In vitro fertilization IVF/ICSI

Women who do not have children generally have an increased risk of genital cancers compared to the general population, even if they do not have hormonal treatments. Long-term studies do not show an increase in this risk if you perform hormonal stimuli.

In a natural cycle, several dozen follicles (formations containing oocytes in different stages) are recruited and lost in the ovary. One follicle grows and ovulates, the others will degenerate, a process called follicular atresia. Stimulating medication does not increase the number of follicles that are lost in a month, but matures those already recruited. Ovarian stimulation does not consume the eggs faster, but, on the contrary, saves eggs that would have been lost in that cycle, allows them to grow and be used.

When the reserve of oocytes left in the ovaries is small, it does not mean that a pregnancy can no longer be obtained, but that there is no more time to wait.

For IVF, reduced ovarian reserve is associated with lower success rates because fewer embryos are obtained. The possibility of embryo selection decreases, as does the probability of having additional embryos for freezing.

The most important factor that determines the quality of the eggs is AGE. Even if in the laboratory the oocytes look the same, the older they are, the less embryos they will generate. Even in young people there may be problems with oocyte quality, from birth or after inflammation, endometriosis or certain treatments. There is no specific test, but the poor quality is seen in the unfavorable evolution of embryos in the laboratory or after implantation.

Genetic analysis of embryos in the laboratory is possible, but not routine, due to limitations and risks: it is invasive (requiring the extraction of cells from the embryo) and can generate false or inconclusive results. It is recommended in particular situations, with high genetic risk.

The success rate depends on a multitude of factors, the most important being:

• Age of patients, especially women
• Number of oocytes collected (Ovarian reserve)
• Number and quality of embryos obtained

The cause of infertility is important, as it influences the above factors. There can be a high chance of success in infertility with severe causes if the age is young. In cases without identified causes, the chances may be low if the age is advanced or the ovarian reserve is reduced.

Clinical protocols, experience, technological methods used are also important.

Lifestyle should not change radically during treatment. Travel by car, train or plane is allowed at all stages, after a discussion with the doctor, in case certain additional measures are needed.

The probability of having a multiple pregnancy is higher if more than one embryo is transferred to the uterus. Transfer of a single embryo is recommended to reduce the increased risk of complications associated with twin pregnancies.

And in the case of single fetal pregnancy, there was a slight reduction in fetal weight at birth. This effect does not occur in the case of frozen embryo transfers.

The risks of miscarriage, ectopic pregnancy or fetal abnormalities also exist in the case of pregnancies after IVF, as well as in the case of pregnancies that occur spontaneously. The IVF procedure does not exclude, but neither does it significantly increase the risks.

The vast majority of injections are given subcutaneously and are not painful.

If over 15-20 follicles develop as a result of ovarian stimulation, the chances of success increase, but complications can occur – ovarian hyperstimulation syndrome. There are ways to avoid or reduce the risks if appropriate measures are taken during treatment.

Oocyte sampling is the only minimally invasive procedure, as it involves puncturing the ovaries. It can be performed without anesthesia, with local anesthesia or with intravenous sedatives or anesthetics for a short time. The other procedures are not painful.

The quality of embryos is assessed according to certain criteria: the appearance and number of cells in each day, the evolution or stagnation in evolution from one day to another, the degree of fragmentation.

The morphological evaluation of the embryos in the laboratory allows the estimation of the implantation chances and the selection of the embryos with better potential.

The morphological criteria do not show whether the embryo has a genetic defect or whether it will have a malformation during its subsequent development in the uterus.

In the Gynera Clinic such an error cannot happen, because in our work protocols are provided rigorous safety measures and verification by three concomitant methods.

In addition to checking the unique number of patients assigned by the electronic database, patients are asked to verbally confirm their own and partner’s name. In addition, the unique MatcherTM system in Romania scans, records and verifies all barcodes on patients’ cards and labels of organic products. For frozen samples, a color-based identification system is also used, making it easier to identify samples in cell and embryo banks.

Embryos that evolve in the laboratory for 5-6 days can reach the blastocyst stage, the stage in which the embryo implants. Most embryos formed in the laboratory (and naturally) do not reach this stage, they stop evolving after 3-4 days. If an embryo exceeds this critical stage and reaches the blastocyst stage, it will have a higher chance of implantation.

The risk of developing a congenital anomaly in the general population is about 2-3% of births and can be affected by age, lifestyle or certain conditions that occur during pregnancy.

IVF does not significantly increase these risks, but does not eliminate them, as they are dependent on various factors, sometimes occurring after implantation.

In the case of severe male genetic pathology, the IVF / ICSI procedure may increase the risk of transmitting genetic abnormalities to the fetus.

In the Gynera Clinic many patients come for treatment from other localities or from other countries. Communication and some monitoring can be done remotely or through collaborations. No procedure requires staying overnight in Bucharest. If you live in another country, consider a period of at least 2 weeks, provided that the treatment plan is organized in advance.