Infertility, IVF & PGD
Infertility is a major health problem worldwide that has been encountered more during recent years. Clinically a couple is considered to be infertile after at least one year without contraception and without pregnancy. The average of 10 percent of Iranian couples suffers from infertility, while this rate varies from 10 to 20 around the world. Thanks to many options existing today such as advanced reproductive technologies and adoption, most infertile couples are able to experience the joy of parenthood. Since 1998 Iran acts as the leader of Stem Cell research and also one of the best developed countries in infertility treatment field in the West Asia.
There are more than 50 infertility clinics throughout Iran, after 21 years of experience in this field and due to the high rate of success many patients from Middle East, Pakistan, Turkey, Azerbaijan, Russia, etc., prefer to have their treatments in these clinics rather than European countries.
Providing a full service for patients with Worldly standards which cost much fewer in compare with European clinics, are some of the reasons that brings them to Iran. After the initial fertility evaluation by asking some questions and reviewing any records, the infertility specialists undergo a series of tests which may require a significant amount of time and energy to identify potential causes for difficulty in conceiving. Besides all kinds of diagnostic tests which contain karyotyping, molecular genetic tests such as Factor V Leiden, Factor II and MTHFR gene, the modern treatments in this field including diagnostic and operative laparoscopy, diagnostic and operative laparahysteroscopy, IUI, ovulation induction, IVF, ICSI, ZIFT, IVM blastocyst, assisted hatching, PGD, and gamete and embryo cryopreservation are also available in these clinics.
What is IVF?
In vitro fertilisation (IVF) is a process of fertilisation where an egg is combined with sperm outside the body, in vitro (“in glass”). The process involves monitoring and stimulating a woman’s ovulatory process, removing an ovum or ova (egg or eggs) from the woman’s ovaries and letting sperm fertilise them in a liquid in a laboratory. After the fertilised egg (zygote) undergoes embryo culture for 2–6 days, it is implanted in the same or another woman’s uterus, with the intention of establishing a successful pregnancy.
IVF is done to help a woman become pregnant. It is used to treat many causes of infertility, including:
There are four basic steps to IVF
Step 1: Stimulation, also called super ovulation
Medicines, called fertility drugs, are given to the woman to boost egg production. Normally, a woman produces one egg per month. Fertility drugs tell the ovaries to produce several eggs. During this step, the woman will have regular transvaginal ultrasounds to examine the ovaries and blood tests to check hormone levels.
Step 2: Egg retrieval
A minor surgery, called follicular aspiration, is done to remove the eggs from the woman’s body. The woman will be given medicines so she does not feel pain during the procedure. Using ultrasound images as a guide, the health care provider inserts a thin needle through the vagina and into the ovary and sacs (follicles) containing the eggs. The needle is connected to a suction device, which pulls the eggs and fluid out of each follicle, one at a time. The procedure is repeated for the other ovary. There may be some cramping after the procedure, but it will go away within a day.
Step 3: Insemination and Fertilization
The man’s sperm is placed together with the best quality eggs. The mixing of the sperm and egg is called insemination. Eggs and sperm are then stored in an environmentally controlled chamber. The sperm most often enters (fertilizes) an egg a few hours after insemination. If the doctor thinks the chance of fertilization is low, the sperm may be directly injected into the egg. This is called intracytoplasmic sperm injection (ICSI).
Step 4: Embryo transfer
When the fertilized egg divides, it becomes an embryo. Laboratory staff will regularly check the embryo to make sure it is growing properly. Within about 5 days, a normal embryo has several cells that are actively dividing. Embryos are placed into the woman’s womb 3 to 5 days after egg retrieval and fertilization. The procedure doesn’t need anesthesia. The doctor inserts a thin tube (catheter) containing the embryos into the woman’s vagina, through the cervix, and up into the womb. If an embryo sticks to (implants) in the lining of the womb and grows, pregnancy results. More than one embryo may be placed into the womb at the same time, which can lead to twins, triplets, or more. The exact number of embryos transferred is a complex issue that depends on many factors, especially the woman’s age.
The whole process normally takes 4 – 6 weeks to complete.
*Generally, IVF guaranteed getting pregnant up to 35% each time.
What is PGD?
Pre-implantation genetic diagnosis, tests if embryo is aneuploid or not. PGS is also called aneuploidy screening. PGD allows studying the DNA of eggs or embryos to select those that carry certain mutations for genetic diseases. It is useful when there are previous chromosomal or genetic disorders in the family and within the context of in vitro fertilization programs. Also, Preimplantation genetic diagnosis provides a method of prenatal sex discernment even before implantation. A 2006 survey found that 42 per cent of clinics that offer PGD have provided it for sex selection for non-medical reasons. Nearly half of these clinics perform it only for “family balancing”, which is where a couple with two or more children of one sex desire a child of the other; therefore, this process with such a reason is banned in some countries and some clinics in Iran such as Royan do not operate it.
Couples should know that PGD will take months, of special diet and consuming drugs for both of them, so they have to be patient.
PGD helps IVF process; and it is done on cases such as:
Yazdan Travel provides all special care you need at the best clinics; and will be with you till the end of treatment.