Couples who have been diagnosed with the help of IVF in Pakistan and who therefore resort to assisted fertilization are on the increase; when the first level administered fertilization techniques (intrauterine insemination and intratubal insemination) are not applicable or have not been successful, it is necessary to resort to in vitro medically assisted procreation methods: IVF – ICSI – PICSI.
These are essential techniques aimed at obtaining the fertilization of the oocyte outside the mother’s body to then program the transfer of the embryo that is generated into the uterus.
The whole procedure takes place in a PMA (medically assisted procreation) laboratory, in optimal conditions for the development of an embryo that has the biological potential to implant itself correctly inside the mother’s uterus and to deliver a baby in her arms.
IN VITRO FERTILIZATION: WHEN TO DO IT
Couples diagnosed with infertility that cannot be resolved with supportive therapies or more straightforward PMA techniques (insemination) are directed to in vitro fertilization.
In particular, in vitro fertilization is used when:
– the woman has tubal factor infertility, for which a natural pregnancy would not be possible, and even assisted fertilization by insemination would not be programmable
– the woman has a diagnosis of infertility due to ovulatory factor: with in vitro fertilization, the presence of the oocytes inside the ovarian follicles is directly verified, and therefore, there is control of the fertilization of the single oocytes
– the male component presents problems in the seminal parameters, and therefore the natural selection of the spermatozoa is essential for the fertilization of the oocytes – the couple is diagnosed with idiopathic infertility. Still, the first-level techniques have given failures, so switching to in vitro fertilization is advisable.
IN VITRO FERTILIZATION: WHAT IT IS AND HOW IT HAPPENS
Two in vitro fertilization techniques are IVF (in vitro fertilization and embryo transfer) and ICSI (intracytoplasmic sperm injection).
Couples who resort to in vitro fertilization are accompanied by a process made up of 3 main stages, which we can schematically summarize as follows:
1. Gentle stimulation of the ovaries
2. Oocyte retrieval
3. Embryo-transfer
Preparation for in vitro fertilization: gentle stimulation of the ovaries
With a specific therapeutic plan, the aim is to obtain multiple growths of the follicles and, therefore, the possibility of recovering more oocytes. Per the personalized therapeutic project, the woman at her home begins the therapy designed for her. She schedules a first follicular monitoring check-up around the 8th day of the cycle. During stimulation therapy, 2-3 check-ups may be necessary to follow the ovarian response step by step and identify the best time for follicle aspiration, the so-called “oocyte pick-up”.
First operative stage of in vitro fertilization: oocyte pick-up
On the established date, around the 12th/13th day of the cycle, the ovarian follicles are punctured, and the follicular fluid is aspirated to search for the oocytes. It is a procedure that takes place under local anesthesia and mild sedation so the woman does not feel any pain, and after a couple of hours in the hospital, she is discharged. Meanwhile, the male partner provides the seminal fluid sample, which is treated in the laboratory for use in vitro fertilization. The laboratory examines the follicular fluid, and IVF or ICSI/PICSI prepares the oocytes present for fertilization. In IVF, oocytes and sperm are placed in contact, and fertilization is expected to occur spontaneously, while in ICSI, it is the biologist who selects a single sperm to be injected into the single oocyte.Â
Conclusion of in vitro fertilization: embryo transfer
In the 3-5 days following the in vitro fertilization, the IVF Cost in Pakistan follows the development of the embryos and plans their transfer into the uterus. As per regulations, a maximum of 3 sources are transferred into the uterus, but generally, 1-2 embryos are transferred, and any redundant embryos are cryopreserved. Embryo transfer is the final step of the in vitro fertilization process: it is a non-annoying and painless procedure that women experience as a prevalent gynecological visit. After 30-45 minutes, the resignation takes place, and about two weeks begin, during which the woman follows home therapy until it is time to verify with a blood test if the in vitro fertilization has given its results—fruits and whether new life is developing in the womb.
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