In Vitro Fertilisation (IVF)

In Vitro Fertilisation (IVF)

This is an assisted reproduction technique which consists of the fertilisation of oocytes by the sperm cells and their subsequent development into embryos, taking place in the assisted reproduction laboratory which attempts to reproduce natural conditions to the maximum.

ICSI

This is a special technique for insemination of oocytes in in vitro fertilisation procedures consisting of the introduction of a single sperm cell within the cytoplasm of the oocyte in order to fertilise it. 

What is the process

1. Ovarian stimulation as in conventional IVF.
2. Preparation of the ovules. Once the ovules have been obtained, they are passed to the embryology laboratory where al granulosa cells around them are removed to check their state of maturity and facilitate injection of the sperm cell. To separate the cells from the cumulus and the crown, both mechanical and enzymatic procedures are used. To do so, it undergoes a series of washes in an 80 IU hyaluronidase solution. Once released from the cumulus, the ovules are observed to check their maturity. Only mature ovules in Metaphase II will be microinjected.
3. Preparation of the semen and obtaining the best sperm cells. Before microinjecting the sperm cells, they have to be processed through capacitation or concentration by regular or slightly modified procedures.
4. Preparation of the pipettes. Special pipettes are used, with the appropriate size and orientation for seizing sperm cells one by one, immobilising them and injecting them inside the ovules.
   • holding pipette, which holds the oocyte
   • microinjection pipette, which introduces the sperm cell
5. Microinjection process. A special inverted microscope is used, with appropriate systems which will allow us to immobilise and capture the sperm cell and introduce it inside the cytoplasm of the oocyte. During the whole process, the plate of the microscope is adjusted to 37ºC and the media used are plugged to prevent pH alterations. From the recovered sperm cells, those which are morphologically normal and which have good mobility are selected. The immobilisation of the sperm cell before the microinjection is essential as this will facilitate the fertilisation.
   • Once the ovules have been microinjected, they are placed in the culture trays in the incubators for approximately 15-20 hours for fertilisation to occur.
6. Evaluation of the fertilisation. The following day, 15-18 hours after the microinjection, the biologists will observe the existence of fertilisation in the ovules. The fertilised ovules or zygotes will continue their embryo development in the culture media until they reach the appropriate embryonic stage for their transfer to the woman’s uterus. The most outstanding characteristic of the ICSI is that its results are not affected by the sperm concentration, mobility or morphology. This is due to us carrying out a selection of the best sperm cells present in the semen samples. This allows us to obtain ICSI results with severe male factor similar to those obtained in classic IVF with normal semen.

The results of the prenatal diagnosis and paediatric monitoring of the thousands of children born through the application of ICSI around the world are very reassuring when confirming that there is not a higher rate of genetic anomalies with regard to the general population, being a safe technique.

At FIV Valencia it is very important to be able to offer the newest, safest techniques which allow us to improve our pregnancy rates, resulting in a lower number of cycles necessary for achieving your objective of having a healthy child. In this way, discomfort and potential complications are minimised, as well as treatment costs and the emotional effects they entail.

Cases in which the treatment is applied:

• Couples where the woman has alterations in the reproductive system which impede the arrival of sperm cells to the oocyte (blocked fallopian tubes, etc.).
• Couples where the partner’s semen has anomalies which may diminish the fertilisation capacity of the sperm cells (minor-moderate male factor).
• Infertile couples for whom artificial insemination procedures have failed.
• Women over 38 years old.
• Diminished ovarian reserve.
• Stage III-IV endometriosis.

Aplications for ICSI

• Low concentration of sperm cells in the ejaculate.
• Low motility of sperm cells in the ejaculate.
• Low percentage of sperm cells with normal forms.
• Concentration of sperm cells after sperm capacitation lower than 1,000,000/ml.
• Patients with valuable semen samples (vasectomised men, men subjected to radiotherapy or chemotherapy).
• Patients for whom conventional IVF has previously failed.
• Patients subjected to a Preimplantation Genetic Diagnosis (PGD).
• Patients with chromosomal and functional anomalies.

Results of In Vitro Fertilisation

At FIV Valencia, the results of in vitro fertilisation are 47% successful. This percentage rises for patients with a good prognosis (aged under 38 years) the pregnancy rate per cycle carried out being around 60%. The accumulated percentage of pregnancy is 75% using supernumerary embryos.

At FIV Valencia, one of the main priorities is the continuous improvement of our results, and great effort is therefore dedicated by the whole team.

This leads patients attending our centre to carry out a lower number of attempts to achieve the desired pregnancy, thereby resulting in lower economic costs and less emotional impact.

Results of ICSI

No difference is observed in the pregnancy rate between the conventional IVF cycle and ICSI provided that there is adequate medical indication.

At FIV Valencia one of the main priorities is the quality of our results, and our whole team works to maintain these levels.