IVF is an acronym for In Vitro Fertilization. In vitro means in glass as the fertilization of the egg happens outside the body.
Egg removal and transfer
The egg cells are removed from the ovaries with a thin needle through the vagina. This happens while the patient is locally anesthetized and awake. During the egg removal there is constant communication between the doctor and the laboratory to continuously asses the number of eggs and their quality. After the egg removal is complete, the patient will rest in the clinic and local hormone treatement of the uterine mucosa is initiated.
Afer a couple of days the egg is placed in the uterus with a thin, soft catheter. We are restricted by Sundhedsstyrelsen's guidelines for the number of eggs that can be transfered.
A pregnancy test is done 14 days after the transfer.
FER (freezing and thawing)
We offer freezing of embryos. We use both slow freeze and vitrification.
Depending on the woman's age and the quality of the eggs 1, 2 or 3 embryos/blastocysts are transfered. After completion of IVF treatment any potentially good embryos/blastocysts can be freezed. The embryos/blastocysts are under Danish law allowed to be kept for 5 years or until the woman turns 46 years.
These so called excess embryos/blastocysts can later be thawed for the purpose of transfer e.g. in a natrual cycle without hormone treatment.
Survival rate after freezing and thawing
Embryos: We only freeze the embryos of the highest quality. 50-70% of them will survive freezing and thawing. The embryos are thawed the day before transfer, this way we can choose the best embryos.
Blastocysts: 80-90% of blastocysts survive freezing and thawing. The blastocysts are thawed on the day of the transfer.
Why store freezed embryos/blastocysts
- To have siblings
- To tranfer in a later cycle than the current IVF-cycle.
- If unforeseen events or diseases occur or there is a high risk of over stimulation.
- To examine the embryos/balstocysts for severe genetic defects.
- For later IVF-treatment if the man or woman will undergo chemo, readioactive or other radio treatment.
The laboratory's primary goal is to replicate the conditions that the egg has in the woman's body.
I case of low sperm count the fertility rate can be increases by adding up to 2 million sperm cells per egg in micro drops.
In case of normal sperm count fertilization in 4 well plates are done where multiple eggs are found in each well. 100,000 sperm cells are added to each well.
ICSI is an acronym for Intra Cytoplasmatic Sperm Inject which is a type of micro insemination. The difference between IVF and ICSI is that for ICSI one sperm cell is selected and directly injected using advanced equipment; however, for IVF treatment the sperm cell makes its way to the egg itself.
ICSI is used in cases of low sperm quality and in cases where no fertilization happens during IVF. When there is a need to remove tissue from the bi-testicles or the testicles ICSI-techniques are used.
During ICSI the outer cells of the egg is removed to allow the lab technician to see if the egg is ripe or not. After the ICSI-procedure the egg is treated normally.
AHA - Assisted Hatching
AHA is a technology that helps the cells in the egg escape the egg shell.
The ripe egg is covered by a shell that the sperm cell has to penetrate. The shell ensures that only one cell can reach and fertilize the egg. When the fertilization is done the shell is hardened. This is a normal phenomenon that keeps the remaining sperm cells away and contains the growing cells in the egg.
The shell can prevent the egg from hatching and thereby avoid a pregnancy as the egg can not settle in the uterus.
During IVF treatment the egg is removed from its natural environment and we know that in some cases the shell can become unusually hard, thin or thick.
AHA of the egg is done in the laboratory moments before the transfer. Multiple methods exists for assisted hatching. Techniques include the use of laser, needles or acid. Here in the clinic we use a needle.