1. Ovarian Stimulation and Control
After the first medical appointment, the woman begins to be treated with ovulation-stimulating drugs, administered by subcutaneous injections. These drugs (similar to hormones that are naturally produced in women) will stimulate the ovaries to produce more oocytes than usual.
The development of oocytes is then controlled by periodic ultrasound examinations and blood tests (to assess levels of hormones).
When the doctor considers that the follicles are sufficiently developed, he prescribes the injection of another hormone (human chorionic gonadotropin - hCG), whose role is to trigger the release of the oocytes from the ovarian follicles.
At this stage timing has a key role: the oocyte pick-up (retrieving oocytes from the ovaries) should be made 35 to 36 hours after the hCG is administered. It is very important that couples respect the timings indicated by the gynaecologist regarding the administration of the injections as a mistake at this stagecould jeopardise the whole treatment process.
At Ferticentro we take special care with this phase of the process - our clinical team is available to patients for 24 hours to ensure that medicines are administered correctly and timely and the patient is kept informed and reassured throughout the whole process.
2. Sperm sample
The donor sperm is selected by the Ferticentro medical team based on very strict medical criteria, after a rigorous process of selection and exclusion of genetic diseases and psychological evaluation. The sperm used at Ferticentro comes from donors selected by the clinic, or from certified foreign sperm banks, with excellent and comprehensive quality control methods. The donor is always anonymous and is referenced by a code. Sperm donation is voluntary, and patients are only charged for the laboratory costs involved in collection, maintenance and treatment. The entire process is carried out with full assurance of confidentiality and with the informed consent of the beneficiary (s) of the treatment.
3. Oocyte pickup and ICSI
The oocyte pick-up is carried out under ultrasound monitoring and involves the introduction into the vagina of a very fine needle that will allow the collection of oocytes from each of the ovaries. This operation is performed under sedation and takes about 15 minutes. From the day of the egg retrieval, the woman starts taking 2 tablets of progesterone every 8 hours, in order to prepare the endometrium for a successful embryo implantation.
After pickup the oocytes are transferred to a culture medium in the laboratory and then treated and microinjected with one sperm per egg. After this process, the oocytes are transferred once again to another medium to encourage the formation of embryos.
4. Embryo Transfer
On the Embryo transfer day (two to five days after fertilization) the embryos (usually two) are transferred into the womb of the womanfor implantation.
In cases where there are several good quality embryos to transfer or when it is necessary to undertake further analysis embryo transfer may be made on the fifth day. At Ferticentro this extended embryo culture has no additional costs for the couple, since it is based on a technical decision made in the interests of the individual patient.
It is recommended to avoid intense physical activity for five days following the embryo transfer. Women can travel by car or plane after transfer, but should avoid any physical activity such as lifting. This type of precaution is advised in the interest of best practice rather than based on any scientific evidence – we encourage all our patients to take some time out to encourage nature to do its work.
4. Embryo Cryopreservation
Any viable surplus embryos that are not used in fresh treatment can be frozen and used later in a subsequent embryo transfer (either because the couple wants to have a second child, or if the first attempt fails); can be donated for scientific research; be donated to another couple or may be destroyed depending on the couple's decision and the conditions laid down by law.