During treatment, drugs will be given to take more eggs than the one usually produced by a woman during a normal cycle. The monitoring of the IVF cycle is done with the help of ultrasound which is repeated at regular intervals usually two or three days. With the help of ultrasound the doses are individualized and the cycle is adapted to the specific problem of each patient. Our goal is to achieve at least three follicles exceeding eighteen millimeters in size. At this stage we consider that the remaining eggs have matured and we are ready to proceed with the Egg Collection process. Many times during the IVF cycle we will have to have some blood tests for certain hormones such as estradiol and progesterone. The whole procedure is performed under the guidance of the medical staff and specifically the obstetrician-gynecologist specialized in in vitro fertilization and infertility, Sykoutri Anastasiou and the contact with the patient is continuous throughout the treatment. The doctor is in constant contact with his colleagues abroad and is aware of all the new data that exist in the field of infertility.
During the ultrasound we do as mentioned before measurements of the follicles. When everything is ready and we have at least three follicles eighteen millimeters in size then the patient should receive an injection of B-chorionic gonadotropin to mature the eggs. Thirty-six hours after receiving this injection and in the operating room under aseptic conditions, the gynecologist with a special device will suck the follicular fluid from the ovaries and consequently the eggs. This fluid is then given to the specialist embryologist to find the ova with the help of a special microscope. This procedure is performed under light anesthesia which is of course administered by a specialist anesthesiologist. Advice on the ovulation procedure will be given by the anesthesiologist the day before and a special information leaflet will also be provided. The procedure is completely painless for the patient and its average duration is fifteen minutes.
After the fertilization process, the eggs are placed in a special culture material. The fertilization is then performed using the sperm of the husband that has already been processed with special techniques in the laboratory. This process is complex and takes place under the constant supervision of medical and laboratory staff. The next morning the fertilization of the eggs is checked and the treating doctor as well as the patients are informed immediately. The process of fertilization is done with the most modern means available to Embryology laboratories worldwide. The inspections are continuous, all the procedures are governed by the Greek law that applies to the in vitro fertilization centers and the possibility of error does not really exist.
Dr. Sykoutris Anastasios has specialized in the process of embryo transfer and has done his work at the University of Bristol in England in this field. His experience in this process is very great both in theory and in practice. The embryo transfer process takes place two to three days after ovulation. In limited cases it takes place on the fifth day after egg collection. The embryos are placed in the endometrial cavity with the help of a special catheter that passes through the cervix. The number of embryos to be transferred depends on the age of the woman and has been based on legislation in force since January 1, 2005. If there is a large number of embryos they can be frozen and used in a future endeavor.
Embryo transfer is a painless procedure for the patient and is performed under continuous ultrasound coverage.
The patient should have a full bladder to improve the image during the ultrasound.
The whole procedure takes an average of ten minutes and is performed in a special area of the operating room.
Twelve days after the embryo transfer procedure, the pregnancy test can be performed. The best way to do a pregnancy test is to take a blood test to determine chorionic gonadotropin. If the test is positive two weeks later, the first ultrasound test should be done during which we should see the sac or sacs with the fetus in the womb. The pregnancy test should not be performed in less than twelve days. If the test is negative the medication given to the patient should be discontinued. It is very important for the couple to meet with the doctor as soon as possible in order to investigate the causes of failure and to plan the next course of treatment based on the new data. It is important for patients to understand that a failure can be a negative event but on the other hand it allows us to plan the next treatment more accurately and see how the patient’s body has responded to the treatment so far.
Of course, throughout the IVF cycle there is the possibility of psychological support from a team of specialist psychologists.
- Genetic testing (if required)
- Embryo transfer of fresh embryos
- In vitro fertilization with natural cycle with or without hormones