In Vitro Fertilization (IVF)

Literally means:

“fertilization in a laboratory.”

This technique started in 1970 with the work of Dr. Patrick Steptoe and Professor Robert Edwards. Since the birth of the first “test-tube” baby, Louise Brown, in 1978, 1.5 million babies have been born throughout the world using in vitro fertilization. The pregnancy rate resulting from this technique has increased much over the last few years, which has increased the number of cycles carried out each year the world.

The results of in vitro fertilization treatments performed in Clinica Santa Maria, are comparable to those obtained in the best international centers of Human Reproduction.

On the chart presented below can be easily observed, how the age of the patient who wishes to undergo in vitro fertilization program has considerable influence on the rate of success.

With an age below 35 years there is a probability of 30% to 40% success with this program. Remember that the basic pathology and diagnosis of the couple also influence the rate of success. Each couple is treated independently and each fertilization program is tailored to the needs of the couple.

Pregnancy rate obtained by age, per treatment cycle. How should statistics be interpreted?

Used under the following circumstances:

Bilateral tube obstruction or damaged tubes
Endometriosis
Ovarian disorders
Male factors
Cause of infertility unknown

Steps in carrying out in vitro fertilization

Preparatory stage:

In the preparatory stage, examinations are carried out to check that the female reproductive organs are capable of receiving embryos; the patient’s hormone profile is analyzed as is the quantity and quality of the partner’s spermatozoids. A course of folic acid is started, something which is recommended to all women who are planning to have a baby so as to prevent abnormalities in the neural tube.

Treatment stage:

Treatment is carried out in 4 stages

Stimulation of the ovaries: special medications are prescribed (gonadotropin) to stimulate the ovaries into follicle production. These are small structures full of liquid. Each follicle contains an ovule or egg. The probability of a pregnancy increases if more than one ovule are taken and fertilized. During this phase, the development of the follicles is monitored by ultrasound on specific days of the cycle and by measuring hormone levels in the blood.
• Follicular aspiration of eggs:using a transvaginal ultrasound, the top of the vaginal sack is punctured. This procedure is carried out under heavy sedation, which means that no pain is felt.
Insemination: once the eggs have been obtained, a semen sample is requested from the partner (obtained through masturbation), the best spermatozoids are selected using sperm washing and then each ovule is inseminated with the prepared spermatozoids.
• Transferring the embryos: 3 or 5 days after the eggs have been aspired, 2 embryos are transferred to the patient’s uterus using a small catheter.

Embryos that are not transferred at this point can be cooled to a very low temperature, frozen and stored in a tank of liquid nitrogen for future use. There are not always enough embryos to freeze some, everything depends on the individual case.

General Risks:

Success / failure:

IVF does not guarantee pregnancy. The pregnancy rate varies according to the patient’s age, cause of infertility and other associated factors. On an individual basis, we will give an approximate rate of success of getting pregnant. The general rate that we handle at Santa María Clinic can be seen in the Pregnancy Rate section (Link).

Multiple Pregnancies:

In the past, the possibility of a multiple pregnancy (more than two fetuses) with IVF was high as usually more than 2 embryos were transferred. In Santa María Clinic it is our policy to transfer a maximum of 2 embryos, this goes to 3 in special cases. This has meant that the risk of a multiple pregnancy is very nearly zero. However, in our center, transferring 2 embryos does create a 30% risk of a twin pregnancy.

Miscarriage:

The risk of a miscarriage does NOT increase with IVF. The normal risk for any patient less than 35 years old is approximately 15% and increasing to 30% after 40.

Ectopic pregnancies:

As the embryo is transferred to the uterus, the risk of an ectopic pregnancy is very low.

Congenital defects:

The risk of the baby being born with a congenital defect is the same as in the general population (more or less 2%). At the moment, there is no scientific evidence to suggest that IVF increases the risk of congenital abnormalities.