IVF: In vitro fertilization

In vitro fertilization is a procedure in which a mature female oocyte and sperm of the male partner are sampled, fertilized in vitro, cultured for 2 to 5 days, and transplanted into the uterus.

In vitro fertilization is targeted to couples that have been unsuccessful in getting pregnant with other fertility treatments, women who have received tuboplasty in the past but have failed to become pregnant for more than 6 months and women with infertility from immunological cause (cervical mucus containing anti-sperm antibodies), cervical abnormalities, or other unknown causes.

An injection called gonadotropin will be injected every day for 8to 10 days from the third day of menstruation to help grow about 5 to 10 follicles. To prevent premature ovulation after follicles have grown to some extent, early ovulation inhibitor (GnRH agonist or antagonist) will be injected. During this procedure, ultrasound and blood tests can be performed to assess the number and size of follicles. If follicles grow to appropriate size, human chrionic gonadotropin (hCG) will be injected 36 hours before the final egg retrieval to aid in the maturation of the oocyte. The types and doses of inducing agent syringes administered during the ovulation induction phase is determined by taking patient’s age and ovarian function into consideration. Self-injection is available in case of 피사 injection.

After 36 hours of administration of hCG, an oocyte retrieval operation will be carried out. Ultrasound-guided follicular fluid can be aspirated under sleep anesthesia to obtain oocytes in the follicles. The entire procedure will take about 15 ~ 20 minutes. After the procedure, it is recommended for patients to take a rest for about one hour before returning home. On the day of oocyte retrieval, your partner can prepare the semen from the semen collection room by masturbation. Male partner must avoid ejaculating for 2 to 3 days before collection and avoid smoking, drinking and sauna during the preparation period. If your partner has azoospermia, you can also take testicular sperm directly by surgical method.

Each egg and a sufficient number of sperm that actively move are placed in a culture dish together and are cultured to be fertilized naturally in an incubator with conditions that are similar to that of a human body.

The embryo transfer process is the last step in in vitro fertilization and involves implanting the fertilized embryo into the uterus. Vaginal tube is inserted while 질경 is used to clearly see the uterine cervix and 1-3 embryos that have been cultured for 2-5 days is guided through a thin soft tube into the uterus. The number of embryos to be transplanted can be determined by consulting with the clinician as patient’s age and condition, embryo status, and previous surgical results will be taken into account. The degree of discomfort during embryo transfer is similar to that of cervical cancer screening so anesthesia is not necessary. Upon completion of procedure we recommend that you take a rest for 30 minutes to 1 hour before returning home and spend next 2-3 days in a stabilized environment. The remaining embryos can be frozen for future use.

Once the egg is picked up, an emperor hormone (progesterone) is administered to create an appropriate endometrial environment to conceive. Emperor hormones may be inserted though injections, intravaginal administration, or oral tablets and you may consult with your doctor on the appropriate route of administration.

Unlike the general procedure in which an oocyte and sperm are sampled and the natural fertilization is induced in the incubator, in some cases, it is necessary to inject a single sperm of good activity and shape into a single oocyte. This procedure is called intracellular sperm injection. If the sperm status is poor or the fertilization rate is too low after natural fertilization, intracytoplasmic sperm injection will help to increase fertility and fertility.

During the natural pregnancy process, the embryo goes though a process of penetrating through the gelatinous outer membrane, called the zona pellucida, before the implantation into the endometrium. If the zona pellucida is determined to be thick, a small hole is made in the zona pellucida with laser to help the implant before transplanting the embryo.

In vitro fertilized embryos can be cultured for more than 3 days in the incubator. After 5 days, blastocyst embryos with more than 80 cells, including liquid-cooled river in the center, may develop. By culturing for more than 5 days, you can choose the healthiest embryo prior to transplantation, minimizing the number of transplanted embryos while maintaining the pregnancy rate.

The remaining embryos after in vitro fertilization and fresh embryo transplantation can be frozen and conceived by embryo transfer without induction of ovulation and oocyte retrieval in the next trial. Vitrification uses supersonic cooling technology to freeze an embryo/oocyte by converting them to glassy solid instead of ice, maximizing their survival rate by avoiding the formation of ice crystals. By increasing the embryonic survival rate after thawing, we are able to ensure high pregnancy rate and fertility rate with frozen embryo transplantation as well.

Depending on the patient's condition, embryo glue and intrauterine hCG injection may be supplemented to assist implantation during embryo transfer.

Unlike collecting multiple mature oocytes through a procedure of induction of ovulation in a general in vitro fertilization, natural cycle IVF examines a single oocyte that grows to naturally ovulate through the natural menstrual cycle of a woman by ultrasonography. Once confirmed, the egg is collected and fertilized in vitro with sperm from the partner. Pregnancy can be attempted through a natural cycle test-tube procedure for patients who are older or have lowered ovarian function compared to their age, female hormone-sensitive cancer patients, or other patients whose ovulation induction is contraindicated.

It is an in vitro fertilization procedure in which immature oocytes are collected from the ovaries without ovulation inducing agent and are matured and fertilized in vitro. This procedure helps patients with polycystic ovary syndrome, patients with side effects from ovulation induction injections, patients with cancer, and patients with other ovarian stimulation syndromes have a safe pregnancy without complications

• - Very few or none superovulation injections are given when menstruation begins
• - Special liquid culture is used for 24-48 hours of in vitro maturation
• - In vitro fertilization (intracytoplasmic sperm injection: ICSI)
• - Embryo implantation

The risk of developing Ovarian Stimulus Syndrome is reduced by administering no or minimal doses of ovulation-induced injections and the procedure can be performed monthly.

Our Miraeyeon OB/GYN Clinic offers a variety of in vitro fertilization methods, including general in vitro fertilization (long-term therapy / short-term therapy), natural cycles or hypotonic in vitro fertilization, and immature fertilization in vitro fertilization. Of these, the most appropriate and safe procedure for the patient can be determined by consulting with our doctors taking patient’s age, ovarian function, other history, response to previous treatment and results into account.