RUA FIV / ICSI Insemination

Treatment Includes:

- a- Medication treatment
-b-   Hormonal and ultrasound monitoring
- c-  Anesthesia in IVF procedure
- d-  Ovarian puncture
-e-  Laboratory work
-f-   Embriotransfer
-g- Cryopreservation of embryos

Chances of success

• The novelty that we introduced in 2009 on the market of assisted human reproductive health services was cryopreservation of embryos. And in 2011 I got the first pregnancy from frozen embryos from which three healthy little girls were born.
• We have the highest number of multiple tasks obtained with a successful completion.
• Today we are leaders in assisted human reproduction services with an impressive success rate.
• We accept even the most difficult cases of infertility - including those that have been refused or have not succeeded elsewhere.
• We use the latest techniques and protocols, being permanently connected to innovations in reproductive medicine.

Chances of conception

Age of woman under 30 years

• Previous pregnancy
• Less than 3 years of design tests
• Sexual contact in the first 6 days before ovulation, especially 2 days before ovulation
• Body Mass Index of women 20-30
• Both non-smoking partners
• Caffeine intake less than 2 cups of coffee/day
• Does not use drugs/drugs
• Low chances of conception

Age of woman over 35 years

• No previous pregnancy
• More than 3 years of design tests
• Incorrectly scheduled sexual contact, which does not take place 6 days before ovulation
• Body Mass Index for women under 20 and over 30
• One or both partners smoke
• Caffeine intake greater than 2 cups of coffee/day
• He regularly uses drugs/drugs

IVF stages

Stage I - OVARIAN STIMULATION
Stage II - OVARIAN PUNCTION
Stage III - DEVELOPMENT AND CULTIVATION OF EMBRYOS
Stage IV - EMBRYO TRANSFER

Stage I - OVARIAN STIMULATION

The ovarian stimulation stage - starts with prescribing an individual treatment in a monitoring sheet where they are written: protocol type, drug name, dose, mode and time of administration, ultrasound results, hormonal results and the date of the next visit. The doctor individually determines the frequency of visits for each individual patient. The couple is asked to follow all the medical instructions to increase the success rate!

a) The maturation stage of the ovarian follicles

Ovarian stimulation starts 2-4 days after the beginning of the menstrual cycle and daily, FSH, FSH + LH drugs are administered intramuscularly, etc. At a certain time to be observed, another list of medicines may be associated. Ovarian stimulation lasts until the size of the follicles reaches 18-22 mm in diameter. Their maturation is established at the ultrasound examination and follows the stage of finishing the follicular maturation for which you are prescribed a different drug dose than the one given during ovarian stimulation. It is given (chorionic gonadotropin) 36 hours before ovarian puncture leading to complete maturation of oocytes from the ovarian follicles.
The maturation stage of the oocytes is performed when the ovarian follicles at the ultrasound have a size greater than 18-22 mm, which speaks to their maturity.

b) Ovarian puncture preparation:

• Note the date and time of the ovarian puncture. If you did not remember - please contact us further to avoid errors and what to do at any of the stages.
• Present yourself at least 20 minutes before punctuation time.
• Please do not wear makeup, do not wear bracelets, chains, watches, rings, and earrings. Do not wear contact lenses, glasses, etc. in the room.
• Do not consume food and drink of any kind, at least 6 hours before anesthesia.
• Do not smoke, do not take other medicines without consulting your doctor, do not use chewing gum or candy.
• Notify your anesthetist about allergies, drug reactions, chronic diseases, prostheses of any kind, etc.
• The passage from the salon to the procedure room is done by changing the clothes with a sterile dressing gown given to you during your stay in the clinic.
• Before puncture, empty the bladder, then measure your temperature, T / A, Pulse Oximetry.
• After a puncture, you are monitored for 2 hours.
• Immediately after the puncture, you may have drowsiness or tingling is normal.
• Only after the doctor decides that the general condition is good can you get up and go home.

c) After ovarian puncture

• We recommend that you do not get behind the wheel, go with someone and spend the rest of the day at home with a family member.
• You can only use painkillers on prescription.
• After you get home you can drink and eat after 3-4 hours from ovarian puncture. recommended using products that are easy to freeze.
• After ovarian puncture you may have bleeding from the genitals of different abundance, you may have pelvic pain related to ovarian puncture.
• It is necessary to contact us if you have: fever> 38.0, pain, bleeding, increased abdominal circumference, vomiting or diarrhea as well as other symptoms that concern you.
• Do not hesitate to call us or see your doctor.

d) Information on sperm collection

• Sexual abstinence before ovarian puncture minimum 3 days, recommended 5 days.
• Your spouse over 2-3 hours after puncture will need to collect sperm in a sterile container where his or her first name, and / or spouse's name will be noted if the wife bears a different family name.
• Ejaculate is obtained through masturbation in a specially arranged room within our clinic. It is necessary that the toilet of the male genital organ be performed in the morning of the procedure. The hands should be washed and ejaculate the sperm in the sterile container.
• After collection, the container must be closed and sent to the embryology laboratory.

e) Further information after the ovarian puncture

• The full payment of the procedure is made before ovarian puncture, in case of failure of a stage the amount is partially refunded according to the price list established in the clinic.
• The doctor informs you about the successes obtained after the ovarian puncture, and in the following days, he informs you about the quality of the oocytes, about the stages of cultivation of your cells and the day of the embryo transfer.
• Remember to take the prescription drug list needed to prepare for the embryo transfer.

 Stage II - OVARIAN PUNCTION

Once you enter the operating room you are placed on a table that resembles a gynecological armchair, and your hands and feet are fixed on the side for your comfort.

• The puncture is performed under short-term intravenous anesthesia, under temperature monitoring, T / A, pulse, P / Oximetry, oxygen support, and monitoring of the anesthesia team.
• Only after the anesthesiologists have analyzed you, the vagina is processed and the vaginal probe of the ultrasound is covered, which is covered with sterile disposable material and a guide is placed, after which a sterile and disposable ovarian puncture needle is inserted at the end of the system is a tube where all the contents of the dotted ovarian follicle are collected.
• On the ultrasound screen, the puncture line that guides the doctor during the puncture of the ovarian follicles is designed.
• Afterward, the contents of the tubes with the liquid from the ovarian follicles are transported to the embryological laboratory located in the room next to the operating room.
• The embryologist visualizes all the oocytes under the microscope and places them in special vessels with nutritional development media in the incubator that provide conditions similar to those of the human body to your cells.
• over 3-6 hours after the puncture begins fertilizing your cells.

Stage  III - DEVELOPMENT AND GROWTH OF EMBRYOS

The stages of the culture of the embryos are done for 3-5 days from the moment of the ovarian puncture. The date of the embryo transfer depends on the quality of the embryos, the growth rate, etc.

a) Classic in vitro fertilization:

• is done when the sperm number and quality is normal with the mature oocyte.
• method: an oocyte is placed in a special vessel with a nutritional environment, which subsequently introduces a large number of sperm into the vicinity and an imitation of the cellular merger takes place as in the human body. The risk of the procedure is non-fertilization of the female cells with the male ones. No one can predict or ensure that fertilization will occur.

b) ICSI (intra-cytoplasmic sperm injection)

• it is most commonly performed in assisted human reproduction techniques.
• as absolute indications being when the number of sperm is low and the sperm parameters have deviated from the normal ones.
• as a relative indication in case of IVF failure

c) cultivation and monitoring stage:

• The oocyte that was fertilized or fertilized with sperm is called a zygote, which contains two sets of chromosomes from parents.
• The development of the embryo is done through the phenomenon of cell division: 4,8,16,32 blastomeres. Then switch to blastomycosis and morula.
• The embryo culture sheet contains all the information about the number of oocytes obtained after the ovarian puncture, where each oocyte has its own number, about the quality of the sperm, about the type of fertilization performed, the way of dividing the cells, and their quality according to the international table.
• Every day the embryologist records in the monitoring record all the information about how the human reproduction process proceeds.

Stage IV - EMBRYO TRANSFER

Embryo transfer is made on day 3-5 from the ovarian puncture. Everything is dependent on how the third stage went.

Embryo Transfer Instructions:

1. Please show up 20 minutes before the scheduled time;
2. Before 1 hour of embryo transfer, consume liquids in the amount of 1 liter to have a full bladder that will facilitate the transfer, because the ultrasound with the abdominal probe is used that guides the doctor to the proper placement of the embryos in the uterus. They can be given spasmolytic (No spa 80mg 1 pill with 3 hours until transfer);
3. The transfer takes a few minutes, does not require anesthesia because it is pain-free.

How the embryo transfer takes place:

• The embryologist and the couple decide how many embryos will be transferred
• The couple will sign the embryo transfer agreement, receive the protocol for ovarian stimulation and embryo cultivation.
• The patient is wearing a medical robe from the clinic.
• Enter the pre-operative salon waiting to be invited to the embryo transfer
• Once you enter the operating room, you lie down on the table that reminds you of the gynecological chair
• Abdominal gel and probe are applied to your abdomen by your doctor's assistant.
• Your doctor will introduce the gynecological speculum to visualize the cervix and to prepare for embryo transfer.
• After it was decided jointly with the couple about the number of embryos transferred
• The embryologist introduces the embryos into the catheter and sends it to your doctor to have it inserted into the uterus under ultrasound guidance.
• then the catheter is sent to the embryology lab and under the microscope the embryologist checks to see if all the embryos have been inserted into the uterus.
• Then the patient stays in the same position for 2-5 minutes
• Then go down to the bathroom to empty the bladder and may stay for 1-2 hours lying in bed in the operating room to enjoy the first moments of motherhood.
• If there will be more than 6 embryos, it will be proposed to freeze them, which will be done by signing a contract to keep the embryos with the monthly payment of the tax established in the price list of the clinic.

Fertility Treatment Required documents:

• Identity document + copy    compulsory
• Marriage certificate + copy    compulsory
• Application for IVF couple (couple)    compulsory
• IVF consent (couple)    compulsory
• Consent for anesthesia (woman)    compulsory
• Application for embryo transfer (couple)    compulsory
• Application for freezing of embryos (couple)    if necessary
• Defrost application / for embryo destruction (couple)    if necessary
• Consent for spousal anesthesia (testicular puncture)    you need it
• Consent for a testicular puncture in husband (male)    if necessary
• Application for freezing sperm (man or couple)    if necessary
• Application for use of donor cells (couple)    if necessary
• Copy passport for foreign nationals    if necessary

* The requests for the provision of the requested services will be completed and signed at the conclusion of the contracts and the presentation of the necessary documents.