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In Vitro Fertilisation (IVF) - ICSI

In vitro fertilisation (IVF) the eggs or oocytes that are located inside the ovaries, will be retrieved and then fertilised with sperm in the laboratory to create embryos, that can then be transferred to the woman's uterus. It can be done with partner's sperm or with donor sperm.

In Vitro step by step

Hormone therapy preceding the egg retrieval is more complex than that applied in artificial insemination procedures. With IVF, the goal of hormone therapy is double:
To stimulate the ovaries to produce as many mature eggs, and also prevent early ovulation before recovery of these oocytes. There are different medications and strategies that can be used to achieve both objectives: ovarian stimulation and control of ovulation.
A personalized plan and choice of medicine will be made, depending on the results of various diagnostic tests of the couple and their history. Given the wide variability existing treatment plans duration of treatment, also it varies depending on the protocol and the patient's response.

Women during ovarian stimulation are closely monitored by vaginal ultrasound and hormonal blood analysis. The first scan is performed at the start of ovarian stimulation and then typically with 2-3 follow up cycles continuously for approximately 8-12 days in order to monitor follicular growth. The dose of gonadotropins is adjusted according to the results of ultrasound and blood tests. Sometimes it´s decided to cancel the cycle initiated if the response to hormone therapy is poor.
When at least three follicles reach maturity, egg retrieval can be programmed. Final follicular maturation is triggered by an injection of HCG 36 hours before removal.

The extraction usually takes 5-10 minutes to complete, but can vary depending on the number of follicles. Usually this procedure is performed using sedation and painkillers intravenously controlled at all times by an anaesthesiologist. Alternatively, the egg retrieval of the patient can be performed without sedation but we wouldn´t recommend it. It is important that you feel comfortable during treatment, with it all being a positive and relaxed experience, we always make a special effort to reduce any discomfort that you may have, so, please don´t hesitate to inform us.

The procedure; a needle is passed through the top of the vagina under ultrasound guidance to get to the ovary and follicles. The fluid in the follicles is aspirated through the needle and the eggs detach from the follicle wall. The oocyte-cumulus complex (cell) is pulled from the follicle wall when we aspirate the fluid through the needle. The follicular fluid is examined by biologists through a microscope for the presence of eggs and then assess whether they are mature and therefore are valid for fertilising.

The recovery period after the egg retrieval lasts for 1-2 hours. There is sometimes a slight bleeding after oocyte recovery, but that is normal. Pelvic discomfort can persist until the next day, but it can be usually controlled with oral analgesia (paracetamol or Nolotil®). It should be possible to a normal routine activity the next day.


Classical IVF

The extracted oocytes are placed in petri dishes containing a culture medium (gel) that provides nutrients needed for growth, and then the sperm of the couple or donor is added to begin fertilization of which fertilization occurs. The plates are placed in incubators. This procedure is called classical IVF. There is another way to fertilize eggs, ICSI, see below.


ICSI
Today, for fertilization of eggs used technique is ICSI, which stands for intracytoplasmic sperm injection. First of all, the best sperms are selected by morphological criteria. One of the selected sperm is injected directly into each mature egg, thanks to highly sophisticated equipment of micromanipulation. ICSI is usually indicated when there are few sperms or when they are not of good quality, or in case of testicular biopsy or previous failures of classical IVF or with a low fertilization rate. But nowadays, ICSI is widespread and is usually used for fertilization in most of cycles, because of its good fertilization rate.
Embryo transfer takes place 2 to 6 days after egg retrieval. The decision on, which date for the transfer of the embryo is performed on an individual basis and depends on the quantity and quality of the embryos.
The decision on the number of embryos to be transferred is also individual, and depends on the age of the woman, previous pregnancies, reproductive history, previous treatment outcomes, and quality of the embryos. Each pair is advised on the number of embryos transferred before treatment, and again at the time of the transfer, to minimize the risk of multiple pregnancies and maximize the chance of pregnancy.
At the time of embryo transfer, the embryos are loaded into a fine plastic catheter and inserted into the uterine cavity. This takes about 15 minutes without causing any discomfort and without requiring an anaesthesia procedure. After embryo transfer the woman rests 15 minutes in her room and then is able to continue daily life normally.

The pregnancy test is performed 12 days after embryo transfer. Ultrasound is scheduled two weeks after a positive pregnancy test to confirm pregnancy in progress.

When is IVF recommended?

This technique is recommended when there are lesions in the fallopian tubes, severe male infertility, severe endometriosis, low ovarian reserve or when other treatments have failed.

IVF Medication
Risks of treatment
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Budget IVF-ICSI

Cycle

Previous Study
Stimulation
Follicular Puncture
Transfer
Post Transfer

*The price with donor sperm increases € 360

Services included

Case-oriented consultation and planning stage

Ultrasound scans (unlimited)
Hormonal controls (unlimited)
Puncture - follicular aspiration
Anaesthesia - sedation
Rest in clinic
Embryo transfer (1 or 2 embryos)
Rest in clinic
Surplus embryos vitrification (unlimited)
BHCG - analytical detection pregnancy (unlimited)
Check results
Vitrified embryos maintenance for 2 years
Total Amount     4.895€
  • Fixed Price: This budget has a fixed price. In some cases provided by medical prescription, a service and / or additional evidence not included in the budget may be necessary, but you would always be told in advance.
  • If you need additional stimulations (oocyte accumulation), each stack will have an additional amount of € 1,840.00
  • If an embryonic devitrification is needed (if not pregnant on the first attempt), an additional cost of € 1,650 is required.
  • Validity: The validity of this budget is 6 months from the date of visit.
  • Medication: By law, the medication is not included and is borne by the patient.
  • Cancellation by the patient: In case of cancellation of treatment, the patient must pay the costs incurred until the stopping of such treatment.
  • In case that it doesn ́t reach the transfer for no evolution pre-embryonic, you will be credited € 160.00 in respect of such transfer not performed.
  • After the first 2 years from the pre-embryonic freezing: The patient must decide whether they wish to allocate the embryos to any legally authorised applications or if instead you want to pay the fee embryo maintenance (€ 395.00 per year). 
  • If you need sperm freezing, it will have an additional amount of € 205.00

About IGIN Institute

IGIN Institute is a medical centre specialising in gynecology and assisted reproduction.
With its head office in Bilbao, in a modern infrastructure that provides its services using the latest technology without underestimating the human connection.