The process of IVF step-by-step

The conventional IVF and IVF-ICSI procedure is the same, except for one of the steps: the union of the ovum and the sperm. On the other hand, the process does not change either if it is carried out in a private clinic or in the Social Security.

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

Index

The step-by-step in vitro fertilization process

• 1. What is the IVF process?
• 1.1. Controlled ovarian stimulation
• 1.2. Follicular puncture
• 1.3. Collection and preparation of semen
• 1.4. Fertilization or fusion of gametes
• 1.5. Check fertilization
• 1.6. Cultivation of embryos
• 1.7. Preparation of the endometrium
• 1.8. Transfer of embryos
• 1.9. Freezing the embryos
• 1.10. Pregnancy test
• 2. Price of IVF
• 3. Questions of the users
• 3.1. How is the frozen embryo IVF procedure?
• 3.2. What is the duration of the in vitro fertilization procedure?

What is the IVF process?

In vitro fertilization means fusing gametes (eggs and sperm) in the laboratory. In order to achieve this union and achieve pregnancy, a series of steps are required:

Controlled ovarian stimulation

Specific hormones are given to women for two main purposes. On the one hand, make all the eggs that start the growth in that cycle, achieve the stage of final maturation and not just one of them as it occurs naturally. On the other hand, with the external hormones we manage to control the ovarian cycle and know approximately when the eggs are mature and therefore, when ovulation is close to occur. This increases the likelihood of success.

There are several medical protocols to stimulate the ovary, although they generally consist of administration of gonadotropins and analogs of GnRH. The doctor will establish the most appropriate treatment for each patient.

During the 6-10 days of stimulation, the patient should go to the doctor's office periodically for the specialist to monitor the evolution of the ovary and to schedule the puncture at the right time.

If you want to know the exact details of this step, visit this link: Stimulation of the ovary.

Follicular puncture

The next step is to obtain the eggs in follicular or ovarian puncture. It is a surgical procedure performed under anesthesia in which the gynecologist performs the ovarian follicles ("bags" containing the eggs) and aspirates their contents. Subsequently, the laboratory will analyze the aspirated follicular fluid in search of the eggs.

Follicular puncture to obtain eggs

This process takes about 30 minutes. If you want to know more data about follicular puncture click here: Ovarian puncture.

Collection and preparation of semen

The sperm sample is usually obtained by masturbation. A few minutes after ejaculation, the sample goes through a process known as sperm training that consists of eliminating poor sperm and seminal plasma. Thus, the sample is concentrated in spermatozoa with progressive mobility.

In cases where masturbation does not allow obtaining spermatozoa, the sample can be obtained by testicular biopsy or aspiration of the epididymis. These types of samples require ICSI because of the low quantity and poor quality of the spermatozoa.

Fertilization or fusion of gametes

It is the moment in which egg and sperm are fused to join the genetic endowment of both parents and give place to the new being. The union can occur with more or less intervention of the embryologist.

In the case of conventional IVF, the embryologist simply places the ovum and spermatozoa on the same culture plate, waiting for the latter to be able to penetrate the ovum.

On the contrary, in the ICSI, the embryologist is the one that directly deposits the spermatozoon inside the ovule. You can see the exact differences by clicking on the link: Conventional FIV and ICSI Differences.

fecundacion"> Check fertilization

After 16 to 20 hours of fertilization, the embryologist checks whether the egg has been properly fertilized or if there has been some mistake that has prevented the fusion. For this, it analyzes the presence of the two polar bodies (CP) and the two pronuclei (PN), which will merge to give rise to the zygote (embryo of a cell). We can see it in the image.

Evolution of the embryo from fertilization

Cultivation of embryos

Zygotes are left in culture to continue their evolution. They will thus pass to the state of embryo and later to blastocyst. In the image above we can see the differences between each state.

They will be left in a specific incubator that maintains the temperature and gas conditions suitable for embryonic growth until the time of transfer. During the time they are in the incubator, their status will be analyzed and their quality determined.

You can read more about the quality of the embryos by clicking on the link.

Preparation of the endometrium

The patient will receive hormonal medication different from that of ovarian stimulation to get her endometrium receptive, that is, capable of interacting with the embryo to implant and start pregnancy.

The endometrium should have a trilaminar aspect and a thickness of approximately 7 to 10 mm to favor embryonic implantation.

The medication that is usually given is estrogens and progesterone either vaginally, orally or in the form of patches. If IVF is made fresh, often the natural release of estrogen is used and only progesterone is given to support the luteal phase.

Transfer of embryos

Based on the quality of the embryos, the best embryo is selected, that is, the one with the greatest implantation potential. It is transferred to the uterus of the expectant mother through a specific cannula, waiting for it to implant in the uterine endometrium and thus to produce pregnancy.

Transfer of embryos to the mother's womb

The transfer is painless and of short duration. It is performed by the gynecologist in the office or in the operating room without the need for anesthesia.

I recommend reading these articles for more information: Embryonic transference.

Freezing the embryos

Spanish legislation allows transfer of a maximum of three embryos, although the common one or in some cases two. Leftover embryos with good quality that are not transferred are cryopreserved through the embryonic vitrification process.

Pregnancy test

Between 10 and 15 days after the transfer the woman will be able to take a beta-hCG test to check if IVF has been successful and therefore has achieved the goal: pregnancy.

The pregnancy test can be done in both urine and blood. Both detect the hormone beta-hCG, known therefore as "the hormone of pregnancy." For this reason, the period between transfer and pregnancy test is known as "beta-waiting".

In the following image we can see a summary of conventional IVF.

The conventional IVF procedure

IVF price

The cost of in vitro fertilization varies depending on the center where the treatment is performed and the characteristics of each patient. Approximately can cost between 3000 and 5000 ?.

It should be noted that many of the steps discussed above are not included in the initial budget, such as embryo freezing. This is considered a separate process and its price is 300-600 ?. The same happens with the medication for the stimulation and for the preparation of the endometrium, which costs the treatment about 1000-1500 ?.

The couple should be well informed of everything included in the initial budget once it has been decided that the assisted reproduction treatment will be carried out.

In Assisted Reproduction ORG we have agreements with Spanish clinics to offer you the best prices throughout the process.

In our discount coupons you have all the techniques that are included in detailed way, besides a first free visit so that you report of everything without commitment. You can download your coupon here: See discounts in FIV / ICSI.

It is important to keep in mind that pregnancy is not always achieved at first. Therefore, you should consult the cost of submitting to more attempts at the clinic and if they make any kind of discount.

User questions

How is the frozen embryo IVF procedure?

IVF with frozen embryos consists directly in the endometrial preparation and the transfer of the embryos to the maternal uterus. The steps of ovarian stimulation, follicular puncture and embryo culture are obviated since the embryos have already been created and cryopreserved.

What is the duration of the in vitro fertilization procedure?

the in vitro fertilization lasts approximately one female cycle, that is, about 30 days. From the beginning of the menstrual cycle, marked at the time the rule drops, the woman begins to be stimulated. About 6-10 days later the follicular puncture will be scheduled, the eggs will be obtained, the embryos will be fertilized and the embryos will be cultured. After 3 or 5 days, depending on the case, the embryos are transferred to the maternal uterus. At this point it will be about 15 days.

Two weeks after the transfer, we will be able to do the pregnancy test and check if the treatment has been successful.