Artificial insemination, in vitro fertilization, is a laboratory technique in which fertilization of an egg takes place outside the uterus. It represents one of the most effective ways of dealing with infertility. The success rate of artificial insemination is high, ranging between 50-60% per IVF cycle. In vitro fertilization consists of several steps.
Make an appointment
2. to 3rd day of menstruation
Stimulation of the ovaries
In the first step, the doctor selects the most appropriate protocol for the patient according to a number of factors. This is followed by hormonal preparation, which can take 8 days to 5 weeks. Both the treatment schedule and the daily injection time are given to the patient by the doctor. The patient injects the hormones subcutaneously after being trained by the staff of the assisted reproduction centre.
During ovarian stimulation, several checks at the centre will be necessary (2-4), during which the response of the ovaries to stimulation is checked by ultrasound and hormonal indicators from the blood are also monitored. The presence of a partner during this step is not necessary.
Side effects of hormonal stimulation of the ovaries
Some discomfort should be expected towards the end of stimulation. This can manifest itself in water retention, a distended abdomen and pain in the ovarian area. These symptoms are normal and go away after a short time.
10. to 12. Day
Final maturation of eggs
This is a very important step to ensure that the eggs are as mature as possible at the time of collection. The patient injects herself with a preparation – Pregnyl, Ovitrelle or Dipherelline – 35 – 36 hours before egg retrieval. The time of application must be precisely observed, since its postponement can affect the outcome of the entire infertility treatment.
Egg retrieval is the only procedure in artificial insemination that is performed under short-term intravenous anaesthesia. It takes 5 – 15 minutes and the patient is wakened immediately after the procedure in the treatment room. The couple arrives downtown first thing in the morning and stays until about mid-morning.
It is necessary for the patient to come to the egg collection on an empty stomach, she must not drink or eat anything from midnight onwards. After the procedure, she remains in the waking room for 2 – 2.5 hours. At this time, the partner will hand over a sperm sample (if not using frozen sperm). This is followed by an interview with the embryologist, during which the partners learn about the quality and number of eggs collected and the parameters of the spermogram. Subsequently, the methodology of fertilization of eggs and other methods that can improve the results of treatment will be agreed upon. The partner will be given a schedule of medications to take after egg retrieval for a full two weeks, until the pregnancy hormone in her blood is determined. At the same time, in this step, we inform you about the amount of payment to be made on the day of the procedure and on the day of the embryo transfer.
While the couple goes home, the eggs are fertilised with sperm in the laboratory using the artificial insemination methods agreed during the consultation.
On the first day after egg retrieval, the embryologist informs the patient about the result of fertilization and arranges a date for embryo transfer – transfer of the embryo into the uterus. For the next 3-6 days, the embryos develop/culture in laboratory conditions that mimic the uterine environment as closely as possible. They are monitored at all times by a device that allows embryologists to evaluate the regularity and timing of the division of each embryo and then select for transfer the embryo with the highest implantation potential.
14. to 18. Day
Embryo Transfer
The transfer of the embryo into the uterus is carried out on 3. – 6. the day after egg collection. The couple will come to the assisted reproduction centre for the embryo transfer at the agreed time. Once the embryologist arrives and writes out the consents, the number of embryos to be transferred or other additional methods will be agreed with the embryologist. As standard, we transfer one of the most viable embryos, and freeze the rest with the consent of the couple. We freeze only those embryos that have the potential to develop after thawing
There is no need to come fasting (only if the embryo transfer is done under anaesthesia for various medical reasons). The procedure itself usually takes up to 1 minute and is performed without anaesthesia. It is not painful, so there is no need to stress. After the procedure, the patient remains in the patient room for about 30-45 minutes and then can go home.
On the day of the embryo transfer, all payments related to the IVF cycle are made at the reception desk of the centre, if they have not been made by then.
26. until 30. Day
Pregnancy after artificial insemination
Pregnancy after artificial insemination is confirmed by determining the level of hCG from the blood. The earliest collection is 14. the day after egg collection. Rather, the results could still be skewed by hormonal preparation.
Waiting for the outcome of infertility treatment is the most stressful time of the whole IVF cycle because nothing actually happens. Therefore, it is advisable to fill this time and avoid stress as much as possible. There is no need for incapacity for work if the cycle of in vitro fertilization proceeded without complications. Any problem should be reported to your doctor, the emergency line or during office hours at the reception of the centre.
What should I do/not do during IVF?
Diet and artificial insemination
We recommend that you continue with the standard diet you are used to. Regimen measures in terms of lifestyle changes and weight adjustments need to be made well before you enter the IVF cycle, so that they have time to have an effect on sperm quality/possible response to ovarian stimulation. We recommend a long-term healthy and balanced diet – fruits, vegetables, fish, whole grains…
Work and exercise during artificial insemination
There is no need to modify your habits in any significant way. Even if you exercise by default, keep doing it. Towards the end of stimulation – about 5-6 days before egg retrieval, some activities (longer running, aerobics, jumping on a trampoline) are no longer suitable, especially in view of the sensitivity of the ovaries to these forms of exercise.
Long endurance runs are not suitable either.
By default, we do not recommend stopping work, it does not interfere with our treatment in any way. It’s up to your discretion. The goal should be to move in the least stressful environment possible. Someone has it at home, if he is alone in peace, someone has it at work. You know yourselves best.
What to avoid in any case during an IVF cycle
Read the ingredients of the products you use and try to avoid those that contain formaldehyde, parabens, benzophenones, BPA, phenols, dioxins, phthalates.
Although most of our cosmetics are safe, try to use natural cosmetics.
Neither sunbathing nor sunbeds are advisable during hormone treatment. Also, towards the end of stimulation and just after embryo transfer, we do not recommend saunas and hot baths. Given that most of the time the medication is also injected into the vagina after egg retrieval, swimming in swimming pools is also not optimal. Do not use tampons during this period.
Which drugs can be dangerous in the process of in vitro fertilization
It is a good idea to tell your doctor about all the medicines you are taking. In particular, painkillers, allergy medications, antidepressants, steroids, anticonvulsants, thyroid medications, hormonal medications…
What nutritional supplements are suitable during artificial insemination
As a standard, we recommend complex prenatal vitamins, it is good to start with them at least a month before the start of stimulation. A few months before an IVF cycle, it is advisable to take folic acid. Vitamin preparations can also help to adjust the quality of sperm in the partner, but they also need to be taken at least 2 months before the IVF cycle. Vitamin D should also be taken when blood concentrations are low, especially in the winter months. Use vitamin supplements from well-known and reputable manufacturers.
Getting enough sleep is also very important. Sometimes taking melatonin at a dose of 2 mg in the evening before an IVF cycle is also recommended. It is a component of some prenatal vitamins.
Sexual intercourse during an IVF cycle
Towards the end of stimulation, 5 – 6 days before egg retrieval and a few days after egg retrieval, sexual intercourse with ejaculation into the vagina is no longer appropriate. During this period, the ovaries tend to be more sensitive and can be painful, plus the cervix can become irritated. Since all eggs are never retrieved from the ovaries during egg retrieval, unprotected intercourse increases the risk of multiple pregnancies, even when a single embryo is transferred into the uterus.
Nowadays, it is no longer the case that on the day of egg collection, a man must have been sexually abstinent for 4 to 5 days. There are studies that claim that shortening the period since last ejaculation to 2 days improves IVF results. Therefore, a 2- to 3-day interval from the last ejaculation is recommended as a standard for men.
Alcohol and coffee in the process of artificial insemination
We do not prohibit adequate drinking of alcohol during hormonal stimulation. Moderate use may even reduce the stress associated with fertility treatment. Of course, any excess is inappropriate. We consider 2 dl of red wine in the evening to be positive, certainly not excessive alcohol consumption.
The moderation is also true for coffee. Two to three cups of caffeinated beverages a day are not harmful and there is no need to limit them.
Smoking is not advisable. Neither in a man nor in a woman. However, it needs to be stopped long before you enter an IVF cycle.
Air travel and artificial insemination
Inform your doctor about your planned air travel. Short flights are acceptable, but sometimes it is necessary to supplement the treatment with drugs that reduce blood clotting. Despite the discrepant results of studies and the opinions of some physicians, long flights, especially intercontinental flights, are not recommended in the period shortly after embryo transfer. In addition to dehydration and the risk of blood clotting after hormone treatment, the dose of radiation to which the passenger is exposed on long flights can also have a negative effect on the early embryo.
Other recommendations during the IVF cycle
Most pets, especially those you have lived with for a long time, are not dangerous and should not be avoided.
Of course, it is advisable to avoid people with acute infectious disease. Even the common flu during stimulation can be dangerous because it can make egg retrieval impossible. In early pregnancy, anyway, try to avoid sick people. However, if you get sick, there is no need to panic. During ovarian stimulation, the center should be informed of this fact, in early pregnancy your doctor. In general, however, high fever is often a bigger problem than the virus itself. Paracetamol should therefore be taken when the temperature is above 38 °C.
How to ideally handle artificial insemination – IVF cycle?
Be positive and believe in success. But at the same time, count on failure, because even IVF treatment is not 100 percent. However, even after failure, there is no need to give up your dream of having a child of your own. The world does not come crashing down, we can often , even on the basis of the first failure, adjust the infertility treatment so that the next cycle is successful.
Prepare yourself and your partner for mood swings. It belongs to this. You have to hold each other up. It’s not easy for either. Drink plenty of fluids, concentrate on that. Getting enough fluids is the best prevention and treatment for hyperstimulation syndrome. Spend time with friends, don’t shut yourself away in solitude.
Exercise if it suits you. Most exercises (except long runs and rotational exercises) are not inappropriate. If in doubt, consult your doctor. Believe that we are doing our best for you and your embryos. Your trust in us is very important.
