Before starting the program, the couple is fully informed about the procedure, which includes: The necessary laboratory check, drug prescription and the protocol to be followed.
Laboratory screening of the female partner
- Haemoglobin electrophoresis (Thalassaemia, sickle cell anaemia
- Blood group, Rhesus
- Toxoplasma, rubella, CMV, HIV, HBsAg (Australian antigen) and anti-HCV, RPR or VDRL.
- Pap/smear test (unless performed within the last 12 months)
- Electrocardiogram, cardiovascular examination.
Laboratory check of the male partner
- HIV antibodies.
- HBsAg (Australian antigen) and anti-HCV.
Before the beginning of the treatment, the doctor prescribes the drugs necessary for ovarian induction as well as the luteal phase support, that is the phase following the embryo transfer. Due to the high cost of the drugs, the couple is advised to ask their insurance company for financial back up.
At the beginning of the program, detailed instructions of the procedure, including the protocol and tests, are given to the couple.
- The oocyte retrieval is performed 34 – 36 hours post hCG injection.
- After the oocyte retrieval the sperm preparation is performed. It includes the collection of the most active and motile spermatozoa and the removal of adverse agents.
- When oocytes reach maturation, they are placed along with the prepared sperm in the culture medium under a layer of paraffin oil.
- The fertilised eggs are closely observed for the following 20-24 hours. As soon as two pronuclei are formed, fertilisation is confirmed. If more than five oocytes are successfully fertilised and are of good quality, it is usually decided a few of them to be cryopreserved for future use. Embryos destined for cryopreservation are placed in liquid nitrogen once they have reached the blastocyst stage.
- At day 2 following fertilisation, the embryos are checked to determine the number of blastomeres (cells of the developing embryo) formed as well as their condition and quality.
- Embryo transfer is normally performed on day 3, following oocyte retrieval. On the day of embryo transfer, up to three of the best quality embryos (the number depends on the woman’s age) are chosen and transferred in the uterus.