IVF PROCEDURES AND PROCESS
We at HMC understand that many couples will have concerns and questions regarding the IVF procedure. Fertility treatment is a challenging process for couples, both physically and emotionally, which is why we maintain a welcoming, professional environment, tailored to your needs. We at HMC are dedicated to the success of your treatment and offer a multitude of supportive services throughout.
IVF Procedures in Israel
Our excellent physicians and advanced medical equipment enable us to perform innovative procedures in the ﬁeld of IVF in Israel. The cost of IVF treatment in Israel is substantially lower than in the United States, and we at HMC are proudly responsible for the birth of 9,000 children since we opened our doors in 1987. To determine your eligibility for IVF treatment, you will need to undergo a series of tests to positively identify the cause of infertility and the viability of the procedure for you. This includes:
- Blood and urine tests
- Breast examination and Pap smear
- Both partners will be tested for HIV/Aids, and Hepatitis B and C
- Genetic testing is highly recommended to screen for hereditary conditions
Further tests are also carried out for both men and women. If your physician determines you eligible, and physically and emotionally prepared, your IVF procedure can commence.
The IVF Procedure – Step by Step
1. Monitoring and Ovarian Stimulation
Ovulation is induced by hormonal treatment, stimulating follicular development in the ovaries. The proper hormonal treatment and dosage directly affects the IVF treatment outcome. Matching the dosage to the specific patient requires the discretion of an experienced physician. Human chorionic gonadotropin (hCG) is then administered to aid in the ﬁnal maturation of the eggs. Ultrasound and blood tests determine when the oocytes (eggs) can be retrieved.
The retrieval procedure is usually performed under general mild anesthesia using ultrasound for accuracy. The doctor accesses the ovary through a puncture in the vaginal wall. A thin needle is inserted into the follicle, and ovarian follicular ﬂuid containing the mature egg is retrieved. The fluid is then examined under a microscope and the mature eggs are transferred to a nutritional solution to maintain cell function.
3. Fertilization and Embryo Development
After obtaining both the egg and the sperm, the IVF procedure begins. In most cases, each egg is united with a large quantity of motile sperm (around 100,000 cells) and left in a tube placed in an incubator to allow for natural fertilization to occur.
Another method of IVF is called Intra Cytoplasmic Sperm Injection (ICSI), used in cases of low quality sperm, where the probability of self-merging between the egg and sperm is extremely low. The principle of ICSI is the artiﬁcial introduction of sperm directly into the cytoplasm of the egg.
In both methods, the fertilized eggs divide over a 48 hour period to form embryos, which are then examined under a microscope. Embryos are classiﬁed based on the rate of cell division, their shape and size, as well as the presence or absence of cell defects.
“High Quality” embryos are more likely to successfully implant in the uterus and result in pregnancy. There is no connection whatsoever between the embryonic quality and the fetus’ future health.
4. Embryo Transfer
The embryos are transferred back into the uterus 48-72 hours after the initial egg retrieval. The transfer is performed using a thin tube inserted through the cervix. This procedure is painless and does not require any additional precautions.
Approximately 12 days after the embryo is transferred, a pregnancy test is conducted to determine if the IVF treatment was successful. In the interim, it is recommended that you do not indulge in unusual or heavy physical activity. Progesterone treatment is also necessary during this time, and can be received either vaginally or through injection.
5. Embryo Cryopreservation
You have the option to freeze the remaining embryos that were not transferred to the uterus. These embryos are kept in liquid nitrogen and can be stored for several years. Freezing embryos can expedite future IVF treatment processes (if needed). It is important to note, however, that not all embryos are suitable for cryopreservation, and Israeli law permits oocytes cryopreservation from women only between the ages 30 to 41.
Hormone therapy used in IVF
The IVF procedure is accompanied by a series of drugs, these drugs are essential in triggering hormonal stimulation, follicle maturation and a controlled pregnancy. For this purpose, the following medications are administered:
- Duphaston – synthetic form of natural progesterone. Administered to prepare the endometrium for embryo implantation and support a full term pregnancy
- Pregnyl – recombinant human chorionic gonadotropin (hCG). This drug is administered prior egg retrieval, it triggers final the final maturation of the oocyte (egg)
- Utrogestan – active ingredient progesterone to maintain luteal phase support and pregnancy.
- Divigel (estradiol gel) – preparation for transdermal application containing estrogen.
- Puregon (follitropin beta) or Gonal-F – recombinant follicle stimulating hormone (FSH). Used to stimulate the development of multiple follicles.
- Ovidrel – recombinant human chorionic gonadotropin hormone to induce final follicular maturation after stimulation
- Buserelin, Decapeptyl, Diphereline, Lupron – analogues of gonadotropin-releasing hormone. One of the products (optional) is assigned in preparation for IVF, before stimulation.
Our specialists at HMC are here to provide further guidance regarding the IVF procedure as well as any questions you may have about the treatment in Israel.