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Patient
Preparation
The
woman's ovaries are stimulated to produce eggs with the use of
injectable hormones called Gonadotropin (FSH and LH).
Specific treatment protocols are available: the Long
protocol (follicular and luteal varietries), the Short
protocol and the Ultrashort protocol, all based on how a
special drug is used, the so-called LHRH agonist.
Newer
protocols use the recently produced LHRH antagonists. Finally,
the natural cycle may be employed where only one egg is used,
the one produced normally by nature.
Patient
monitoring
During
the ovarian stimulation the egg production and growth is
monitored with the aid of the Ultrasound scanning and the
blood hormone (Estradiol) level.
Ovum
Pick-Up (OPU)
When
the eggs are mature, they are collected vaginally with the aid
of the Ultrasound Scanner. The woman is given very brief
anesthesia, therefore she feels no pain during the procedure
which lasts only a few minutes. At the
same time the husband produces a sperm sample.
Fertlization
The
eggs are fertilized in the lab either with the classical
method by putting spermatozooa around the egg and allowing
them to penetrate the outer membrane of the egg or with the
ICSI method by piercing the egg membrane with a
microneedle under microscopic control and placing one
spermatozoon in the center of the egg.
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Culture
- Embryo Transfer
The
fertilized eggs are cultured for 2 or 3 days before
transferring them back into the woman's uterus (womb).
Newer
developments have led to the successful culture of embryos up
to 5-6 days, at which time the embryos become blastocysts.
Blastocyst transfers are successful but they are employed
under certain conditions and for certain indications.
OTHER
TREATMENTS
1)
Treatment of Azoospermia: TESA - TESE - MESA
When
there are no spermatozooa in the ejaculate, attempts can be
made to find mature or immature spermatozooa or their
precursors in the testes. When this is successful,
fertilization of the egg is attempted with the ICSI method.
2)
Ovum Donation
There
are women who have insufficient egg production or eggs of
inadequate quality. In these cases the couple may wish
to become recipient of eggs donated by another woman. The couple may find their own donor or our IVF center may find
one for them. The success rate of ovum donation is quite
high, in fact higher than the routine IVF or ICSI treatments.
The donor and recipient are synchronized for their cycle
days before the embryo transfer.
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