ASSISTED REPRODUCTIVE TECHNOLOGY (ART) IS THE TECHNOLOGY USED TO HELP ACHIEVE PREGNANCY IN PATIENTS WITH FERTILITY PROBLEMS.
IVF LAW AND LEGISLATION IN ROOYA
- IVF treatment available only to couples not individuals
- Women age on the day of embryo transfer may not exceed 48 years + 364 days
- Infertile couple must be of different sexes
- Artificial insemination can be used for sex selection
- Egg, sperm and embryo donation is not allowed
- Surrogacy is not allowed
- Couples must be married
- Single women and lesbian couples are not allowed by law to be treated
- PGD and PGS are allowed.
- There is no legal age limit for treatment but bearing in mind that only a woman’s own eggs can be used in treatment, many clinics will not treat women above 46 years
- Embryos can be stored for 10 years but couples should annually let the clinic know their intentions regarding storage
- There are laws on how many embryos are allowed to be transferred:
- -Women less than 35 years old are allowed one embryo transferred for the first and second cycle. Two embryos are allowed with the 3rd cycle.
- -Two embryos allowed for women older than 35 years old.
Fisrt step of Assisted Reproduction begins at the clinic – consultation with an IVF Specialist. Reproductive history and abilities of a couple are analysed in detail. Depending on the analysis, specific methods are recommended and a treatment plan is drafted.
What would follow:
DAY 0. = Eggs, Sperm
To discover what the problem may be a woman goes through thorough examination. Age-related inability to produce eggs is one of the most common causes of female infertility. During the analysis we find how efficient her ovaries are, and evaluate the quality of her oocytes.
If there is no problem for use of own eggs for the treatment, eggs are retrieved via puncture and gently applied suction from ovaries under short-term general anaesthesia.
The basic examination of the man is spermiogram. A spermogram is the primary method of establishing the presence and cause of male infertility. Male fertility depends on sperm quality, count and motility.
According to sperm analysis, a suitable method of egg fertilization is determined. If no sperm cells in the ejaculate are found, surgical sperm retrieval from testicles using MESA or TESE guided by a urologists under general anaesthesia is recommended.
Egg fertilization and embryo development
The fertilization of an egg can either take place in a woman’s body (IUI) or outside of a woman’s body – a true in vitro fertilization solution (IVF). In Vitro Fertilization or IVF is a technology in which eggs cells are fertilized by sperm outside the body.
An injection of sperm directly into the oocyte, ICSI method, limits increases the probability of conception. It is carried out under a microscope using micromanipulator.
We recommend PICSI (physiological ICSI), an additional and even more precise method for sperm selection. For oocyte fertilization, we use the sperm cells that are most attracted to a drop of the chemical substance that is also contained by an oocyte.
DAY 1. – 5. = Embryo cultivation
By oocyte fertilization an embryo comes into existence. It is impossible to ensure that the connection between a sperm cell and an egg develops only into perfect embryos. It is a matter of coincidence.
Prolonged cultivation of embryos is the most basic method allowing IIVF specialist to distinguish between healthy and imperfect embryos. Defective embryos stop to develope during the first five days in the lab. The embryos that continue to develop until day 5 are considered healthy. One, maximum two, embryos will be transferred into the uterus and the rest of the available good quality embryos can be cryopreserved.
When a risk of congenital genetic diseases is increased, we can assess chromosomal genetic characteristics of an embryo via PGD (pre-implantation genetic diagnosis) and eliminate the transfer of a defective embryo.
DAY 5. = Transfer of an embryo into a uterus
After successful cultivation, the suitable embryo is transferred into a uterus. Embryo transfer is a procedure whereby embryos are placed into the patient’s uterus. It is a simple, painless procedure very much like a routine gynaecological exam. Embryos are deposited in the uterus through a thin catheter.
Non-transferred developing embryos can be cryopreserved providing an opportunity to conceive another child at a later date by thawing a fertilized embryo (FET).
DAY 6. – 7. = Embryo implantation
On day six and seven of embryonic development, thus one or two days after the embryo transfer, an embryo implants into the endometrial lining. The implantation is influenced by different factors and mediators, which are not perceptible via any visual technique. The endometrial height visible on the ultrasound is an indicator to be considered.