Ovulation Monitoring
Ultrasound examinations during the natural cycle monitor the follicle. The patient may have previously taken clomiphene. When the follicle is 18 mm, chorionic gonadotropin is given for its rupture (not necessary) and the couple has intercourse.
Intrauterine Insemination (IUI)
After taking clomiphene or FSH products, the evolution of the follicles in the first phase of the cycle is monitored by ultrasound. When 2-3 follicles are 18 mm, chorionic gonadotropin is given to rupture the follicle and in 2 days the partner’s sperm, after being properly processed, is transferred to the endometrium.
In Vitro Fertilization (IVF)
The ovaries are stimulated with FSH. The stimulation phase lasts 8-10 days until the follicles are the correct size. This is followed by the harvesting of the eggs, called egg collection. The eggs are fertilized with the sperm and the embryos, after 3 days (or 5 days if they have reached the blastocyst stage), are transferred inside the uterus, to the endometrium, and it is called embryo transfer.
Egg Donation (ED)
It is the borrowing of eggs from a third person. This is recommended in cases of poor ovarian response or premature menopause. It takes place after hormonal coordination between the donor and the recipient; the eggs of the donor are fertilized with the sperm of the recipient’s partner. The embryos are then transferred to the recipient.
Surrogacy
It is chosen in cases where the couple wants to become parents, but the woman cannot get pregnant for medical reasons. Another woman, agrees to become a surrogate mother to bear their child (embryo). This embryo results from In Vitro Fertilization of the couple’s egg and sperm. The eggs can come from egg donation from a third woman, but not from the surrogate. The newborn will be raised by the intended parents and the intended mother should not be older than 50 years of age.
Surrogacy is recommended in the following situations:
• Cases of absence of the uterus due to genetic syndrome
• When surgical hysterectomy has preceded (ex: after malignant surgery or a hysterectomy due to uterine bleeding in a previous pregnancy)
• In serious diseases where pregnancy endangers health or life threatening (ex: severe heart disease, kidney disease)
• In severe endometritis, which despite treatment, the thickness of the endometrium does not increase
• After major obstetric complications in a previous pregnancy
• In cases of recurrent miscarriages, or implantation failures after repeated IVF treatments
The surrogate mother must be healthy and able to conceive, has given birth at least once but has not undergone more than two caesarean sections. She undergoes a thorough psychological evaluation before conception. Embryo transfer to a surrogate mother requires court permission and legal guidance before the procedure.
