In Vitro Fertilization – IVF
With in vitro fertilization, the egg-sperm fusion takes place in vitro, i.e. in the laboratory, creating the embryos that will be transferred to the womb of the mother-to-be.
In vitro fertilization is recommended
- For women with fallopian tubes problems
- For women with few or poor quality eggs
- For women with severe endometriosis
- For men with sperm disorders
- After failed insemination treatments
- For couples with unexplained infertility
- Ovarian stimulation
Fertility drugs are used to stimulate the ovaries. 8-15 ovarian follicles will mature to give high quality eggs.
There are three main protocols used for ovarian stimulation: Long, Short and Antagonist protocols.
Depending on the protocol and the woman’s response, each treatment lasts from 10 to 20 days.
- Egg retrieval
Ultrasound is used to ensure that the ovarian follicles have grown to the appropriate size and there is sufficient number of eggs. Then, the hCG hormone is administered to help the eggs mature, as it would happen during a normal cycle.
Egg retrieval is carried out in surgery with sedation, it takes approximately 10 minutes and is generally a painless procedure.
Once the eggs are retrieved and the sperms from the partner’s semen sample are collected, we proceed to the stage of fertilization. Fertilization happens in the laboratory by experienced embryologists.
The process followed is either conventional in vitro fertilization, where sperm and eggs are put together and normal fertilization occurs without further interventions, or intracytoplasmic sperm injection, or ICSI (in case of low sperm quality or prior failure with conventional IVF), where sperm is injected directly into the egg in a perfectly safe way, using a small glass pipette.
- Embryo transfer
On the day of the transfer, the best embryos (i.e. the ones with the right development) are selected to be placed in the womb under ultrasound guidance. This procedure is very quick and totally painless.
In Greece, egg donation is set by law (L. 3305/2005). Thanks to egg donation, women who are unable to use their own eggs may receive a donor’s egg.
According to the law, the donor must meet certain strict criteria:
- Age up to 35.
- Normal medical history.
- Normal reproductive system.
- Normal results in the evaluation consisting of chromosomal screening (karyotyping), cystic fibrosis carrier testing, hepatitis, HIV, syphilis, Rh factor testing.
The donor’s eggs are fertilized in the laboratory using the sperm of the recipient’s partner, when feasible.
Embryo transfer takes place 3-5 days later, with the embryos being placed in the recipient’s womb, in order for the latter to get pregnant.
It is recommended for:
- Women with reduced number or quality of eggs due to
- early menopause
- autoimmune disorders (hypothyroidism, Addison’s disease, diabetes mellitus, anti-ovarian antibodies etc.)
- environmental factors, like smoking etc.
- age-related ovarian dysfunctions
- surgical removal of ovaries or chemotherapy due to cancer
- Women who may have sufficient number of eggs but have a history of hereditary genetic abnormalities, chromosome anomalies or recurrent miscarriage history.
Egg donation allows those women who are not able to have children in any other way, to live the miracle of pregnancy that will fulfill their dream of having a baby.
It is a process where a man may donate his sperm to the sperm bank in order to help a couple start their own family.
The current legal framework requires from the donor to undergo a compulsory special screening for certain diseases prior to the donation, thus safeguarding the safety of the procedure.
Sperm donation is anonymous both for the donor as well as for the recipient.
In the case of women where pregnancy is either impossible or even life-threatening, surrogacy is the answer.
This option refers to women without a uterus or women suffering from a severe medical condition such as heart disease, high blood pressure, liver disease, kidney disease, recurrent miscarriage history etc.
This means that another woman, a.k.a. surrogate mother, will bear through pregnancy the embryo created from the in vitro fertilization of the mother’s egg and her partner’s sperm.
Surrogacy authorisation is granted with court ruling prior to the transfer and upon request of the woman who wishes to have the child, provided that the conditions set forth in the law are met.
In Greece, surrogate motherhood is established in law 3089/2002.
Upon approval of the request, the court grants permission to the doctor to proceed to embryo transfer. The process is monitored by a legal counsel who works with the couple and the medical team.