IVF (in vitro fertilization) is a type of assisted reproduction technology (ART) where a woman’s eggs are fertilized with the sperm in a specialized laboratory.
Every IVF treatment begins with hormone therapy, which encourages the growth of multiple eggs in the patient’s ovaries. Once the follicles (fluid-filled sacs in a woman’s ovaries that contain immature eggs) reach an adequate size, eggs are collected using ultrasound-guided aspiration. Mature good-quality eggs are then fertilized with the partner’s or donor’s sperm using intracytoplasmic sperm injection (ICSI) to create embryos.
The embryos remain in a culture medium for between 3-5 days before being transferred to the woman’s uterus. Our embryologists conduct a quality assessment on each of the embryos to see how they are developing within the incubator during the 3-5-day period. This is a non-invasive method that allows our medical team to choose only the best embryos for implantation.
The process of embryo implantation is made even easier thanks to EuroCARE’s use of embryo glue and assisted hatching. This sticky solution allows the embryos to attach to the wall of the uterus and continue growing into a healthy child. Good-quality embryos that are not transferred during the first IVF cycle can be frozen and used in a second attempt for pregnancy through IVF.
What is the Process of IVF
Step One: Consultation with a Fertility Specialist
Your first step towards parenthood begins with meeting our fertility specialist. During your initial consultation, our specialist will review your medical and reproductive history and discuss any previous tests or treatments you have undergone. This is a great opportunity for you to ask questions and meet the EuroCARE IVF team. Once you’ve addressed all your concerns, you’ll get instructions on how best to proceed. You may be advised to undergo additional fertility tests to assess your uterus and ovarian function.
Step Two: Ovarian Stimulation
After the initial consultation, you will begin ovarian stimulation. With the use of fertility drugs, you’ll be able to produce multiple eggs for fertilization. This stage can take between 10 and 12 days. Your specialist will determine which mediation will be best for you and if a further adjustment needs to be done depending on your body’s response.
The stimulation drugs used during your IVF cycle contain a hormone called follicle-stimulating hormone (FSH). Some brands use a combination of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). FSH stimulates the growth of multiple eggs. Having more eggs available for fertilization increases the likelihood of more embryos being produced. Having a wider choice of embryos for implantation is super important for increasing your chances of IVF success.
Step Three: Monitoring
During ovarian stimulation, you will have routine check-ups to determine the response of your ovaries to the fertility drugs and evaluate the development of your follicles/eggs. Ultrasound scans and blood tests are used to monitor your ovaries. This enables our doctor to determine the perfect timing for the trigger shot.
Step Four: Trigger Shot
Once the eggs become fully mature, our doctor will prescribe you an hCG injection (also known as a trigger shot) to stimulate ovulation. To identify follicle size on the day of the trigger shot is very important as this will result in more mature eggs being retrieved following ovarian stimulation. Around 36-38 hours after the trigger shot, you’ll be scheduled an egg retrieval procedure at our fertility clinic in North Cyprus.
Step Five: Egg Retrieval
During this 15-minute process, sedation is required to keep you asleep and relaxed. Your eggs will be then collected using ultrasound-guided aspiration that is inserted through the cervix and into each of the ovaries. Multiple eggs are aspirated within a couple of minutes. Bed rest is advised following an egg retrieval procedure. The next day you can return to your routine activities.
Step Six: Egg Fertilization (ICSI method)
Once the eggs have been collected, they will be fertilized with your partner’s (or donor’s) sperm in our laboratory. Collected eggs are assessed based on two factors: maturity and quality. Eggs that meet these criteria are used for fertilization with the sperm in a procedure called intracytoplasmic sperm injection (ICSI). With this technique, single sperm cells are immobilized and then injected directly into each egg.
Three days after fertilization, normal embryos will be between seven and nine cells. On the fifth day of fertilisation, some of the embryos will reach the blastocyst stage. Hormone medication will be prescribed to help you prepare for the embryo transfer. This medicine will encourage your womb to accept the embryo(s).
Step Seven: Transferring the Embryo
Embryos are transferred using a catheter that is inserted through the cervix into the uterine cavity. Here, our fertility specialist will deposit the selected embryos. This procedure is far simpler than egg retrieval and sedation is not required.
The number of embryos that will be transferred during this step depends on your age and the quality and stage of development of your embryos. The grading reports will be reviewed and the decision as to the date and number of embryos to transfer will be discussed between the EuroCARE IVF team and the patient(s).
Once the procedure is completed, you will be required to remain at the clinic for bed rest. The next day you can resume your daily activities. Pregnancy is confirmed through a test twelve days after the embryo transfer. This test will help us unserdtand if implantation is taking place and if IVF was successful.
What is the Success Rate of IVF
IVF success rates are age-related. Data were obtained from the IVF cycles carried out at the EuroCARE IVF center. Pregnancy rates for fresh IVF cycles in 2018 were as follows:
- < 35 – approximately 78%.
- 35-39 – approximately 55%
- 40-44 – approximately 35%
Egg donation cycles resulted in slightly higher pregnancy rates due to the use of donor eggs obtained from young, healthy women aged between 21 and 28. Success rates of IVF using donor eggs were as follows:
- < 35 – approximately 80%.
- 35-39 – approximately 79%
- 40-44 – approximately 78%
- > 45 – approximately 70%
Will IVF Work First Time
For couples who cannot get pregnant on their own, IVF offers the chance of having a baby. While IVF raises the couple’s chances of conceiving a healthy child, pregnancy success depends on many factors including age, cause(s) of infertility, use of donor eggs, lifestyle factors, etc.
1) Age. Unlike men, who experience a drop in their fertility in their 40s, women are born with a fixed number of eggs in their ovaries. This is called ovarian reserve which is subject to two processes.
Firstly, ovarian reserve gradually diminishes as a woman gets older. This decline in the number of eggs is not hormone-dependent and is not affected by fertility treatment or by the use of fertility drugs. It is a natural consequence of the aging process and little can be done to prevent the depletion of the ovarian reserve. Women who are interested in building their families in the future can now preserve their fertility by freezing their eggs earlier in life.
The second process that affects eggs is the decline of egg quality. Older eggs are more likely to produce embryos with chromosomal abnormalities. Women in their 40s are strongly recommended to have PGS (preimplantation genetic screening) on their embryos before implantation. PGS can help our fertility team to exclude embryos with chromosomal defects from being transferred to the patient’s uterus.
Both processes – the decline in the number of eggs and their quality seem to speed up after the age of 35.
IVF success depends on both the number of eggs that the doctor manages to retrieve and on the quality of the eggs retrieved. Embryos produced during an IVF cycle are graded for quality before the embryo transfer. Only the best, healthiest embryos are placed into the patient’s uterus.
2) Cause(s) of infertility. Certain fertility issues make IVF success more difficult to reach, including fibroid tumors, uterine disorders, double factor infertility, ovarian dysfunction, advanced stage of endometriosis, etc. IVF, however, can very successfully overcome most of these infertility issues.
3) Embryo Quality. The quality of embryos depends on a woman’s age, her ovarian reserve, and the sperm quality of the male partner. The higher quality eggs, the better your chances for pregnancy success.
4) Sperm Quality. If the male partner has fertility issues, there is a greater risk he’ll produce embryos of lower quality. New screening technology is helping us to reduce the negative effects of poor-quality sperm to make pregnancy more successful.
5) Donor Eggs. Women whose eggs are of poor quality due to age or other factors are advised to use donor eggs to increase their chances of IVF success.
6) Embryo Transfer. Embryo transfer is the last step of the IVF process. The quality and stage of development of embryos will determine the success of embryo transfer.
7) Uterine Receptivity. Factors such as the thickness of the uterine lining, immunological factors, uterine polyps, and adhesions can all affect the chances of successful embryo implantation.
8) Lifestyle Factors. Certain lifestyle habits such as smoking and drinking alcohol can reduce the chances of success. Smokers have a 50 percent lower chance of implantation compared to non-smokers. Maintaining a healthy weight is also important in improving the chances of IVF success. Obesity can affect hormones and the effect of fertility medications, making it more difficult to conceive or carry a baby to term. The good news is that you can change your lifestyle and these aspects can be actively improved.
How to Prepare for IVF Success
If you have decided that IVF is the best course of action, here are a few tips that will help you prepare for IVF success.
- Maintain a healthy weight. Maintaining a healthy weight is extremely important in increasing chances for IVF success. Being obese (BMI >35) or underweight (BMI <19) can increase the time of conception by 2 and 4 times respectively. Obesity may interfere with your hormonal balance and can make stimulating and monitoring the ovaries during IVF more difficult. Diet changes along with cardio activities can help you reach a better body weight.
- Improve sperm quality. Maintaining optimal body weight as well as taking vitamin supplements can improve your sperm quality. We encourage you to talk to our fertility specialist for any abnormalities in your semen analysis.
- Choose the right fertility clinic. Choosing the best fertility clinic does not have to be a hard decision to make. With our expert team, you can feel supported every step of the way. Our highly-trained care professionals will make sure that your IVF journey is as successful as possible. The EuroCARE IVF clinic in North Cyprus has reported high success rates since its first opening in 2013.
- Reduce stress. We recommend trying exercise and relaxation techniques that reduce stress and make you feel more relaxed. Acupuncture, yoga, mind-body programs, resilience training workshops can all help you cope with the stress during the IVF procedure.
- Prenatal supplements. Vitamin supplements with folic acid have shown some positive results in terms of improved egg and sperm quality. Ensure you have adequate levels of vitamin D before conception. Deficiency in Vitamin D can worsen IVF outcomes.
- Be patient. Some patients require more than one cycle of IVF to achieve positive results. If your first cycle wasn’t successful, our doctor can adjust the medication protocol to optimize your subsequent treatment cycle. Remember, with the right support infertility does not have to stand on your way to achieving your dream of parenthood.
Can Stress Affect IVF Success
Emotional distress does not prevent women from becoming pregnant through IVF. In a study, women have had their stress levels assessed before beginning treatment. The aim of this study was to determine if women who were more stressed before the start of their IVF treatment were less likely to become pregnant. The results showed that stress had no impact on whether a woman became pregnant or not. However, patients should not forget that stress can cause changes to their endocrine system which can potentially complicate the process of IVF.
Women who do not get pregnant following a cycle of IVF often blame themselves for getting too stressed out. The need for patients to receive support should not be ignored. Our clinic makes sure that every patient feels supported on their emotional journey to becoming parents.
IVF at EuroCARE IVF in North Cyprus
If you are considering starting IVF treatment, you’re probably wondering if it will work for you. The good news is that IVF is generally successful. The field of reproductive medicine is rapidly progressing with many technological advances and these have significantly improved IVF success rates in recent years. Advances in both science and technology mean that we can help more people achieve their dream of parenthood. When combined with expertise, IVF can offer hope to potential parents around the globe. To find out more about how can IVF help you start a family, please call +90 533 885 4222 (Cyprus) or +44 203 389 7633 (UK Patients), or complete our contact form.