In Vitro Fertilization (IVF) is one of the most effective methods of treating infertility, where the fertilization of the egg by sperm occurs outside the woman's body, in laboratory conditions.

Main Stages of the IVF Program:

• Preparation for IVF
• Conducting the IVF program
• ICSI Method (intracytoplasmic sperm injection)
• Preimplantation Genetic Diagnosis (PGD)
• Assisted Hatching
• Blastocyst Transfer
• IVF with Cryopreserved Embryos
• Possible Complications in ART Programs
• Reasons for IVF FailuresReverso Context

Historical Reference:
The first child conceived through IVF, Louise Brown, was born in the UK in 1978. This event revolutionized reproductive medicine and gave hope to millions of infertile couples. Decades later, ART technologies have significantly improved, introducing methods like ICSI, PGD, embryo cryopreservation, and more.

As of 2024, over 12 million children worldwide have been born through assisted reproductive technologies, with approximately 70% conceived via IVF.

Preparation and Stages of IVF Treatment:
1. Couple's Examination: Comprehensive clinical and laboratory examination of both partners to identify potential causes of infertility and contraindications for the procedure.
2. Ovarian Stimulation: Starting on the 2nd–3rd day of the menstrual cycle, the woman receives gonadotropin-containing medications. The goal is to mature multiple follicles, monitored through ultrasound and hormonal assessments. Ovulation is triggered with hCG or, in certain cases, GnRH agonists.
3. Follicle Aspiration: Performed 34–36 hours after ovulation trigger. Eggs are retrieved transvaginally under ultrasound guidance and short-term intravenous anesthesia. If quality eggs cannot be obtained, donor material may be used.
4. Sperm Processing: Conducted on the day of aspiration using methods like "washing," gradient centrifugation, and, if necessary, selection of morphologically normal sperm (IMSI, PICSI). Donor sperm may be utilized.
5. Fertilization and Embryo Cultivation:

• Classic IVF: Eggs are placed in a nutrient medium with processed sperm.
• ICSI: In cases of severe male infertility, a single sperm is injected directly into the egg.

A zygote forms 16–18 hours later. On day 2, the embryo typically consists of 4 cells. By day 5, it develops into a blastocyst, the optimal stage for transfer.
6. Embryo Transfer: Performed on days 3–5 post-aspiration. Usually, 1–2 embryos are transferred to minimize the risk of multiple pregnancies. The procedure is outpatient, without anesthesia, using a soft catheter.
7. Post-Transfer Support: Medications like progesterone (tablets, suppositories, injections) and/or hCG are prescribed to support implantation. Pregnancy is diagnosed through blood hCG levels 10–14 days post-transfer, with ultrasound on day 21.

Additional Procedures:

• ICSI: Used in cases of severe male infertility, azoospermia, poor sperm quality, or previous IVF failures.
• Preimplantation Genetic Diagnosis (PGD): Allows for the exclusion of embryos with genetic anomalies, especially in cases of repeated miscarriages or maternal age over 35.
• Assisted Hatching: A technique where the embryo's shell is partially opened with a laser, potentially increasing implantation chances.
• Embryo Cryopreservation: Unused high-quality embryos can be frozen (vitrified) for future transfer cycles, enhancing the cumulative success of IVF programs.

Complications and Failures:
Possible Complications:

• Ovarian Hyperstimulation Syndrome (OHSS)
• Multiple pregnancies
• Ectopic pregnancy
• Complications related to aspiration

Reasons for IVF Failures:

• Genetic anomalies in embryos
• Endometrial receptivity issues
• Advanced maternal ageWikipedia
• Uterine blood flow abnormalities
• Suboptimal ovarian stimulationPersona Clinic+5Wikipedia+5Ida-Tallinna Keskhaigla+5

Modern Trends in IVF:

• Shift towards individualized stimulation protocols
• Increasing preference for single embryo transfer to minimize multiple pregnancy risks
• Emphasis on frozen embryo transfers as more physiological and effective