IVF – In vitro fertilization

First, either the intended mother or an Egg donator is stimulated with hormones. During IVF treatment, the woman takes hormones that cause her ovaries to produce more eggs than during a normal menstrual cycle.

There are essentially two different ways of carrying out IVF treatment, long or short program. The long program involves the woman using a nasal spray for three weeks before starting the injections. Hormone injections are then given for two weeks. Some women may experience symptoms such as sweating and mood swings. The short program involves starting hormone injections immediately on the 2-3rd day of menstruation/bleeding.

It is up to the treating doctor to decide which program to use.

Once the follicles have grown to the correct size, the doctor decides when to retrieve the eggs – this usually happens 10-12 days after the start of injections. Under local or general anesthesia, the follicles are punctured and the fluid in the follicles is suctioned out with a thin needle.

On the day of egg retrieval, the man provides his sperm sample. When the sample arrives at the laboratory, the embryologist makes an initial assessment. They look at the amount of sample, the sperm count and their motility. If everything is normal, standard IVF is usually chosen, which means that the sperm are allowed to fertilize the eggs on their own. Fertilization takes place within a few hours, but the eggs and sperm are left together in a warming cabinet until the following morning when the embryologist looks at them again.

If the sperm sample is of poor quality, microinjection (ICSI) is used, which means that the sperm is inserted into the egg with a thin needle. ICSI is also commonly used as the standard method in surrogacy processes.

The day after egg retrieval, the embryologist can see whether the eggs have been fertilized or not. Cell division takes place and on day 4 the cells join together in what is called a morula. By day 5, the embryo is made up of hundreds of cells and is called a blastocyst, which is the stage of embryo most commonly used in surrogacy processes.

Before cryopreserving the embryos, genetic screening is sometimes performed on the embryos. The results of the test may show chromosomal abnormalities already at the embryo level. The embryos are then cryopreserved while waiting for the surrogate to be ready for embryo transfer.

The embryo of the highest quality is selected for transfer. During embryo transfer, the doctor first performs an ultrasound and then inserts a guide catheter into the uterus. The embryologist inserts the selected embryo into a thinner catheter and hands it to the doctor. The catheter is placed in the guide catheter and the embryo is put in place in the uterus.

The surrogate can then live as normal until the pregnancy is confirmed.
After the embryo transfer, a period of waiting and hoping begins. Pregnancy tests are done about two weeks after embryo transfer and only then will it be known if a pregnancy has occurred or not.