Gonal-f pen: doses of 300, 450 and 900 - How does it apply?

In vitro fertilization (IVF) is a highly complex assisted reproduction technique that consists of extracting the eggs by follicular puncture and then fertilizing them in the laboratory with the spermatozoa of man. Next, the evolution of the embryos is observed until they are transferred in the uterus of the future mother in order to achieve the pregnancy.

Next you have an index with all the points that we are going to treat in this article.

Index

In vitro fertilization (IVF): What is it and what is its price?

• 1. When does IVF need to be done?
• 1.1. Male Infertility
• 1.2. Feminine infertility
• 2. Requirements for IVF
• 3. What is IVF?
• 4. Results and probabilities of success
• 5. Advantages and disadvantages
• 5.1. Advantages of IVF
• 5.2. Disadvantages of IVF
• 6. Possible risks
• 7. Price of IVF
• 8. Questions from users
• 8.1. What negative effects can IVF medication have?
• 8.2. What are the requirements for IVF in Social Security?
• 8.3. Is it possible to have a natural pregnancy after IVF?
• 8.4. Is IVF medication always the same?
• 8.5. What are the symptoms of positive IVF?
• 8.6. What is the probability of success of a second IVF?
• 8.7. Do you need to rest after IVF?
• 8.8. What type of IVF is better? Conventional IVF or ICSI?

Depending on how we perform the union of the gametes (ovule and sperm), we will talk about one type of IVF:

• Conventional IVF: ovules and spermatozoa are placed on the same culture plate waiting for them to be able to fuse by themselves.
• ICSI (intracytoplasmic sperm injection): the sperm is introduced directly into the egg through microinjection.

Performing one or another method will depend on the infertility conditions of each couple, as well as the preferences of each assisted reproduction center. In any case, with the exception of the fusion or fertilization itself, the previous steps are the same. You can see them in detail in the following video:

As we can see in the video, IVF is more complex than artificial insemination . There are more necessary steps and medical intervention. However, the likelihood of pregnancy is also greater, so it is usually the technique that is applied in a greater number of cases.

You can discover more differences between IVF and artificial insemination by clicking on the link.

When does IVF need to be done?

There are several situations of sterility that can lead a couple to need the IVF technique to get pregnant. Infertility can be due to both male and female problems or even a combination of both.

The following are the most common indications of in vitro fertilization:

Male Infertility

In cases of moderate or severe male infertility, in vitro fertilization can be used to try to achieve pregnancy:

• Oligozoospermia
• Teratozoospermia
• Astenozoospermia
• Cryptozoospermia
• Combination of the above alterations

Feminine infertility

In women, complications usually occur in the following points:

• Ovulation problems caused by ovarian endocrine factor
• Tubal factor
• Uterine factor
• Cervical factor
• Endometriosis

Requirements for IVF

In order to apply in vitro fertilization, it is necessary for women to be able to produce eggs. In addition, it is necessary that it does not have problems or uterine abnormalities that impede the implantation of the embryo or the evolution of the gestation.

In the case of man, the requirements vary depending on the type of IVF that we are going to perform. If the seminal quality allows it, ie if it has an REM of between 1 and 3 million / ml, conventional IVF will usually be performed. If, on the contrary, the sperm has serious problems of mobility, morphology or concentration ICSI will be chosen. Also samples that do not come from ejaculate require ICSI, since their quality is usually very low.

In any case, even if the requirements for conventional IVF are met, there are fertility clinics that prefer to perform ICSI.

Conventional in vitro fertilization or ICSI

On the other hand, if the woman does not meet the egg production requirement due to a low ovarian reserve or menopause, she can perform IVF with egg donation. If you want more information about it, I recommend reading this article: IVF with egg donor.

It is also possible to perform IVF with donor semen and even IVF with double donation, ie donated eggs and spermatozoa.

What is IVF?

The IVF process is complicated, as there are several steps that must be taken to achieve the ultimate success of the treatment.

Controlled ovarian stimulation the woman receives hormonal medication for approximately 10 days to stimulate egg production and thus obtain a greater number of them. In addition, this medication allows to control the time of ovulation, thus increasing the chances that the eggs obtained are mature and fit for fertilization. Ovarian or follicular function the surgical procedure in which mature eggs are extracted from the ovary. It is performed by aspiration, lasts about 20-30 minutes and requires anesthesia. Collection and preparation of the semen collects the sample of the male generally by masturbation although it can also be obtained by aspiration of epididymis or testicular biopsy. The sperm then undergoes a process of sperm training that will make the spermatozoa capable of fertilizing and giving rise to the embryo. Fertilization and sperm are fused either by themselves (conventional IVF) or by microinjection (ICSI). If you want to know more details about the differences between one and another way of merging the gametes you can read this article: Differences between IVF and ICSI. First steps in an IVF cycle Embryos once the ovum has been fertilized, the embryos are left in a specific incubator that maintains optimal conditions of embryonic development. It is observed its evolution until the transfer, that can be realized in day 3 or in day 5-6 of development.Preparación endometrialla woman receives estrogens and progesterona so that its endometrio (uterine layer where implants the embryos) have the aspect and thickness suitable to favor implantation. Embryo transfer will choose the embryo of the highest quality and will be transferred to the uterus of the expectant mother waiting for implantation to occur and pregnancy begins. Although it is recommended to transfer a single embryo, in Spain is allowed up to a maximum of 3 embryos. Freezing embryos quality embryos that have not been transferred are cryopreserved by the vitrification method, for later use. Pregnancy test between 10 and 15 days after the transfer, the woman will be able to perform the pregnancy test that detects the hormone hCG, produced from the embryonic implantation. IVF process from the fertilization until the embryonic transference

In the following article, each of these steps is explained in more detail: In vitro fertilization step by step.

Results and probabilities of success

As in all assisted reproduction techniques, treatment success is measured by several factors, with the patient's age being one of the most influential.

Specialists have been able to stipulate certain parameters of treatment success. They are:

• 40% in women under 35 years.
• Between 27-36% in women aged 35-37 years.
• Between 20-26% in women between 38 and 40 years.
• Between 10-13% in women over 40 years.

When we talk and compare success rates between different techniques or between different reproductive centers, it is important to take into account what we mean by success, because there are times that the results are given in probability of pregnancy, probability of childbirth, probability of healthy child at home, etc. .

The actual success of IVF refers to the birth of a healthy child and not only to the fact of achieving pregnancy, since unfortunately not all pregnancies are evolutionary.

Success rates of in vitro fertilization

You can read more about the results and pregnancy probabilities in this article: IVF Success.

Advantages and disadvantages

As with other reproductive techniques such as artificial insemination, in vitro fertilization has advantages but also drawbacks. We summarize them below:

Advantages of IVF

The main advantages of in vitro fertilization are as follows:

• High success rates.
• It allows pregnancy in couples with severe fertility problems. In particular, ICSI offers the possibility of fertilization in cases of severe male infertility. such as obstructive azoospermia.
• It is possible to perform the process with donor eggs and spermatozoa, thus allowing pregnancy in numerous cases of infertility.
• In general, the possible side effects are not serious.

Disadvantages of IVF

However, IVF also entails a number of drawbacks that we must also take into account:

• The patient must self-administer hormonal medication, which can lead to complications.
• Requires surgical intervention under anesthesia. Although it is a simple operation and of short duration, it is not totally free of risks.
• Its price is higher than other reproductive techniques such as artificial insemination

Possible risks

As we have seen in the previous section, ovarian stimulation and follicular puncture performed in the IVF process may give rise to certain risks that the patient must know before starting treatment.

Ovarian hyperstimulation syndrome (OHSS) occurs as a consequence of the high response of women to ovarian stimulation medication. There is an increase in the size of the ovaries and extravasation of fluids out of the bloodstream due to increased permeability of the blood vessels. In extreme cases, it can compromise the hepatic, hematological, renal and respiratory systems.Embarazo multiplei is transferred a single embryo, the probability of multiple pregnancy is low. However, if two embryos are transferred, there is a 6% chance of twin pregnancy and if 3 are transferred, the probability of having twins is 12% while that of triplets is 3%. In any case, these rates will depend on other factors such as maternal age or quality of the uterus. Main risks and side effects of FIVAborto natural about 20% of pregnancies achieved by IVF end in a natural abortion, and most occur in the first weeks of pregnancy. In any case, just like the multiple pregnancy, it will depend on the age of the patient and the conditions of each woman or couple. Ectopic pregnancy is a pregnancy in which the embryo has implanted outside the uterine cavity. Between 2% and 5% of women who undergo IVF treatment may experience an ectopic pregnancy. This figure contrasts with the approximate 1% of cases in which this type of pregnancy can occur naturally.

If you want more information about the risks of IVF I recommend reading this article: Risks of IVF.

IVF price

In vitro fertilization has an approximate cost of between 3000 and 5000 ?. The price will vary depending on the needs of each situation, the fertility clinic where the treatment will be performed, the necessary tests, etc.

Normally, the medication that the patient receives is not included in the initial budget and usually costs between 1000 and 1200 ? the stimulation and around 300 ? the endometrial preparation.

It is important that the couple carefully review the additional costs and those included in the price given by the specialist.

It should also be considered that pregnancy does not always occur in the first attempt of IVF so it is convenient to consult the cost of additional processes such as embryo freezing, transfer of frozen embryos, etc.

In Assisted Reproduction ORG we have agreements with Spanish clinics to help you get the best price on your treatments. You can access our Discount Section directly to get your coupon and a free first visit: Discounts on FIV / ICSI.

On the other hand, there are centers that make special discounts after the second or third attempt of IVF.

User questions

What negative effects can IVF medication have?

Answer by Fertility Madrid

Medications used in assisted reproduction may produce several side effects such as headaches, mood swings, abdominal pain, hot flashes, and bloating. Occasionally, they may produce ovarian hyperstimulation syndrome.

With ovarian stimulation more eggs develop than in a natural cycle, but this will not cause menopause to occur before. Women are already born with a finite number of eggs and maturation has no effect nor will the reproductive stage be terminated earlier.

What are the requirements for IVF in Social Security?

The basic requirements for access to an in vitro fertilization treatment in Social Security are: that the couple does not have healthy children in common and that the woman is under 40 years old.

Is it possible to have a natural pregnancy after IVF?

There are numerous couples who achieve the second pregnancy naturally after having undergone an "in vitro pregnancy", as it is often called IVF pregnancy. This happens in situations where the cause of infertility is reduced or disappears.

Stress is an example of this. Some couples find their fertility reduced due to the stress caused by the pregnancy search. Anxiety can affect the quality of your eggs and sperm and make it difficult to conceive.

A change in lifestyle (relaxation, feeding, reduction of toxins, etc.) can lead to a substantial improvement in fertility potential.

This can also happen in cases of infertility or infertility of unknown cause.

Is IVF medication always the same?

No, although the goal of the administered medication is the same, there are different protocols and way to stimulate the ovary and prepare the endometrium.

Depending on the situation of each woman, the medication and the dose most appropriate to its characteristics are determined. For this reason, it is essential to perform a good fertility study for women prior to the IVF process. Also, it is important to control the response to the indicated medication and change the type of drug or dose depending on it.

What are the symptoms of positive IVF?

After the success of IVF, that is, after obtaining a positive pregnancy test, the symptoms do not have to be different from those of the natural pregnancy. It is possible that the medication given may lead to some special discomfort such as bloating or heaviness, but in principle they do not have to vary.

You can read more about symptoms here: Pregnancy symptoms.

What is the probability of success of a second IVF?

Depending on the cause of the failure on the first attempt of IVF, a second attempt may or may not improve the probability of success.

For example, if the failure of the first IVF has been due to poor endometrial preparation, the second attempt will change the medication protocol to try to improve this aspect.

Normally in the second attempt some aspects are changed to improve the treatment and this usually results in a greater probability of success, although as we have said, it will depend on each situation.

Do you need to rest after IVF?

Usually not. Neither after follicular puncture nor after transfer is the woman required to rest, beyond the minutes indicated by the physician. only in exceptional cases, the specialist will recommend rest.

What type of IVF is better? Conventional IVF or ICSI?

There is not one technique better than another, as both have advantages and disadvantages. Depending on the characteristics of each couple and their situation of infertility, it will be more advisable to carry out one or the other method to fertilize the ovum.

There will be cases such as situations of severe asthenozoospermia in which it will be necessary to perform the ICSI to be able to achieve the pregnancy. However, there will be other cases such as alterations in ovulation or tubal obstruction, in which conventional IVF can solve the problem.

Conventional IVF is closer to the natural process and requires less manipulation. However, with ICSI we are one step closer to pregnancy, because we force the union of ovum and sperm.