In Vitro Fertilisation (IVF) is one of the most common procedures performed at Barbados Fertility Centre. IVF when translated means fertilisation “in glass” and refers to the process where a woman’s eggs are fertilised with male sperm outside of her body in a laboratory to produce embryos. IVF is an option for many couples who struggle to conceive naturally. Once these embryos are created they are transferred to the woman’s uterus after 3 to 5 days and it is here that nature takes over for the embryo/s to implant and progress to a successful pregnancy. At Barbados Fertility Centre our patients come to us from all over the world to avail of our high IVF success rates which considerably higher than the national average rates for both the UK & US.
Blastocyst Transfer IVF
In natural conception embryos arrive in the uterus 5-6 days after fertilisation. With present day IVF, embryos are routinely transferred back 3 days after fertilisation. Recent breakthroughs in the laboratory and developments in media culture have made it possible to grow embryos in vitro for up to 5 days. This is referred to as blastocyst development.
By growing the embryos to blastocyst stage you have the potential to choose the best developing embryos and also to transfer fewer embryos, which results in increased pregnancy rates and lowers the multiple pregnancy rates.
However, not all patients are suitable candidates for this procedure.
At Barbados Fertility Center we will guide you through if this procedure is suitable for you..
There is another critically important component of the embryo that is often overlooked, the zona pellucida (ZP) or the egg shell. The zona pellucida is secreted by the egg and has several important functions, such as:
During fertilisation, it serves to prevent the access of more than one sperm to the egg. It keeps the cells of the embryo together during early development, until the embryo reaches the blastocyst stage. At the blastocyst stage, the embryo has enough structural integrity that it no longer needs the protection of the ZP and the embryo “hatches”.
In 1989 Cohen and his co-researchers observed a higher implantation rate in patients undergoing IVF, who had the ZP of their embryos mechanically opened.
Prospective randomized clinical studies have been performed in order to evaluate the effectiveness of assisted hatching in IVF. Several studies report a significant increase in embryo implantation and clinical pregnancy rates, in select groups of patients whose embryos have undergone this procedure.
The following patient groups may benefit from assisted hatching : women older than 36 years of age, those with elevated FSH levels, couples with previous IVF failures, embryos with an abnormal appearing zona pellucida, and when using cryopreserved embryos.
There are a number of ways to introduce a hole or a weakness into the zona:
Mechanical: Some embryologists will perform assisted hatching by mechanically piercing the ZP with a specifically designed pipette.
Chemical Erosion: involves exposure of the embryo to an acidified media called acidified tyrodes solution. This acidic solution is microscopically applied to the ZP to induce thinning.
Laser: This specifically designed laser system includes the laser, which serves as the energy source to create an opening in the ZP, and a computer which allows the operator to precisely control the laser energy output, laser pulse duration, and gap size. This system has many benefits when compared to the more standard mechanical and acidified tyrode’s techniques.
The computer assisted laser method is more precise, resulting in a more consistent ZP opening. Laser assisted hatching takes less time and does not expose the embryos to potentially adverse chemicals, so embryos spend less time out of the optimal culture conditions of the incubator.
The cumulative effect of these factors is to minimize the stress placed upon the embryo during the performance of assisted hatching. This in turn translates into improved implantation and pregnancy rates.
At Barbados Fertility Centre, we have routinely performed assisted hatching since 2002. We offer both the mechanical and the laser method for hatching.
When a woman begins IVF treatment, she is prescribed fertility medications by our IVF Physicians, which are specific to her reproductive health profile. These medications stimulate the ovaries with the goal of developing several mature follicles, with the hope that each follicle contains an egg. This process is regularly monitored through ultrasound and blood testing to ensure the ovarian stimulation process is progressing appropriately.
Once mature follicles have been produced by the ovaries, the eggs are then collected at Barbados Fertility Centre during an outpatient procedure, which is performed under sedation/local anaesthetic by our IVF Specialist Physician. The process is completed using an ultrasound-guided needle which travels through the vaginal wall and into the ovary, where the needle collects the eggs. Once the collection process has been completed, the eggs are immediately sent to the embryology laboratory.
On the same day that the eggs are collected, a semen sample is produced by the male partner. The semen sample is prepared in the laboratory in an effort to consolidate as many motile, normal-looking sperm as possible. The prepared sperm and eggs are then cultured together in the laboratory overnight
The following morning, the eggs are inspected for signs of fertilisation. Those eggs which show normal fertilisations are cultured in the laboratory for another 24-48 hours. The fertilised eggs are now called embryos. The development of the embryos are monitored and the couple are kept advised of their progress.
Once we have determined that embryos are ready to be transferred to the uterus, an appointment will be made with our fertility specialist. Prior to this procedure, you and our IVF Specialist Physician will discuss how many embryos you will transfer. During your appointment, the embryo transfer procedure will be performed using a small catheter which is inserted through the vagina into the uterine opening. The embryos transfer procedures takes no more than a half hour and most women experience little or no discomfort.
Following the embryo transfer procedure, any embryos that were not transferred will be assessed for their suitability to be cryopreserved for use by the couple in the future.
Success rates are dependent on many factors and can vary depending on your individual circumstances. Your specific success rate will be communicated to you by our IVF Specialist Physician once your medical history has been reviewed.