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The fundamental role of an IVF treatment is to help couples who have been trying to become pregnant up to 1 year if the female is under the age of 35, or up to 6 months, if the female is over the age of 35. IVF is also an excellent option for young women facing fertility-affecting issues, such as Polycystic Ovarian Syndrome, to improve their chances of getting pregnant dramatically. In these cases, the female partner undergoes a gynaecological examination that observes the cervix, along with the structure of the ovaries, endometrium and the uterus, with an ultrasound. That aside, IVF provides solutions for male infertility as well.
To determine the cause that prevents the couple from achieving a natural pregnancy. The next step is to select the most appropriate technique for the case and administer the treatment to the patient at the right time. A fundamental part of an IVF treatment is to generate eggs by stimulating the ovaries with hormones that will enable them to produce multiple follicles. The produced eggs will be later retrieved and fertilised with the male partner’s sperm or donor sperm.
This involves an extremely significant initial analysis that your doctor will conduct before you begin an IVF treatment. In this pre-treatment consultation, you and your partner will be required to undergo a thyroid test, hormone tests, and others.
Also, the male partner will be asked to undergo a spermiogram (sperm analysis). As for the female partner, we will carry out a vaginal ultrasound and a full gynaecological examination while also assessing egg capacity by asking the female partner to have an AMH and an antral follicle count. In order to evaluate the uterine cavity and Fallopian tubes, HSG (hysterosaplingography) needs to be applied. This first stage will help us identify any conditions that could hinder the successful outcome of an IVF treatment and show whether either (or both) of the partners has an underlying condition that needs to be treated before the couple is presented with the most suitable IVF treatment options.
The results of all these screenings will also enable us to decide on the best solution and select the most individualised treatment protocol. In some cases, we may need to ensure cycle synchronisation by giving hormone medication. Besides, this initial consultation and evaluation phase of IVF treatment will set the foundations of a professional relationship between you, your doctor, and the specialist nurse assigned with your case.
The second stage involves the drug-induced stimulation of the ovaries, which usually takes place within the first three days of your menstruation (your period). We explain the injection procedure in full detail and then inject the medications easily into the abdomen (under the skin) with a fine needle. Let’s note that you can either choose to visit our clinic and have our specialist nurse inject the remaining doses to you, or you may do so yourself at the comfort of your home.
The stimulation period generally takes between 8 and 12 days, although this time frame can vary based on each individual case. The ovary stimulation process also involves several scans that will enable us to monitor the development of the follicles (a sac inside the ovaries that is filled with fluid which may contain an immature egg (oocyte)). This means that we evaluate the size and quality of the developing follicles on specific days during the ovary stimulation phase.
Depending on the progression of this stage, we may also require blood tests (progesterone and estradiol) on the final days of the hormone injections. The results from both the blood test and the ultrasound will pinpoint the exact date for not only the stimulation of the ovaries (the best date to administer the medication), but also the collection of eggs.
When the ultrasound reveals that we have enough follicles (three or more) at the right size (at least 18mm), and provided that the blood hormone levels are suitable, we inject a drug that will cause ovulation at the appropriate time. Generally speaking, this injection contains HCG (human chorionic gonadotropin) and is made around 35-36 hours before the egg harvest. To perform the egg collection, the patient is sedated (a form of anaesthesia) with a mild sedative. Then, an ultrasound guide helps aspirate the ovary-surrounding follicle fluids. Our expert embryologists will then put the follicles under the advanced IVF Clinic microscope and separate the eggs inside the follicles. This is a critical step that will provide the doctor with an adequate oocyte count.
The harvested eggs are re-evaluated under a microscope approximately 2 hours after their collection. Before ICSI, collected eggs are stripped (Denudation) to remove unneeded cells (cumulus). Those in metaphase 2 (the most mature ones) are selected for ICSI procedure. After that, we use time-lapse (embryoscope) monitoring to check their development. It should be noted that not long ago, the embryos often needed to be taken out of their incubation chambers, which caused unnecessary (and even embryo life-threatening) changes in humidity and oxygen levels. Thanks to our modern equipment, we can maintain the special conditions required to mimic an embryo’s natural environment – the uterus. This, boosts the chances of transferring a viable egg during the implantation/embryo transfer stage.
Cyprus IVF Clinic strongly suggests ICSI is performed at our own facilities because our state-of-the-art and fully-equipped laboratories, combined with the profoundly in-depth IVF-related knowledge and expertise of our world-esteemed embryologists, which allows us to expect much higher success rates.
Approximately 16-18 hours after harvesting the eggs, our embryologists will evaluate the condition of the fertilised eggs and decide how many of them they can use in this final stage. The selected eggs are then placed in an appropriate environment, where their development is assessed on a daily basis until they reach the appropriate maturation. These eggs are then transferred into the uterus – usually three to five days after their harvest.
In some instances, we may need to thaw (freeze) the embryos, such as when estradiol levels at high levels or when we notice a steep increase in estrogen levels before the B-Hcg injection (ovarian hyperstimulation syndrome or OHSS).
