What is in vitro fertilization (fiv)?

In vitro fertilization (IVF) is a technique of assisted reproduction of high complexity that consists of extracting the ovules by means of follicular puncture and then fertilizing them in the laboratory with the spermatozoids 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 pregnancy.

Below you have an index with all the points that we will discuss in this article.

Index

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

Depending on how we make the union of the gametes (ovum and sperm), we will talk about a type of IVF:

Conventional IVF: the ovules and sperm are placed on the same culture plate, waiting for them to be able to fuse on their own.
ICSI (intracytoplasmic sperm injection): the sperm is introduced directly into the interior of the ovule through microinjection.

Performing one or the other method will depend on the infertility conditions of each couple, as well as the preferences of each assisted reproduction center. In any case, except for the merger 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 probability of pregnancy is also higher, 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 do you need to do IVF?

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

Below we present 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 previous 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 that the woman be able to produce ovules. In addition, it is necessary that you do not have problems or uterine anomalies that prevent the implantation of the embryo or the evolution of pregnancy.

In the case of man, the requirements vary depending on the type of IVF that we are going to carry out. If the seminal quality allows it, that is to say, if it has a REM of between 1 and 3 million / ml, conventional IVF will usually be performed. If, on the other hand, sperm have 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 fulfilling the requirements for conventional IVF, 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 requirement of egg production due to 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 donor of ovules.

It is also possible to perform IVF with donor sperm and even IVF with double donation, that is, with donated sperm and eggs.

What is IVF?

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

Controlled ovarian stimulation. The woman receives hormonal medication for approximately 10 days to stimulate the production of ovules and thus obtain a greater number of them. In addition, this medication allows control of the time of ovulation, thus increasing the chances that the ovules obtained are mature and suitable for fertilization. Ovarian or follicular function of the surgical intervention in which mature ova are removed from the ovary. It is performed by aspiration, lasts about 20-30 minutes and requires anesthesia.Collection and preparation of the semense sample collected from the male usually by masturbation but can also be obtained by aspiration of epididymis or testicular biopsy. Next, the sperm goes through a process of sperm capacitation that will make the sperm able to fertilize and give rise to the embryo. Ovulation and sperm fusion are 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 fusing the gametes you can read this article: Differences between FIV and ICSI. First steps in a cycle of FIVCultivation of embryos Once the ovum has been fertilized, the embryos are left in a specific incubator that maintains the optimal conditions of embryonic development. Its evolution is observed until the transfer, which may be carried out on day 3 or on day 5-6 of development. Endometrial preparation The woman receives estrogen and progesterone so that her endometrium (uterine layer where the embryos implant) has the appearance and adequate thickness to favor implantation. Embryo transfer will choose the highest quality embryo or embryos and will be transferred to the mother's uterus, waiting for the implantation to take place and pregnancy to begin. Although it is recommended to transfer a single embryo, in Spain up to 3 embryos are allowed. Freezing of embryos The 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 embryonic implantation. IVF process from fertilization to embryo transfer

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

Results and chances of success

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

The specialists have managed to stipulate certain parameters of treatment success. They are the following:

40% in women under 35 years old.
Between 27-36% in women from 35 to 37 years old.
Between 20-26% in women from 38 to 40 years old.
Between 10-13% in women over 40 years.

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

The real 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.

Rates of success of in vitro fertilization

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

Advantages and disadvantages

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

Advantages of IVF

The main advantages of in vitro fertilization are the following:

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

Disadvantages of IVF

However, IVF also involves a series 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 can lead 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 the extravasation of fluids out of the bloodstream due to the increased permeability of the blood vessels. In extreme cases, it can compromise the hepatic, hematological, renal and respiratory systems. Multiple pregnancies transfer 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 the quality of the uterus. Main risks and side effects of FIVAnatural abortion 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 multiple pregnancy, it will depend on the age of the patient and the conditions of each woman or partner. Ectopic pregnancy is about a pregnancy in which the embryo has implanted outside the uterine cavity. Between 2% and 5% of women who undergo IVF treatment may suffer 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 you read this article: Risks of in vitro fertilization.

IVF price

In vitro fertilization costs approximately ? 3,000 to ? 5,000. The price will vary depending on the needs of each situation, the fertility clinic where the treatment will be carried out, the necessary tests, etc.

Normally, the medication received by the patient is not included in the initial budget and usually costs between ? 1000 and ? 1200 for stimulation and around ? 300 for 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 advisable 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 directly access our Discounts section to get your coupon and a first free visit: Discounts in FIV / ICSI.

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

Questions from users

What negative effects can the IVF medication have?

Response by Fertility Madrid

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

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

The basic requirements for access to 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 gone through an "in vitro pregnancy", as it is often called pregnancy by IVF. This occurs in situations in which the cause of infertility is reduced or disappears.

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

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

This can also occur in cases of sterility or infertility of unknown cause.

Is the IVF medication always the same?

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

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

What are the symptoms of a 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 natural pregnancy. It is possible that the medication administered gives rise to some special discomforts such as swelling or heaviness, but in principle they do not have to vary.

You can read more about symptoms here: Symptoms of pregnancy.

What is the probability of success of a second IVF?

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

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

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

Do I 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 doctors. Only in exceptional cases, the specialist will recommend rest.

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

There is no better technique than another, because both have advantages and disadvantages. Depending on the characteristics of each couple and their infertility situation, it will be more advisable to carry out one or the other method to fertilize the ovule.

There will be cases such as severe asthenozoospermia situations in which ICSI will be needed to have the possibility of achieving 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, as we force the union of egg and sperm.

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