CONVENTIONAL IVF

Conventional IVF is typically recommended for women who have failed to achieve a pregnancy after undergoing a series of less complicated medical procedures, such as Intrauterine Insemination (IUI).

Conventional IVF

 Conventional IVF is typically recommended for women who have failed to achieve a pregnancy after undergoing a series of less complicated medical procedures, such as Intrauterine Insemination (IUI).

Candidates for Conventional IVF

IVF is recommended for:

  • Women in their advanced maternal years – over 35 years of age
  • Women having blocked or damaged fallopian tubes
  • Women diagnosed with endometriosis
  • Women with ovulation disorders such as premature ovarian failure or uterine fibroids
  • Male factor infertility – including blockage, decreased sperm count or motility
  • Unexplained infertility

1. Initial treatment with medications

In conventional IVF, initial treatment with medications is used to generate a relatively high number of egg cells. For this purpose, patients are usually given daily subcutaneous injections of 150 225 IU of FSH (Gonal-F or Puregon) or an FSH/LH mixture (Menogon). Depending on the stimulations protocol, various additional medications will be required to prevent premature ovulation (Synarel spray, Zoladex, Enantone, Decapeptyl).
If enough follicles (egg vesicles) have grown, the so-called “ovulation injection” (Brevactid, Pregnesin, Ovitrelle) is administered to end the egg cell maturation phase. At this point, egg retrieval must be performed.

2. Egg retrieval

Ultrasound-guided transvaginal follicular aspiration (puncture) generally requires the patient to be under anesthesia for a short amount of time. This procedure takes place 32 to 36 hours after the hCG injection.

During this procedure, an aspiration needle in a guide sheath is inserted into the vagina on the ultrasound transducer head. The ovary is only a few millimeters away. The needle is then advanced through the vaginal wall and directly into the individual follicle. The liquid is drawn out and passed directly to the biologist so that it can be determined immediately whether the follicle contains an egg cell.

3. Fertilisation

The egg cells are placed in a nutrient solution in the laboratory and coated with approximately 50,000 to 100,000 sperm with good motility. The dishes are incubated (cultured) in an incubation cabinet overnight.

After it has been determined 19 – 21 hours later how many cells have reached what is known as the pronucleus (PN) stage, a maximum of 3 PN-stage cells (this is the case in Germany, at least) must be selected to complete the fertilisation process. The pronuclei each contain the chromosomes of the egg cell and the sperm cell.

On day 2 or 3 after the sperm has been introduced, when one or more embryos have developed, the embryo(s) are transferred into the uterine cavity. A transfer on day 5 is also possible and is advisable if one or more blastocysts have developed.

On day 2 or 3 after the sperm has been introduced, when one or more embryos have developed, the embryo(s) are transferred into the uterine cavity. A transfer on day 5 is also possible and is advisable if one or more blastocysts have developed.

4. Embryo transfer

Embryo transfer is performed on days 2, 3, or 5 after the sperm has been introduced. This is an entirely pain-free procedure that involves a catheter being advanced into the uterine cavity, if necessary with ultrasound guidance. The embryo(s) are carefully positioned there.

To prepare for the transfer, the woman can take medications to relax the muscles in the uterus. Over the next 14 days, progesterone (luteinizing hormone: Crinone-Gel, Utrogest) should be added to achieve optimal conditions in the mucous lining for implantation (nidation) of the embryo.

The embryo is drawn into the embryo transfer (ET) catheter under a stereo microscope prior to embryo transfer

During the time following embryo transfer, patients should avoid excitement and excessive activity. They should also avoid cardiovascular exertion such as sports and severe increases in temperature (such as saunas or hot baths). Otherwise, there are no specific recommendations. Even sex is more likely to have a positive effect.

12 to 14 days after fertilization, a urine pregnancy test or a blood test can be performed to determine whether the woman is pregnant.

One advantage of this method is that in most cases “sufficient” (partially) inseminated eggs are “leftover”. These can then be used in later “cryo cycles” However, more recent studies indicate that the percentage of “good” egg cells appears to be higher if fewer follicles are cultured. This would mean that the frozen cells (obtained from conventional IVF) would include fewer cells capable of development than expected and hoped fo

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