With the term in vitro fertilization (IVF), we mean the pairing of the egg with the spermatozoon in the laboratory – in vitro – in order to create embryos. Fertilization is achieved either by classical fertilization or by ICSI microfertilization, when sperm quality is not good. IVF is the most common method of Medically Assisted Reproduction. It is estimated that every year more than half a million babies are born worldwide with the help of IVF. In our country, more than 25,000 IVF cycles are performed annually.

IVF – When is it indicated?

Infertility is a problem that concerns both partners, since its causes are found equally in the female and male factor. At the same time, 20% of infertility cases remain unexplained.

Every year more than half a million babies are born worldwide with the help of IVF, while in our country more than 25,000 IVF cycles are performed. 

What are the most common factors leading to IVF?

The most common factors leading to the implementation of IVF are the following:

Female factor:

  • Pathology of the fallopian tubes, such as hydrosalpinges, pyosalpinges
  • Endometriosis
  • Hormonal disorders
  • Premature ovarian failure
  • Advanced reproductive age

 Male factor:

  • Poor sperm quality
  • Poor sperm motility
  • Oligospermia
  • Azoospermia

Finally, IVF is chosen by couples with a history of inherited genetic diseases, in order to avoid the risk of transmitting a disease to the fetus.

What is the IVF process?

The IVF process lasts from 15 to 30 days and consists of the following stages:

 A) Ovarian stimulation

Depending on the protocol followed, which is personalized and according to the response of the woman's body, it usually takes 10-20 days. During this time, monitoring is done by ultrasound examinations of the follicles and examination of hormone levels.

B) Egg collection

When the follicles reach the appropriate dimensions and after ultrasound examination, egg collection is scheduled. This occurs 36 hours after the administration of hCG hormone, which helps in the final maturation of the follicles by mimicking the normal cycle. This procedure is performed under light anesthesia of the woman and lasts about 15-30 minutes. Egg retrieval is performed transvaginally and is ultrasound-guided.

C) Fertilization

Once the eggs have been collected, they are placed together with properly processed sperm, at laboratory level, in order to achieve fertilization. In some cases, a single sperm is selected by the embryologist and inserted inside the egg (ICSI).

D) Embryo culture

The embryos that have resulted from the fertilization of the eggs are under constant monitoring in appropriate laboratory conditions. They are evaluated according to embryological criteria and the best quality ones are selected. Poor quality embryos are discarded and not stored.

E) Embryo transfer

Embryo transfer is a procedure in which the best quality embryos, through a guide catheter, are placed into the endometrial cavity. This can happen either in the same cycle of the IVF procedure, or in subsequent cycles depending on the condition of the endometrium and the woman. It is an operation that does not require anesthesia, is quick and painless. The pregnancy test is performed 10-15 days after embryo transfer.

F) Cryopreservation of embryos

The remaining good quality embryos are preserved with new methods (vitrification) in the laboratory for future use.

How many embryos are transferred to a woman's uterus?

Since multiple pregnancies are high-risk pregnancies, the number of embryos should be selected with great care and limited as far as possible.

How many IVF cycles can a woman undergo?

According to international guidelines, women should not undergo more than 4 IVF cycles per year. It is estimated that the vast majority of women will have achieved pregnancy after 3-4 IVF cycles. Although there is no restriction on the cycles that a woman can perform throughout her life, it should be noted that according to Greek law the maximum age limit of women who can proceed with IVF is 50 years.

What is the cost of IVF?

Certainly, every IVF cycle is an expensive process. This cost is difficult to determine precisely, since it varies depending on the medications that each woman will need. At the same time, if embryo freezing or ICSI is required, the cost of IVF goes up.

Trying IVF is a stressful and often painful process for the couple and especially for the woman. However, achieving pregnancy fills the couple with happiness and is able to soothe any difficult memory.

Athanasios Papanikolaou as Reproductive Assistant is fully specialized in assisted reproduction methods. The Doctor is a close associate of the Institute of Life – IASO, as he holds an active role in the team of reproductive physicians.

The continuous scientific training of the Doctor and his many years of experience ensure high rates of successful pregnancy in infertile couples. Do not hesitate to contact the Doctor for any infertility issue that concerns you.

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Athanasios G. Papanikolaou
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Athanasios Papanikolaou

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