IN VITRO FERTILIZATION
WITH GENETIC STUDY OF EMBRYOS
In Vitro Fertilization with genetic study of embryos
WHAT IS IT?
In Vitro Fertilization with genetic study of embryos represents the highest safety conditions in an Assisted Reproduction treatment. It is the combination of an In Vitro Fertilization process with preimplantation genetic diagnosis ( Preimplantation Genetic Testing, PGT ) in order to select embryos that are chromosomally normal or free of hereditary diseases. A biopsy is performed before implantation, extracting a small amount of cellular material to carry out a genetic study, without affecting the subsequent development of the embryo. This technique allows to reduce abortions, and increase the chances of success and of having a healthy child at home.
WHO IS IT AIMED AT?
- Advanced maternal age (> 40 years)
- Recurrent miscarriages
- Patients with pregnancies with previous genetic diseases
- Repeated implantation failures
- Severe male factor (altered FISH)
- Carriers of monogenic diseases (disease caused by a mutation in a single gene) (PGT_M)
- Carriers of chromosomal rearrangements in the karyotype (translocations, inversions…) (PGT-SR)
What advantages does it have compared to normal IVF?
Increased likelihood of implantation and pregnancy.
Decreased risk of miscarriage.
Increased probability of having a healthy baby.
Increased probability of achieving pregnancy in a single Assisted Reproduction cycle.
STEPS TO FOLLOW
STEPS TO FOLLOW
FIRST CONSULTATION
The first consultation at Embriogyn is essential to meet our fertility specialist gynecologists, who will conduct a thorough study of your medical and reproductive history. During this visit, you can provide all the medical tests and results you have. In addition, you will be advised to undergo a complete gynecological examination and a semen analysis of your partner, if applicable, to be able to make a detailed diagnosis.
OVARIAN STIMULATION
In a female menstrual cycle, naturally, only one egg reaches maturity. The aim of ovarian stimulation is to achieve more than one mature egg in the same cycle, through the administration of hormones, and to have a greater chance of pregnancy.
During the stimulation process, ultrasound checks (4 or 5) are performed to monitor follicular growth. Once the follicles have reached the desired size, the hormone that triggers ovulation (human chorionic hormone (HCG)) is administered and follicular puncture is scheduled.
EGGS EXTRACTION
The egg retrieval or follicular puncture is performed in the operating room of the Center under sedation, using a transvaginal ultrasound. It is a simple procedure that lasts between 15 and 20 minutes, in which the fluid from the mature follicles is aspirated to obtain the eggs. The patient is discharged home between 1 and 2 hours after the puncture.
IN VITRO FERTILIZATION LABORATORY
Identification and collection of eggs
At the same time as the puncture is being performed, the biologists search the follicular fluids for the extracted eggs. The eggs obtained are stored in incubators that will maintain them in their optimal conditions. This will be the first control step of the Witness system (link) , which ensures the security and correct identification of the samples.
Semen preparation
The sperm sample is processed in the Andrology Laboratory in order to select the sperm with the best mobility, morphology and lowest fragmentation rate for use in fertilization techniques. At this point, a second control is carried out by the Witness sample traceability system.
Fertilization Technique
When a genetic diagnosis of the embryos must be performed, the fertilization technique used is ICSI, in order to avoid the presence of sperm or granulosa cells in the egg (as occurs in conventional IVF), which could interfere with the subsequent genetic analysis.
ICSI (Intra Cytoplasmic Sperm Injection) is the technique that allows us to introduce a sperm into the mature egg. Fertilization rates for this technique are around 75%, and it is a technique that can be applied to very low quality sperm samples.
Fertilization assessment
Between 16-20 hours after ICSI, it is necessary to assess whether fertilization has occurred correctly. For it to be correct, it must present two polar corpuscles and two pronuclei (one from the egg and the other from the sperm).
Embryo culture, the EMBRYOSCOPE
The EmbryoScope is a state-of-the-art incubator that has a built-in camera, which allows us to collect the images captured and generate a video, providing a large amount of information about embryonic development. The EmbryoScope allows us to select those of better quality, increasing the probability of pregnancy by 15-20%. The embryos will be cultured until the fifth day of development when the biopsy of those of good quality, at the blastocyst stage, will be performed.
EMBRYONIC BIOPSY
Embryos that reach the stage of day 5 of their development, forming a correct blastocyst structure, will be biopsied .
In the embryonic biopsy, carried out by specialized personnel, several cells are extracted from the outer layer that forms the embryo (trophoectoderm), and these will be genetically analyzed. The embryo in this initial stage has the ability to regenerate and its development is not affected by the fact of being biopsied.
VITRIFICATION OF EMBRYOS
The biopsied embryos are frozen immediately after the embryo biopsy using the vitrification technique . This technique allows the embryos to be kept frozen while awaiting the results of the genetic analysis (3 weeks).
RESULTS
Once we have the results of the genetic analysis of the embryos, the Center will contact you to arrange a visit with your gynecologist to explain the results obtained and begin planning the transfer of one of the genetically correct embryos.
CRYOTRANSFERENCE
Cryotransfer, or frozen embryo transfer, is a simple procedure that can often be done during a woman’s natural cycle. It consists of observing the moment of ovulation, and then thawing the genetically correct embryo and transferring it back into the mother’s uterus.
The transfer is performed using a catheter that is inserted vaginally, allowing us to reach the bottom of the uterus and correctly deposit the embryo.
PREGNANCY TEST AND ULTRASOUND
The days following the transfer ( beta-waiting ) are days in which it is necessary to maintain normality. A positive attitude can help us make our dream come true. The pregnancy test is performed at home 14 days after ovulation, with the first urine of the morning. If the result is positive, it will only be necessary to check the viability of the pregnancy with an ultrasound 3 weeks later.
95% of patients who undergo treatment at Embriogyn end up becoming parents.
More than 97% of patients rate the perception of innovation and technology used as good or very good.
More than 93.3% of patients rate their experience as excellent.
in Embryogyn.
PREIMPLANTATIONAL GENETIC DIAGNOSIS (DGP)
PREIMPLANTATIONAL GENETIC DIAGNOSIS (DGP)
Pregnancy rate per genetically normal embryo transfer
Cumulative pregnancy rate per cycle
Accompanying in vitro fertilization with preimplantation genetic diagnosis is the most powerful combination of treatments that we can offer patients.
When we transfer embryos knowing their genetic information, we can approach pregnancy with much greater chances of success. The preimplantation genetic study that we apply to the embryos after obtaining a small sample on day +5 of their development, allows us to transfer only those embryos that are genetically normal. Thus, the probability of achieving a pregnancy that results in a healthy baby at home is 66.6% in one transfer and 80% after transferring all the genetically normal embryos generated in a cycle.
WHAT DOES THE TREATMENT INCLUDE?
- Hormone analyses during the cycle
- Medical visits and hormonal stimulation checks
- Follicular puncture and anesthesia
- Witness system for security and traceability of biological samples
- Processes in the IVF laboratory
- Processes in the andrology laboratory
- ICSI (Sperm microinjection)/IVF
- Embryo culture with Embryoscope technology
- Embryo biopsy on day 5/6
- Embryo transfer
- B-HCG pregnancy test
- Pregnancy check ultrasound
MAKE AN APPOINTMENT
It’s quite simple. All you have to do is contact Embriogyn and make an appointment with our specialists at the time that suits you best. In case you can’t come in person to the clinic, visits can also be arranged via Skype.