After your Comprehensive Assessment Program we will recommend the best treatment for your individual case and we will outline a plan to continue together. In case the recommended treatment is IVF or ICSI, these would be the objectives of the cycle:
- Extract as many good quality ovules: To achieve this it is necessary that the follicles grow symmetrically during ovarian stimulation.
- Obtaining high quality embryos: For this we invest a lot of effort building the best embryology laboratory in Latin America, thanks to which we have high rates of fertilization, blastocysts and pregnancies.
- Seleccionar los mejores embriones para transferir: Gracias al cultivo extendido de embriones podemos filtrar los mejores embriones, es decir aquellos con mejor oportunidad de lograr un embarazo exitoso.
- Select the best embryos to transfer: Thanks to the extended embryo culture, we can filter the best embryos, that is, those with the best chance of achieving a successful pregnancy.
Each step will be discussed with the prospective parents, answering any questions they may have at each stage of the process.
Below you will find a summary of the steps to achieve each of the objectives:
Ovarian stimulation and follicular monitoring
This stage lasts between 8-12 days per cycle.
Stimulation: You will have to administer between 2-3 injections every day, using very small needles.
Follicular monitoring: You should go to the clinic for 20 to 30 minutes a total of 4 to 6 times during ovarian stimulation. During these visits we will perform vaginal ultrasounds and blood hormone tests to determine if the dose that is being used is adequate.
Oocyte maturation: Once the follicles are the right size, an injection will be administered that matures the oocytes so that oocyte extraction can be performed 34 to 36 hours after the injection.
It is a procedure that lasts approximately 20 minutes which is performed under sedation level. Patients usually go home 1 hour later and require the same amounts of pain medications as Tylenol or Ibuprofen.
On the same day as your retrieval, your partner should produce a semen sample using the same procedure used when the semen analysis was performed.
In some cases, frozen semen will be used, which will be thawed on the same day as the aspiration. It is also possible to choose to collect semen at home before oocyte extraction.
Before the IVF or ICSI our embryology team will process the semen in the andrology laboratory. This process takes about 1 hour being the primary objective of this phase to be able to select the most healthy and mobile sperm; likewise these are separated from bacteria and other components that can negatively affect the oocytes.
It is performed between 4 and 6 hours after oocyte extraction.
Once you have the eggs and sperm in the laboratory, it is necessary to get them to join. This can be achieved in two ways: In vitro fertilization (IVF) or ICSI (Intracytoplasmic sperm injection).
The embryo transfer is the last step before the pregnancy test (9-12 days later).
This takes a few minutes and is not painful. The main complaint that can be felt is having a full bladder since it is a requirement to be able to make the ultrasound guided transfer.
Between 9 and 12 days after the embryo transfer you will go to our clinic for a pregnancy test which will determine if the embryos implanted succesfully.
Waiting for results is usually the most difficult stage of the whole process, we will be there for you every step of the way.
IVF (In Vitro Fertilization)
What is it?
An egg is placed together with an approximate 50,000 mobile sperm so that the best sperm can fertilize the egg.
What is it for?
This method is used when problems of male infertility have been ruled out and no problems are expected during fertilization.
ICSI (Intracytoplasmic Sperm Injection)
What is it?: Our embryology team manually selects a mobile and healthy sperm that will then be injected directly into the ovule using a micro needle.
What is it for?: It is the method of choice when there are problems of male infertility and / or there is expected to be some problem during fertilization.
Embryonic development and culture
The morning after the extraction and fertilization of the ovules, they are checked to see if they became embryos (fertilized). Normally embryos have 2 pronuclei (one contains DNA from the ovule and another from the sperm), both of which must be visible.
Recent advances in reproductive medicine allow embryos to grow in the laboratory until 5-7 days. Which facilitates the selection of those with greater potential since the others will not develop until after that window of time.
Usually, embryos that reached the blastocyst stage (200 cells) on the 5th day are searched, these being considered the best quality. It is thought that those who did not reach this stage in the embryology laboratory were not going to achieve it within the body.
In some patients where few embryos develop, it may be recommended to transfer on the 3rd day of embryonic development.
The genetic examination of the embryos is carried out on the 5th, 6th or 7th day of embryonic development. This allows obtaining from 5 to 7 cells for genetic analysis from an embryo of 200 cells. Several studies indicate that performing the biopsy at the blastocyst stage does not have a negative impact on the embryo or future baby.
If you want to perform a genetic analysis to improve pregnancy rates by transfer or reduce the risk of pregnancy losses, it is recommended to cryopreserve the embryos after the biopsy to wait for the results of the analysis.
Embryo cryopreservation has been performed for more than 30 years and in our laboratory more than 99% of these survive thawing.