In Vitro Fertilization (IVF) is inseminating the eggs, which we retrieve from the female, with the sperm that we collect from the male and process in the laboratory. Then, we keep the fertilized eggs for 2-3 days in incubators. After that, those which developed to good quality embryos are suitable for transferring into the womb.
What are the steps of In Vitro Fertilization (IVF)?
We wash the eggs that we retrieve and place them into special fluids for fertilization and embryo development. In the laboratory, the team washes the semen produced by the male to remove the seminal fluid. This enables them to clean most of the dead or immotile sperm and to concentrate good quality sperm. The number, motility and morphology (shape) of the sperm are the important factors that we focus. Sperm is brought to a concentration per egg and added into the fluid that contains the eggs.
The day after (16-18 hours later) collection, we examine the eggs under the microscope for assessment of fertilization and transfer those whose fertilization happens naturally into a new dish with fresh solution. Tracing cleavage goes on for 2-3 days and we score the embryo qualities. After selecting one or two best quality embryos, transfer into the uterus occurs. We also freeze remaining embryos with good quality after obtaining informed consent from the couple.
Who can go for IVF?
There are certain criteria to apply In Vitro Fertilization (IVF). Sperm and Oocyte qualities should meet certain standards. In cases with low sperm count, or poor morphology (shape) as with poor oocyte quality, fertilization can be compromised or even not occur at all. Therefore, it is appropriate to apply IVF to couples with good sperm and Oocyte quality.
Intra-cytoplasmic sperm injection (ICSI) is one of the most widely used insemination method in assisted conception treatments. It is simply the injection of a single sperm cell into one egg. ICSI is especially useful in cases with low sperm count, or poor sperm morphology. Additionally, the usage of it in the cases, which conventional IVF resulted in poor fertilization, is common.
As ICSI is an easy technique and results in acceptable fertilization rates, it is widely used in most clinics around the world.
Under normal circumstances, sperm penetrates the egg membrane by the aid of its motility and certain organelles (structures). This fertilization procedure enables us to select healthy sperm while we can eliminate those with abnormal genetic content. During ICSI however, the embryologist select the sperm, so the selection of unhealthy sperm is impossible. While keeping the risk to a minimum, it is essential to remember that elimination of embryos arising from unhealthy sperm (or the egg) during development occurs.
To whom is ICSI applicable?
Cases which previously failed conventional IVF attempts, cases with low sperm count, and/or poor sperm morphology or motility, as well as those with poor egg quality can benefit from ICSI. First trial cases where sperm or the egg does not display any structural or physiological abnormality should try conventional IVF.