An IVF treatment consists of the fertilisation of the woman’s eggs in the laboratory with the sperm of her partner or donor and the subsequent transfer to the uterus of the embryos.
IVF/ICSI treatment is indicated for women who have their fallopian tubes blocked or when they have fertility problems which cannot be solved by artificial insemination.
Before initiating an IVF/ICSI treatment, it is necessary to carry out hormonal analyses which provide information on whether this treatment is the right one for the patient.
To undergo an IVF/ICSI treatment, the patient receives hormonal therapy which maximises her chances of becoming pregnant. This therapy lasts for 10-14 days, starting at the beginning of the menstrual cycle.
During the therapy, the patient has to receive a series of ultrasounds to control the growth and number of follicles containing the oocytes. Once the follicles reach the optimal size, the egg retrieval takes place.
The egg retrieval consists of extracting the eggs with an ultrasound-guided needle. The process is painless because it is done under sedation. After the egg extraction, the patient must rest for an hour and then she can go home.
Right after the extraction, the oocytes are fertilised applying in vitro fertilisation or intra-cytoplasmic sperm injection technique in the laboratory.
ICSI
Fertilisation occurs by introducing a single spermatozoid into the egg cytoplasm. This technique enables obtaining a higher rate of fertilisation with low-quality semen, which would be impossible to achieve through IVF.
The embryos are cultivated in an incubator for 3 to 5 days. If possible, it is better to allow the embryo development for 5-6 days to reach the blastocyst stage. Finally, the best embryos are transferred to the uterus.
The embryo transfer is a simple and painless procedure which takes a few minutes. It is performed with a small catheter introduced to the vagina. No anaesthesia or sedation is needed. As it is regulated by Spanish law, we can transfer a maximum of 3 embryos.
If one or more good-quality embryos remain after the transfer, they must be vitrified for future treatments.
PASOS EN UN TRATAMIENTO DE DONACIÓN DE ÓVULOS
Our IVF/ICSI programme for couples or single women allows us to achieve high success rates. Here, we explain every step of the process, so you have all the information from the beginning. We hope the following details will clarify your questions regarding the IVF/ICSI treatment.
1. Before starting the treatment
We are at your disposal from the moment you contact us, willing to inform and help you with anything you need. We understand that the decision to undergo fertility treatment is difficult and important for you, so we will endeavour to clarify all your questions and we will assess your particular case to be able to advise you on the best possible solution. For this purpose, we will ask you to provide us with your medical history and recent test results that you may have, so that we can carefully review them and offer you the best medical assistance. This information will also help us to expedite your first consultation and hence avoid repeating any test unnecessarily.
2. First online or face-to-face consultation – free and without commitment
To get your first appointment with the doctor, who will follow you during the entire process, you must contact us, and your coordinator will inform you about available dates.
This appointment has two modalities depending on your needs or availability:
- First online consultation (Zoom, Skype, and other platforms): suitable for women who count on a gynaecologist in their country of residence who is willing to support them during the treatment and prescribe the required medications.
- First face-to-face consultation at our clinic: suitable for patients having difficulties in performing the required tests or who are willing to come to Logroño. Furthermore, once at the clinic, the doctor will be also able to perform the pelvic ultrasound scan and a transfer test.
Moreover, suppose you decide to visit our clinic for the first consultation. In that case, it is a good opportunity to carry out the required tests or to leave a sperm sample, which can be an economical and practical solution to complete your medical records. If you wish, we can provide you with the required prescriptions to get the medications that you can also buy in Spain.
In case you are living abroad, your international coordinator will be present both during online or in-person consultations, and facilitate the dialogue with the doctor, she will inform you about prices and conditions.
If during this first consultation, you agree on setting the dates for the treatment, you will also receive all the required administrative documents and the therapy plan that you must follow to start the treatment.
3. Starting the treatment: ovarian stimulation
Once the dates for the treatment have been set, you will receive a THERAPY PLAN containing every indication you must follow.
The treatment starts while you are in your country of residence by taking a contraceptive pill to control your menstrual cycle.
The ovarian stimulation is induced by administrating subcutaneous injections and is monitored by vaginal ultrasound scans performed by your gynaecologist. Administration of the medicines is simple, and you can inject them yourself or with your partner’s help. The ovarian stimulation therapy lasts for 10-14 days, allows to stimulate the follicular growth and produces more oocytes than during a natural cycle. It also helps to prepare your uterus to receive the embryos.
The ovarian stimulation is monitored by vaginal ultrasound scans that must take place on specific days. We will tell you in advance the dates when you must have these scans, and with each result, we will let you know how to continue the therapy.
By the third scan, the follicles usually have reached the required size, and at this moment, we will inform you about the next steps that will take place in Spain.
4. Oocyte collection, fertilisation, and embryo transfer at Manzanera Fertility Clinic
Your stay in our city will take 7-10 days. You must arrive the day before the oocyte collection or earlier. The embryo transfer will take place 3-5 days after the egg retrieval.
4.1. The follicle or oocyte collection
Based on the results of the last ultrasound scan, we will schedule the exact time for extraction of the follicles. The oocyte collection or harvest is a painless procedure done under sedation or anaesthesia in the surgery room of our clinic.
After the collection, you will rest in a single room for the required time. Afterwards, we will inform you about the collection result.
4.2 Fertilisation
Once the eggs have been retrieved, they will be fertilised in our laboratory through In Vitro Fertilisation (IVF) or ICSI technique.
The difference between IVF and ICSI consists of how the eggs are fertilised, that is, how the spermatozoid penetrates the egg. Our embryologists will assess every situation to choose the most appropriate technique:
IVF: oocytes and a proper concentration of spermatozoids are set in a laboratory dish. The fertilisation takes place naturally, without external manipulation.
ICSI: fertilisation is achieved by microinjecting a single spermatozoid into the egg. This technique enables us to achieve high fertilisation rates when using low-quality sperm.
The resulting embryos will be kept in an incubator until the transfer. It takes 5-6 days if the embryos must be developed to the blastocyst stage.
4.3 The embryo transfer
After incubation, our embryologists will check the quality of every embryo to select the best ones that will be transferred to the uterus. This thorough selection aims to increase the implantation success chances.
The embryo transfer is a simple and painless procedure, which takes a few minutes. It is performed with a small ultrasound-guided catheter, which is introduced into the vagina, and there is no need for anaesthetic or sedation. We can transfer 3 embryos at most.
After the embryo transfer, you will rest in an individual room at the clinic.
The gynaecologist will inform you about how to continue your therapy. This is the time to clear up any remaining doubts you may have. We advise you to rest for one or two days before travelling back home.
5. Back home: Pregnancy test
6. After the treatment
Is IVF/ICSI treatment suitable for me?
Before starting the IVF/ICSI treatment, you will be required to undergo a hormonal check-up to determine whether this treatment is suitable for you. At Manzanera Fertility Clinic, we assess your case individually to ensure that we offer you the best options.
How does the hormonal treatment work?
What is the difference between IVF and ICSI? Can I choose the technique I prefer?
On the other hand, with ICSI, fertilization is achieved by microinjecting a single sperm into the egg. This technique enables us to achieve high fertilisation rates when using low-quality sperm.
The embryologists determine which fertilisation technique is the best for each patient individually.
May we qualify for a “shared maternity”?
Are there any risks or side effects with an IVF treatment?
Is there a legal age limit for IVF/ICSI?
There is no legal age limit in Spain when undergoing fertility treatment. However, after 38 years old, the success rates decrease progressively every year.
What is the success rate for IVF/ICSI?
Can I become a mother if I am single?
Can we have a baby if one of us is HIV positive or has another contagious illness like hepatitis?
It will be necessary to have some previous tests, including viral load.
Are there any waiting lists for this treatment?
e-mail to arrange an appointment with a coordinator on a date that is convenient for you.
What is the first step to begin the treatment?
After the first informative contact with our international personnel, we will help you to organise your first consultation with one of our medical specialists, either for a first online consultation or a face-to-face visit. It is recommended to provide the results of blood tests and fertility study which you already may have for the first visit.
A. First online consultation (Zoom, Skype, and other platforms): it takes 30-60 minutes. If you have an online consultation, you have to travel to Spain only once;
or, as an alternative:
B. First face-to-face consultation at the clinic: the doctor will explain to you in detail how the treatment works and will review your medical history. Besides:
• he will carry out a gynaecological examination and an embryo transfer test;
• the male partner can leave a sperm sample, that will be checked and, if its quality is sufficient, it can be frozen and hence preserved for later egg fertilisation, if necessary;
• at our clinic, you can also have all the required tests and obtain the results shortly;
• if you live abroad, you can also buy all the required medications here, to have everything ready for the time you must start the therapy.
Once the dates for the treatment are set, you can start the therapy, which the doctor has organised specifically for you, and you must follow until the date that the doctor indicates to you.
Why is it recommended to freeze sperm on the first visit to the clinic?
What tests and analyses are required prior to commencing the treatment? Can I have them done at Manzanera Fertility Clinic? Can I bring them from my home country if I have already had them done?
For the IVF/ICSI treatment:
1º The woman must have a hormonal test and a vaginal ultrasound scan. The man must have a sperm test.
2º Both woman and man must also have the following tests:
• Blood group and Rh Factor.
• Serology: HBsAg (hepatitis B), HIV, HCV (hepatitis C), and VDRL (syphilis): these results expire after 6 months.
• Karyotype (chromosome screening). The doctor will individually assess the need to have this test, as well as any other advisable ones.
3º The woman must have a pre-operatory test: full blood count and coagulation study.
You can either have these tests done at the clinic or in your home country and then provide us with the results.
What are the treatment steps?
The process of our IVF treatment has 3 steps:
1. First appointment (online or face-to-face).
2. Starting the therapy in your country of residence: control of your menstrual cycle and subsequent ovarian stimulation for 10-14 days, monitored by ultrasound scans that will be made by your gynaecologist in your country and according to the scheduled dates in your therapy plan we will provide you with.
3. Stay in Spain for the last stage of the treatment: ultrasound scan control, egg retrieval, fertilisation, and embryo transfer.
How many days do I need to stay in Spain?
How many days of sexual abstinence are required before the treatment?
How many eggs are usually collected? How many embryos will I have?
What happens to the remaining embryos?
How many embryos can be transferred?
What happens to the vitrified embryos when I decide I do not want them to be transferred in the future?
After a year of preservation in the clinic, if the embryos have not been transferred, these are the possible options for them: a donation to other infertile couples (Embryo adoption programme); keeping them vitrified for future treatments (this incurs an annual maintenance fee) or thawing them with no other purpose.
Legally speaking, the frozen embryos are the couple’s responsibility. One year after the vitrification, if the couple decides to dispense with them, they must provide the clinic with written confirmation to donate or thaw the embryos. We will send you the required document that you both must sign according to the Spanish law on assisted reproduction.
How do I get to the clinic?
It is easy to get to the clinic by road, train, or plane. We offer a chauffeur service that can pick you up at any airport in the area: Logroño, Bilbao, Zaragoza, Santander, Pamplona, Vitoria, or Madrid. We can also help you by booking your accommodation in our city. If you need any help or information about means of transport, flight connections, etc., please contact your coordinator by email or phone.