The steps in IVF

The In vitro fertilisation (IVF) consists of reproducing in the laboratory what happens naturally in the Fallopian tubes: fertilisation and the first steps of embryo development. It involves six steps:

The first step lasts for about 14 days. For the patient, it consists of taking two hormonal medicines to stimulate the ovaries and help the production of several egg cells:

• One medicine, analogous to GnRH, blocks the patient's natural cycle and allows ovulation to be controlled and triggered at the best moment.
• A follicle-stimulating hormone (FSH or HMG) to be taken in the form of daily injections. It helps the production and growth of ovarian follicles (which contain egg cells) and promotes fertilisation.

During this step, the patient is checked by ultrasound scans so that the stimulation can be monitored.

When the follicles are ready (are of adequate size), you will receive a last injection of a specific hormone which triggers ovulation.

The egg cells are collected 36 hours after this injection.

The egg cells are collected (follicular puncture) under general anaesthesia, which takes about 20 minutes: the specialist punctures the follicles with a needle through the vaginal wall and collects the egg cells by aspiration of the follicular fluid, all the time under ultrasound control.

The intervention is followed by rest for a few hours in our day hospital.

Sperm is collected on the same day as the egg cell puncture, following a period of abstinence from sex for two to four days. This is done in a suite designed for this purpose or, if the conditions allow, at home. The sperm is prepared in the laboratory used to fertilise the egg cells.

The egg cells identified in the follicular fluid are transferred to a culture medium to be fertilised by the sperm (IVF). The result of fertilisation is observed 20 hours later.

The embryos will then be kept in culture in our laboratory to await transfer, which will take place three, five or six days after fertilisation (this depends on the number of embryos obtained). You will have the opportunity to discuss this with the laboratory team throughout the process of developing your embryos.

Intracytoplasmic sperm injections (ICSI)

One or two embryos are transferred between three and six days after fertilisation. The embryo(s) are delicately deposited into the uterus by means of a thin catheter. After this painless procedure, you can resume your normal activities.

Any embryos which are not transferred may then be cryopreserved. They may be used subsequently during a thawing cycle. Data currently available demonstrate that the pregnancy rates with cryopreserved embryos are equivalent to those with fresh transfer. The law allows your embryos to be stored for 10 years.

In our unit and according to clearly established criteria, we have a protocol of transferring only one embryo so as to maximise your chances of pregnancy and minimise the risk of multiple pregnancy, which bears its own risks. We will talk with you throughout all the stages of your treatment.

Sixteen days after egg cell puncture, a blood sample will confirm the onset of pregnancy. If the test is negative, continuation of the treatment will be discussed with you during a consultation with your doctor.