In vitro fertilization (IVF)
In vitro fertilization (IVF) is a kind of artificial insemination, in which the fertilization of the oocyte does not take place within the mother’s boy, but rather in a laboratory. Since this usually happens in a glass dish, it’s often referred to as ‘in vitro’, meaning ‘in/behind glass’.
In vitro fertilization (IVF)
An IVF treatment could be useful in, for example, the following situations:
- If the mother’s ovaries are blocked or gone;
- If the father’s sperm quality is lower than normal;
- If the mother suffers from (severe) endometriosis;
- If several IUI treatments have failed to result in a pregnancy
- If no cause for infertility has been found despite an inability to conceive (idiopathic subfertility or ununderstood infertility)
What is the timeline for an IVF treatment?
- Hormonal stimulation: The odds of success when undergoing an IVF treatment increase dramatically when multiple oocytes are made to mature fully at the same time. The maturation of multiple oocytes is stimulated using a hormone treatment. If it is not possible or not desirable to have multiple oocytes mature at once, for example due to a relatively small ovarian reserve or religious reasons, IVF can be done using fewer oocytes. This is known as mild-stimulation IVF. We aim for stimulating at least four oocytes to mature at a time.
- Obtaining and preparing the oocytes: As soon as the oocytes have matured fully, your treating nurse or physician will use a hollow needle to suck them out, while monitoring the procedure using an ultrasound. This is called an oocyte retrieval. An oocyte retrieval will generally take mere minutes. During this procedure, we offer the possibility of taking painkillers intravenously. Thank to this, most women find this procedure relatively easy to endure. After the retrieval, the obtained oocytes will be taken to our laboratory immediately, where they’ll be prepared for fertilization.
- Fertilization: In our laboratory, the processed sperm cells will be united with the oocytes. In the case of an IVF treatment, the sperm cells will then have to fertilize the oocytes without any further support. On the day after the oocyte retrieval, we check whether any oocytes were fertilized. The fertilized oocytes will develop into embryos, which we keep in an incubator for three days.
- Transfering the embryo into the uterus: A physician will use a smooth, flexible catheter to place an embryo into the uterus. The treatment itself will only take a few minutes. Usually, we’ll only transfer a single embryo at a time. Depending on the age of the hopeful mother and the number of previous (failed) IVF/ICSI treatments, we may occasionally choose to transfer two embryos instead. After being transferred, the embryo can start to lodge in the endometrium and start the next stage of its development. After roughly 14 days, you’ll be able to perform a pregnancy test to determine whether the treatment was successful or will need to be repeated.
What are the odds of having a successful IVF treatment?
For an IVF treatment, the odds of conceiving largely depend on the mother’s age. The success rate of an ICSI in 30-year-old women is roughly 30-40% for each embryo transfer. In 40-year-old women, the success rate is roughly 10%. This means that on average, one in three procedures will lead to a successful pregnancy.
If it’s not possible to transfer all of the fertilized oocytes, we offer the possibility of freezing them (cryopreservation) for use at a later date. Transferring a cryogenically preserved embryo at a later date means that the mother will not need to go through the hormonal treatment and the oocyte retrieval next time.
What are the risks associated with an IVF treatment
Cryopreservation has been a commonplace procedure for many years, and most research supports the notion that it doesn’t cause any negative effects. Of course, personal advice from a physician tailored to your situation should always be considered in your treatment.
Will the costs of an IVF treatment be covered by insurance?
In the Netherlands, IVF treatments are covered by basic insurance. Basic insurance will cover three complete IVF treatments. One IVF treatment consists of the hormonal stimulation, the oocyte retrieval, and the transfer of all resulting embryo into the uterus.