Conventional stimulation IVF
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This is the “classic” stimulation protocol used and the primary technique employed for most women and couples seeking assisted reproduction treatment. The programme entails the use of hormonal ovarian stimulation with the aim recruit and induce the growth of multiple follicles, resulting in the collection of multiple oocytes during oocyte pickup.
Conventional stimulation IVF has several different steps:
- Baseline monitoring with blood tests and ultrasound. This is conducted prior to or at the beginning of your menstrual cycle to ensure optimal initial conditions to begin stimulation, in addition to providing information for dosage individualisation.
- Ovarian stimulation using subcutaneous gonadotropin injections and/or oral medication.
- Cycle monitoring via transvaginal ultrasound and hormonal measurements. These measurements facilitate constant assessment of the cycle progress and allow for minor adjustments, in order to ensure optimal stimulation outcome. Monitoring becomes more frequent as the cycle progresses.
- Injection of GnRH agonist or antagonist may be administered to prevent premature ovulation.
- When most follicles have achieved adequate growth, ovulation triggering may be performed to achieve final maturation and oocyte retrieval scheduled accordingly.
- Oocyte retrieval is a minimally invasive procedure that entails the aspiration of the follicular fluid that contains the mature oocyte. This procedure is performed under total intravenous anaesthesia and does not require intubation or mechanical ventilation. The oocytes are obtained transvaginally with a fine aspiration needle under ultrasonographic guidance.
- Subsequently, the collected oocytes are fertilised using IVF and/or ICSI. Alternatively, oocytes may be cryopreserved in the context of fertility preservation.
- The fertilized embryos are incubated in conditions that resemble the natural endometrial environment and are monitored for their growth and eventual quality. In cases of increased risk for chromosomal or other genetic abnormalities, PGT may be performed at this stage.
- The incubated embryos are transferred on the 3 rd or 5 th day (blastocyst stage) of incubation (fresh embryotransfer). Embryotransfer is a painless procedure and is usually performed without anaesthesia. It involves the insertion of the embryo directly in the uterine cavity via a specialized catheter under ultrasonographic guidance.
- Any remaining embryos may be cryopreserved and utilized in the future, after a thawing and preparation process (frozen embryotransfer). Alternatively, in conventional IVF cycles where a fresh embryotransfered is contraindicated or unwanted, all resulting embryos may be cryopreserved for future use (freeze-all protocol).
Conventional ovarian stimulation and IVF are indicated in most cases of infertility as an effective solution, namely for couples or individuals with:
Modern conventional stimulation IVF offers several advantages, such as:
- Higher oocyte yield per treatment (no need for multiple cycles as in other options).
- Multiple embryos available for transfer
- Option to cryopreserve surplus embryos for future use
- Modern protocols ensure minimization of adverse effects and Ovarian Hyperstimulation Syndrome (OHSS)