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Main stages of in-vitro fertirization and embryo transfer

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  • 10/01/2019 17:35:27
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1. Ovarian Stimulation

Ovarian stimulation involves hormone injections to induce development of multiple follicles and increase the number of eggs available for collection. Antagonist is used in the majority of our treatment cycles to prevent premature ovulation. Full guidance on self-injection will be given.


Transvaginal ultrasound examination is performed to monitor ovarian response during hormone injections which normally last for 7 to 10 days. When the eggs become mature (leading follicle reaching 18mm in diameter and at least 3 follicles reaching 16mm in diameter), human chorionic gonadotrophin (hCG) injection is given to induce final follicular maturation prior to egg collection 36 hours later.


2. Egg Collection


Egg collection involves the insertion of a long fine needle under transvaginal, ultrasound guidance passing through the vaginal vault, puncturing the ovarian follicle and aspirating the fluid content. The aspirated fluid is examined immediately under the microscope by the attending embryologist to ascertain the presence or absence of an egg. This procedure is repeated until all the larger follicles have been punctured and aspirated.


3. Collection and Processing of Sperm


On the day of the egg collection, the husband needs to provide a semen sample to the laboratory in the semen collection room by masturbation.

After sperm processing, the egg will be fertilized by conventional insemination (the eggs and sperm are mixed together in a dish and the sperm fertilizes the egg ‘naturally’) or by intracytoplasmic sperm injection (a single sperm is injected directly into each egg), which is depending on the quality of the egg and the sperm.

After fertilization, the egg becomes a zygote, which in turn divides to form an embryo.


4. Embryo Transfer


An embryo is placed inside a tiny catheter and is transferred to the uterine cavity under the abdominal ultrasound guidance by the doctor.

Surplus good quality embryos will be frozen to be transferred later.

After the embryo transfer, luteal phase support with progesterone either by vaginal route or injections will be prescribed.

Blood samples will be taken for pregnancy test 10-14 days after embryo transfer. Generally, pregnancy rate is around 30-40% and it varies according to age, ovarian response and egg / embryo quality.