles are then aspirated, all under intravenous sedation and local anesthesia. The collected fluids are examined and then placed in a culture medium reproducing conditions close to those encountered in the fallopian tube.

When the procedure is completed, you will be informed of the total number of eggs collected. On the same day, these eggs will be put in contact with sperm in vitro in order to be fertilized and then form embryos.

3. Insemination

Insemination is performed on the same day as the egg retrieval. The eggs are brought into contact with sperm in vitro in order to be fertilized and then form embryos. Sometimes, sperm are injected directly into the eggs to facilitate fertilization. The solutions are placed in an incubator at 37°C. The next day, it is possible to observe the number of fertilized eggs, but it is only 48 hours after the follicular puncture that the number of embryos obtained can be known.

4. Embryo transfer

Embryo transfer involves placing one or more embryos inside the uterine cavity, usually 5 days after egg retrieval. This procedure requires the patient's bladder to be full in order to obtain better visualization using the abdominal ultrasound probe.

And after?

Waiting for the pregnancy test is often the most anxious time for patients undergoing IVF treatment. A blood test is performed 7-10 days after the transfer: it accurately detects the pregnancy hormone (hCG) in your blood, and determines whether or not the in vitro fertilization was successful.

To learn all about the different treatments for infertility in women offered by Procrea, visit our dedicated page here. Our fertility specialists are here to answer all your questions with respect and listening.

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