IVF/Fertility Treatment

 In Vitro Fertilization (IVF): What Is It?

In vitro fertilization is an assisted reproductive technology (ART), commonly called IVF. In vitro fertilization is the process of fertilization by extracting eggs, retrieving a sample of sperm, and then manually combining an egg and sperm into a laboratory dish. The embryos are then transferred to the uterus. Other forms of ART include gamete intrafallopian transfer (GIFT) and zygote intrafallopian transfer (ZIFT).

The following patient’s need IVF to treat their fertility:

  • Fallopian tubes are blocked or damaged
  • Male infertility factor, including reduced sperm count or sperm motility
  • Women that have ovulation disorders, premature ovarian failure, uterine fibroids
  • Women whose fallopian tubes have been removed
  • People with the genetic disorder
  • Unexplained infertility

1. I.V.F. standard package

Standard IVF Global Package

The global fee includes the following services:

  • Monitoring office visits
  • Monitoring ultrasounds
  • Monitoring blood tests
  • Transvaginal egg retrieval
  • Basic laboratory culturing
  • Embryo transfer
  • Pregnancy tests
  • Up to three OB ultrasounds

 

The services not included in the global fee are:

  • Pre-cycle testing and evaluations
  • Anesthesia
  • ICSI
  • Assisted Hatching
  • Embryo cryopreservation

Cycle medications

2. IVF + Sperm Donation

In the event that you have has multiple IUI attempts which have failed to achieve pregnancy or if there are other female factors, IVF with sperm donation may be recommended. Although controversial, some studies suggest that frozen-thawed sperm is much less effective than fresh semen in achieving fertilization of eggs with IUI.

When a frozen sperm sample is dissolved, the embryologists will analyze the specimen. If the sperm concentration and/or sperm mobility is low, thawing may be recommended by the embryologist as a second vial or may decide to perform ICSI and inject sperm directly into the egg.

Donor sperm can also be used as an alternative in the case of very severe male infertility. In such cases, the urologist will first try to recover sperm surgically from the testicle(s). In rare cases, when the recovered sperm is insufficient to inseminate the egg of the partner it may be recommended that donor sperm be available as a backup.

3. Egg donation + In vitro fertilization

For donor egg IVF, a patient that is receiving the egg can select an egg donor. In addition, an egg donor can be a family member, a sister, a close friend, or a relative of the recipient.

Women who are carriers of genetic diseases can be treated successfully with donor egg IVF, women who have had multiple failed IVF cycles, women with impaired ovarian function or older women who are in good health. This IVF treatment also increases the risk of pregnancy for women whose in vitro fertilization attempts have shown poor response to fertility drugs or whose eggs did not fertilize well or form viable embryos.

Benefits of Egg Donation IVF

A high rate of success is one of the main benefits of IVF egg donation. The principle seems to be that egg age, and not the uterus, is the deciding factor. The success rates for donor egg IVF can be three to ten times higher than the traditional IVF. Much of this success is due to the use of young and normally fertile egg donors.

There are some likely benefits provided by egg donor IVF over adoption. The first benefit is that the egg donor recipient carries the pregnancy and thereby they are in control of the gestational environment. The woman can be sure of receiving excellent prenatal care and avoids alcohol, tobacco, illegal drugs, or unnecessary medicines while it is attached to her in-utero offspring. Second, the child is related to a male partner.

4. Male Fertility Treatment

Infertility affects about 1 out of every 6 couples. Diagnosis of infertility is recommended for couples that cannot conceive within a period of one year. When the problem concerns a male partner, we talk about male infertility. Factors of male infertility make up about 30% of all cases of infertility, and only male infertility makes up about one-fifth of all cases of infertility.

The common causes of infertility of men

The “Malefactor" contributes to infertility about half a time, and about one-third of the time is the leading cause of infertility. Moving or making the sperm seems to be the most common problem.

One of the following factors may result in a low sperm count or abnormal sperm:

Varicocele in urology treatments - abnormal collection of bulging veins above the testicles; they are the most common cause of correctable infertility in men, which makes up 38% of cases

  • Undescended testicles
  • Infections of the testicles (orchitis), prostate (prostatitis) or other parts of the body that causes a fever
  • Cancer chemotherapy in oncology treatments
  • Medicines such as anabolic steroids or anti-seizure drugs
  • Genetic abnormalities
  • Hormonal problems

In most of the cases, these problems can be reversed, in some other times, they cannot be reversed. Doctor's assessment is the only way to solve the problem.

Sometimes sperm creation is not a problem. The problem is getting the sperm where they have to go. Men with this type of male infertility have normal sperm in the testicles. But sperm in semen is either abnormal, very little or not present at all. Below are some of the causes of this type of infertility:

  • Retrograde ejaculation. This is the condition in which the sperm ejaculates back into the bladder instead of getting out of the penis. Usually, the main cause of this condition is the previous operation.
  • The absence of the main sperm gas pipeline which is called the vas deferens. This condition is a genetic problem.
  • Obstruction. Obstruction can occur anywhere in the plumbing between the testicles and the penis.
  • Anti-sperm antibody. Antibodies can abnormally attack the sperm of a man on their way to the egg.

Idiopathic infertility has been found to be responsible for about 25% of infertility in men. This means that they have abnormal or low levels of sperm for no reason.

The ultimate goal of treating male infertility is to create a pregnancy. Ideally, the cause of infertility is reversible and conception may be the result of a natural sex.

 

5. Artificial Insemination

This is a type of fertility treatment method that is used to deliver sperm directly into the cervix or uterus with the aim of becoming pregnant. In most of the cases, the sperm is washed or "prepared" in order to increase the chance of a woman getting pregnant.

There are two main approaches to artificial infiltration: intrauterine ossification (IUI) and intracervical insemination (ICI). Some women may also take medicines to stimulate ovarian follicle growth and increase the chances of conception.

What is the standard ivf protocol?

Before a woman can become pregnant, the man's sperm must travel up the vagina, through the cervix, into the uterus, and into the fallopian tube where the eggs are fertilized. However, a man's sperm is sometimes not mobile enough to make this journey. Secondly, the cervix of a woman may not be favorable to allow the passage of sperm into the uterus. In these and other situations, artificial fertilization can help the woman conceive.

Artificial insemination can be recommended for a couple if:

  • After six months of unprotected sex, if a woman is over 35 years of age
  • After one year of unprotected sex if a woman is less than 35 years of age

ICI. this is a type of artificial insemination that involves the insertion of sperm into the cervix. The cervix is the passageway just outside the uterus. This approach can be done in a doctor’s office or at home. The steps involved in this procedure include:

The woman will monitor her ovulation cycle by using calendars, ultrasound, regular temperature taking, or combination of these methods. Sometimes a doctor may prescribe medication to induce ovulation and increase the risk of a woman releasing more eggs. One of the commonly prescribed drugs is clomid.

The female partner will donate the sperm or the woman will receive sperm samples from the donor.

The sperm will be inserted into the vagina by the use of a special syringe. One other option is to place the sperm in a cervical cap which is inserted into the cervix and remain for a certain period of time.

Women are usually asked to lie for 15 to 30 minutes. It ideally allows sperm to ascend from the cervix to the uterus.

The woman can continue her usual activities after this time. For about two weeks or a little longer, the woman will run a pregnancy test. This is done to determine if the process of insemination is successful.

IUI

IUI is a process that involves inserting sperm past the cervix and directly into the uterus. The steps of this procedure are similar to those of ICI but are usually performed in a doctor’s office and with specially prepared sperm. Other steps are mentioned below:

The sperm is prepared or "washed" this is done to get rid of potential proteins that can affect fertilization. It also makes sperm more concentrated. Ideally, this will increase the chances of a woman conceiving.

A special instrument called a speculum is used by the doctor to facilitate access to the uterus. A special, thing instrument is inserted into the vagina and put sperm in the uterus.

Artificial insemination is a treatment that makes it possible for couples, including same-sex couples and single women throughout the world to get pregnant after finding it difficult to conceive. If a woman has difficulty getting pregnant or wants to get help in conceiving, she should get in touch with her doctor to talk about fertility treatment options.

The usual 2024 protocol for undergoing n Vitro Fertilization procedure typically involves several steps and can vary depending on individual circumstances and the clinic's practices.  

Initial Consultation and Evaluation:

The journey begins with an initial consultation with a fertility specialist or reproductive endocrinologist. During this visit, the doctor will review your medical history, conduct tests, and discuss your fertility concerns or challenges. We advise to arrange a fertility consultation remote thanks to Whatsapp through a video consultation tool.

Treatment Planning:

Based on the evaluation, the doctor develops a personalized treatment plan tailored to your specific needs. This plan outlines the steps, medications, and procedures involved in the IVF process.
Ovarian Stimulation:

The IVF process often involves ovarian stimulation. You'll be prescribed fertility medications, such as gonadotropins or other hormonal injections, to stimulate the ovaries to produce multiple eggs instead of the usual one during a menstrual cycle.
Monitoring through blood tests and ultrasound scans helps track the growth and development of ovarian follicles.
Egg Retrieval (Oocyte Retrieval):

When the follicles reach an optimal size, a trigger shot (hCG) is administered to induce final maturation of the eggs.
About 36 hours later, a minor surgical procedure called egg retrieval is performed. It involves using a needle guided by ultrasound to retrieve mature eggs from the ovaries. Sedation or anesthesia is often used during this procedure.
Fertilization and Embryo Development:

The retrieved eggs are combined with sperm in a laboratory setting through conventional insemination or intracytoplasmic sperm injection (ICSI).
The resulting embryos are monitored for several days as they develop.
Embryo Transfer:

Once the embryos reach a certain stage of development (usually between days 3 to 6), one or more embryos are selected for transfer into the uterus.
The embryo transfer procedure involves placing the selected embryos into the uterus using a thin catheter.
Luteal Phase Support:

After the embryo transfer, medications (such as progesterone) may be prescribed to support the uterine lining and embryo implantation.
Pregnancy Testing:

Approximately 10-14 days after the embryo transfer, a pregnancy test is conducted to determine if the procedure was successful.
Throughout the process, regular monitoring, check-ups, and consultations with the fertility team are crucial. The protocol may be adjusted based on individual responses to medications and treatments. What will affect the price of an in vitro fertilization procedure  - and this is true also when an egg donnor is planned or when an egg freezing procedure is scheduled - is the cost of hormon fertility medicines. The average price in 2024 is around 910 $ and price will slightly differ from one country to another.