OVARIAN STIMULATION

PREPARATION OF THE UTERUS

The endometrium is the layer of the uterus that must receive and host the embryo. It is equally important that its preparation is correct. For this to be possible, it is necessary to have previously synchronized the two members of the couple so that they are in the same phase of the menstrual cycle. The objective of this synchronization is that, when the mother who provides the eggs is ready for extraction, at the same time, the mother who will receive the embryos, has her uterus prepared to host the embryo. To do this, the recipient mother who is to receive the embryo must also follow the minimum medication regimen and undergo ultrasound checks.

EGGS EXTRACTION

The extraction of the eggs or follicular puncture is a process that is carried out in the operating room of the center under sedation. It is a simple procedure, which lasts between 15 and 20 minutes. With a needle attached to a transvaginal ultrasound probe, the aspiration of all the follicles is performed, collecting their contents in laboratory tubes.

After 1-2 hours of the puncture, the patient is discharged and home rest is recommended for the rest of the day.

IN VITRO FERTILIZATION LABORATORY

Identification and collection of eggs

At the same time that the follicular puncture is being performed, Embriogyn biologists are already searching the liquids obtained for the eggs that will be used to carry out the in vitro fertilization process.

These eggs are kept in incubators to maintain them in the physiological conditions that guarantee their good development. At this first point, traceability control of the gametes and future embryos begins using the Witness system, marking the plates containing the eggs with the couple’s identification card.

Semen preparation

In the case of the ROBA method, the semen used for in vitro fertilization is a donor’s semen. The sperm samples used are from anonymous donors from a duly accredited Semen Bank. The samples are kept frozen and meet the requirements established by the current law regarding cell and tissue banks. The law regulates that the Bank must ensure that it offers semen with the greatest possible similarity in terms of physical characteristics, blood group and Rh. Sperm donation is a free, anonymous and free act of a man of legal age whose psychophysical state meets the requirements of a mandatory donor study protocol.

In the Andrology Laboratory, the sperm sample will be thawed and processed with the most appropriate sperm training technique to select the best sperm to perform fertilization techniques.

Fertilization techniques

There are two techniques for carrying out fertilization:

• Conventional in vitro fertilization (conventional IVF): is the technique in which previously treated eggs and sperm are placed together, so that fertilization occurs spontaneously and naturally.
• ICSI (Intra Cytoplasmic Sperm Injection): consists of introducing a sperm directly into the mature egg with the help of a microscope and a micromanipulation system.

Fertilization assessment

To verify that fertilization has taken place correctly, it is necessary to wait a few hours to see the first signs of genetic activation of the egg and sperm. After about 16-20 hours, it is possible to verify whether fertilization has been correct by visualizing the two characteristic structures: two polar corpuscles and two pronuclei. The other possible structures that can be observed must be discarded, as they do not correspond to correct fertilization. At this point, we can already know the number of embryos generated and the biology team will contact the couple to update the information obtained.

Embryo culture, the EMBRYOSCOPE

In the days following fertilization, the embryos will be kept in culture in incubators for between 3 and 6 days. At Embriogyn we have the EmbryoScope, which is a state-of-the-art incubator that allows images of embryonic development to be obtained at all times. Its use provides great information on the embryonic division process, thus helping to select the best embryo to transfer to the maternal uterus and increasing the chances of pregnancy by up to 15-20%. Every day, information on the evolution of the embryos will be communicated and transferred to the couple so that they are informed at all times of the state of their embryos.

EMBRYO TRANSFER

Once the best embryo has been selected, it will need to be deposited in the uterus of the recipient woman. Embryo transfer is a simple and painless procedure in which the embryo is placed in the fundus of the uterus with the help of a catheter specifically designed for this purpose. We recommend that after this process, rest in the Center for about 15 minutes and relative rest at home until the day after the transfer.

Embryo transfer can be of 1 or 2 embryos, depending on the characteristics of each couple. It is a consensus decision between the couple and the medical team, taking into account the history of each particular case, in order to offer the greatest probability of pregnancy and minimize the risk of multiple pregnancy.

PREGNANCY TEST AND ULTRASOUND

In the days following embryo transfer (beta-waiting), we recommend leading a completely normal life, without major physical exertion, and maintaining a positive attitude. Going out, staying busy, and having fun will help you enjoy this period more.

The pregnancy test is performed 14 days after the date of egg retrieval. It is a test that can be done at home, in an intimate and comfortable way, through a pregnancy test with the first urine of the morning.

If the result is positive, we will make an appointment three weeks later to have an ultrasound to check that the pregnancy is progressing correctly.