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In vitro (IVF)
In vitro fertilization, or IVF, is a medical procedure used when other therapies to achieve pregnancy do not work. IVF is a safe treatment that has been used successfully for more than 40 years. For its development, Dr Robert Edwards was awarded the most prestigious honour in 2010 - the Nobel Prize in Medicine.
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What is in vitro?
In vitro fertilisation, or IVF, is a medical procedure used when other methods of treatment do not produce the desired results. It is the most advanced and effective method of treating infertility, and has been used successfully for over 40 years. For its development, Dr Robert Edwards received the most prestigious award in 2010 – the Nobel Prize in Medicine. Take advantage of our knowledge and experience. In Poland, we have been accompanying patients on their journey to desired parenthood for years.
Procedure
IVF is always preceded by a thorough examination of both partners. The treatment itself consists of several stages: it begins with ovarian stimulation with the help of hormonal drugs, strictly controlled by the attending physician. Next, reproductive cells are taken from both partners and combined under laboratory conditions. The resulting embryos are cultured for several days. The final step in the procedure is the delivery of the embryo into the uterine cavity.
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Indications for IVF
In vitro fertilization (IVF) is a procedure recommended after an exhaustive diagnosis of infertility. It is performed when the cause of conception problems is:
- Tubal factor
- No possiblity of safe ovulation
- Endometriosis
- Male factor (including ICSI with sperm retrieved from a testicle or epididymis in the case of obstructive azoospermia)
- Carrier HIV or HCV status of one of the partners
- Patients’ age
- Diminished/diminishing ovarian reserve
- Treatment failure using other methods
- The presence of unexplained causes of infertility
In vitro with own eggs
The in vitro process with own cells involves the following steps:
Step 1
Online consultation with a doctor
An online consultation with a doctor is the initial stage of beginning IVF treatment. During this session, the doctor reviews your medical records, gathers your medical history, and then creates a detailed, personalized plan tailored to your needs.
Step 2
First visit to the clinic
At this appointment, qualification tests will be conducted, both partners will sign the necessary consent forms, you will have an ultrasound, and a stimulation plan will be created. However, in your situation, coming to the clinic might not be required. If your partner cannot be present on the day of egg retrieval, his sperm can be frozen in advance.
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Step 3
Start of stimulation (at your home location)
If starting stimulation is contingent upon the results of specific tests done beforehand, you will be informed ahead of time.
Step 4
Follow-up visit and egg collection
The initial follow-up visit should occur on days 9–10 of stimulation. Further steps, such as scheduling additional monitoring visits or determining the date for egg retrieval, will be decided based on your progress at this time. Required blood tests will also be conducted during this stage. The process concludes with the egg retrieval procedure, performed under short general anesthesia, and the total stay at the clinic will not exceed one week.
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Step 5
Embryo transfer
This phase includes up to two clinic visits, one of which is the embryo transfer.
Step 6
Confirmation of pregnancy (at your home location)
Our medical team will continue to support and guide you during this stage. If further consultations are necessary, you can access them via phone or online.
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In vitro without secrets - Detailed description of the stages
Hormonal stimulation
In vitro fertilization (IVF/ICSI) is preceded by several days of hormonal stimulation. An appropriate stimulation protocol is selected for each patient, depending on the results of hormonal tests, age, and obstetric-gynaecological history. During stimulation, drugs are given to suppress the pituitary gland (i.e. the patient's own hormonal activity) for a period of time and then drugs are given to stimulate ovarian follicle growth are turned on.
The stimulation takes place under ultrasound control, which means that it is necessary to monitor the growth of the follicles every few days while taking the medication. The level of hormones (estradiol and progesterone) in the blood is also observed. When the follicles in the ovaries reach an appropriate state of maturity, the patient takes a drug to induce ovulation, and, 36-37 hours after the administration of the drug, the procedure of collecting oocytes takes place. Usually several to a dozen oocytes are taken.
Collection of eggs and sperm
On the day of the puncture, the patient should come to the clinic fasting. The oocyte retrieval itself involves puncturing the ovaries through the vagina, under ultrasound guidance and short-term general anaesthesia. The procedure takes about 10-20 minutes. Immediately after the procedure, the fluid with oocytes is delivered to the IVF laboratory, and the patient is awakened and stays in the recovery room for about an hour. Complete psychomotor efficiency returns about 30-60 minutes after the procedure.
The man donates semen by masturbation on the day of the procedure. It is recommended that he has a 3-7 day break in sexual intercourse before this donation. Previously frozen semen or semen from an anonymous donor may also be used for insemination.
Fertilization and embryo culture
Depending on the indication, fertilization may proceed in two ways:
In vitro fertilization (IVF):
Approximately 2-4 hours after the egg cells are collected, properly prepared sperm is added to the cells. The cells are then placed in a special culture medium in an incubator at a temperature of 37 degrees Celsius, elevated carbon dioxide concentration and reduced oxygen concentration. The effectiveness of classical IVF reaches 25-45% of pregnancies per embryo transfer.
Micromanipulation (ICSI):
Approximately 2 hours after collection, the oocytes are cleared of surrounding follicle cells. A single sperm is inserted into each egg cell using a thin pipette. The cells are then placed in a special culture medium in an incubator at 37 degrees Celsius with elevated carbon dioxide and reduced oxygen.
On the following day, i.e. approximately 18 hours after fertilization, it is evaluated whether the fertilization process has been successful. A sign of normal fertilization is the presence of two pre-nuclei in the egg cell - a female and a male, as well as the presence of two directional bodies indicating that the oocyte has completed meiotic division. As a result of the technique of ICSI, about 70-80% of the cells fertilize correctly.
After another hour of culture, the fertilized cells (zygotes) begin to divide, the so-called furrowing stage. Two days after the puncture, properly developing embryos reach the 2-4 cell stage, and three days after the puncture, they reach the 6-8 cell stage. In each embryo, the number of cells and the morphology of the embryo are determined.
Embryo transfer
Between the second and fifth day of culture, 1-2 embryos are introduced into the uterine cavity using a special catheter. The embryotransfer procedure is painless, is performed without anesthesia, under ultrasound guidance, with a filled bladder. After the transfer, the patient remains in the gynecological chair for about 20 minutes. With a larger number of embryos obtained it is usually suggested to perform the transfer on the fifth day of culture, when the embryos have already reached an advanced stage of development - blastocyst.
Embryo freezing
All embryos that were not given during embryo transfer and have reached an advanced stage of development (called the blastocyst stage) on the fifth or sixth day of culture are frozen. It is important to remember that not every fertilized cell will develop into a blastocyst, as some embryos do not develop properly and stop during subsequent divisions and then degenerate.
Normal embryos are frozen using the currently most effective vitrification method and stored in liquid nitrogen for administration during subsequent embryotransfers.
The freezing process is so safe that the percentage of pregnancies after embryiotransfers of frozen embryos is the same as after embryiotransfers of "fresh" embryos.
After treatment
The patient takes medication containing progesterone for the next 10 days. This is called luteal phase supplementation and is intended to help the embryo implant and maintain an early pregnancy. After this time it is advisable to do a HCG test from the blood and consult the further procedure with the doctor in charge.
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In vitro with eggs donated
The IVF process with egg donation involves the following steps:
Step 1
Online consultation with a doctor
This marks the start of the IVF treatment journey. During the consultation, the doctor reviews the submitted medical records, carries out an in-depth interview, and based on this information, develops a personalized treatment plan designed to meet the patient's specific needs.
Step 2
Filling in the phenotype cards (online)
In the case of IVF treatment using donor eggs, an important step is filling out the phenotype cards. This process helps to ensure the closest possible match between the donor’s and the recipient’s (and/or partner’s) physical traits.
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Step 3
First visit to the clinic
At this stage, you can anticipate several important preparatory steps for the IVF procedure: completing the necessary treatment paperwork, including consent forms; undergoing a psychological consultation; performing diagnostic tests; and freezing the partner’s sperm to ensure it is available on the day of the ICSI procedure.
Step 4
ICSI fertilisation
ICSI (intracytoplasmic sperm injection) is an additional technique performed during IVF where a single healthy sperm is directly injected into an egg to increase the likelihood of fertilization. This procedure is carried out in a specialized IVF laboratory, under conditions designed to support embryo development as naturally as possible. The quality and safety of the process are maintained by experienced and highly skilled embryologists, using advanced equipment such as RI Witness and Embryoscope+, which are utilized in every cycle. This stage does not require you to be present at the clinic; all updates and information are communicated via phone and through the Patient Portal.
Step 5
Embryo transfer
This phase consists of no more than two clinic visits, one of which includes the embryo transfer.
Step 6
Confirmation of pregnancy (at your home location)
At this stage, our medical team ensures ongoing care and support. Should you require any further consultations, these can be conducted via phone or online.
Embryo adoption
The course of the IVF procedure with embryo adoption:
Step 1
Online consultation with a doctor
This is the initial phase of the IVF treatment process. During the online consultation, the doctor reviews the provided medical documents, performs a comprehensive interview, and uses the collected information to create a personalized treatment plan tailored to the patient’s unique needs and health condition.
Step 2
Completion of phenotype cards (online)
The information on the phenotype cards is used to optimally match embryos from anonymous donors with the physical traits of the intended parents. The entire procedure is conducted with full anonymity and patient convenience—data is manually completed from home through secure online forms.
Step 3
First visit to the clinic
During your initial visit, you can expect several important preparatory steps for your IVF treatment: completing the necessary paperwork and consent forms; undergoing a psychological consultation; having diagnostic tests performed; and receiving an ultrasound examination.
Step 4
Embryo transfer
This stage requires no more than two visits to the clinic, one of which will include the embryo transfer itself.
Krok 5
Confirmation of pregnancy (at your home location)
At this stage, our medical team continues to provide ongoing support. If needed, you can arrange extra consultations by phone or online, enabling you to maintain your care comfortably without needing to come to the clinic.
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You are in safe hands!
We are pioneers in the use of the RI Witness safety control system. It involves a unique way of labeling germ cells and embryos, which guarantees their error-free identification at every stage of laboratory operations and storage.
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