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We know that struggling with infertility can be stressful for you and your partner. We are the best option if you are looking for fertility treatments to achieve your dream of starting a family. Today, our fertility specialists will discuss how is IVF when using your eggs.
Before explaining the procedure, we will tell you what IVF with own eggs includes:
On the second day of your ovarian stimulation cycle, in the case of IVF/ICSI, it will be necessary that our fertility specialist perform a pelvic ultrasound to check your uterus and endometrial thickness.
And check how many follicles are within your ovaries to determine the dose and types of drugs to use during your ovarian stimulation.
Once the above is done, the specialist will have a sheet with indications about the medications and their dosage, the days of vitamins, supplements, Prednisone, and injections. We will mix these meds in one syringe for a single daily injection using two or more medications for ovarian stimulation (such as Pergoveris plus Gonal F).
We commonly apply injections between 3 and 5 days and schedule an appointment between the fourth or sixth day to review the evolution of your endometrium and ovaries. Then, we will determine if we should continue with the same dose of medication or if it is necessary to increase or decrease it.
When this happens, you can continue your daily activities, except for smoking or drinking alcoholic beverages.
The ovarian stimulation lasts 10 to 12 days on average. Once the follicles reach a size of 18 to 20mm, one or two subcutaneous injections will be applied for the final maturation of the eggs.
On the day of the injections, blood tests will be taken to measure Estradiol and progesterone levels, which are very important in deciding whether or not an embryo transfer is possible in the same cycle.
On your appointment for this step of the procedure, our team will start with the preparations: they take you to the recovery room, where they will put you in an intravenous catheter, and the patient will be given medication for anesthesia (our anesthesiologist will discuss the type of sedation).
In some cases, according to the number of follicles, eggs, and Estradiol hormone levels, a catheter will be placed in the bladder to empty it, as we will use medications to try to reduce the swelling of ovaries and prevent fluid in your abdomen days after the egg retrieval.
The egg retrieval is performed in the operating room, next to our lab, where our specialists will be in charge of the magic with your eggs and sperm samples to create embryos.
According to the development of the embryos, the third-day embryos have an average of 8 cells, and the blastocyst has an average of 100-200 cells or more. Still, only some embryos can evolve from day 3 to day 5 of embryonic development.
In the case of a study for chromosomal abnormalities (PGT-A), the embryos must reach the blastocyst stage. Once the embryos have been biopsied for the PGT-A study, the embryos are vitrified (frozen). The result of the PGT-A takes between 15 to 30 days.
On the day of frozen embryo transfer, it is recommended to arrive at the clinic half an hour before the scheduled time and, according to the indications provided, to begin the intake of water to fill the bladder (instrumental in visualizing the endometrium) at the time of the embryo transfer.
Once the bladder is of adequate size, you will move to the recovery room and then to the transfer room, where the procedure will be performed. You will be placed in the same position as in the pelvic ultrasound. Our fertility specialist will place a speculum to see your cervix, which will be cleaned of progesterone residues with a unique tool under an ultrasonographic guide.
Our embryologist is informed to place the embryos in the second catheter and bring them from the lab to the surgery room to introduce them. Then, our specialist will place the second catheter with the embryos in the middle of the endometrium.
Once the procedure is done, and the catheters are removed, the embryologist checks them and assures the cleaning. You will rest between 15 to 20 minutes and get an injection of progesterone. Then and last, you go to the bathroom to empty your bladder, and later in the office, the final instructions will be provided to you.
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During controlled ovarian stimulation, on the day of the injections, we will take a blood test to measure Estradiol and progesterone levels, which are very important to decide the possibility of an embryo transfer in the same cycle or not. If Estradiol levels are too high, it increases the risk of ovarian hyperstimulation syndrome, it affects the quality of the endometrium, which will be less receptive to embryo implantation. If this is the case, postponing the embryo transfer is the best.
During ovarian stimulation, the ovaries grow in size because the follicles grow. The follicles are a kind of “balloons or circles” that appear black on ultrasound containing follicular fluid and the egg (some follicles contain only fluid and no eggs, especially in women over 40 years of age). After egg retrieval, the follicles with blood and the ovaries grow larger.
Once the first menstrual cycle starts again (approximately 10 to 15 days after the retrieval), the ovaries decrease to half their size, so it is advisable to use birth control pills for a month so that in the following second cycle, the ovaries will return to their normal size.
In the second menstrual cycle, we will begin with a protocol of endometrial preparation, consisting of taking contraceptive pills for 21 days.
In the third menstrual cycle, we start the endometrial preparation protocol with a pelvic ultrasound on the first or second day of the cycle, as well as taking Estradiol.
Once the protocol starts, you will be given indications with the doses and days of intake of pills as well as the specific days to perform a second ultrasound and blood tests for Estradiol and Progesterone.
The ultrasound is essential to know if the endometrium growth is good and the levels of Estradiol and Progesterone.
When the transfer is done, our doctor will give you certain recommendations about physical activity, nutrition, and immediate care after the procedure. If the result is positive, a second pregnancy test must be performed 48 hours later to check the hormone level.
They may be the longest 14 days of your life! But with hope, great care, and the support of our team, your dream is possible.
We know your dream of starting a family is strong, and struggling with infertility may be challenging. Our team at The Fertility Center will stay at your side in every part of your journey. Contact us today and schedule an appointment!
Gynecology, Obstetrics and Biology of Human Reproduction Surgeon at the Autonomous University of Guadalajara, specialist Biologist of Human Reproduction by the Mexican Institute of Infertility.
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