Welcome to Swedish MedCare fertility treatment!
If a couple of childbearing age is unable to conceive during the first or second year of trying, they may be among the 10%-15% of people who need help getting pregnant. It is not unusual for multiple factors to be involved in infertility, in both men and women. No matter what the reason is, it is possible to solve most of these problems using IVF (popularly known as test tube fertilisation)
Swedish Medcare offers an IVF program that you can use to get help quickly.
The IVF program
The preparatory stages for the treatment take place in Sweden with the help of a consulting gynaecologist. The doctor will explain how IVF works, prescribe medications, and monitor the IVF cycle by performing repeated ultrasounds and analysing blood samples. For the initial preparations, 3 to 5 visits are required over a two-week period. Then you will be ready to travel to SMC in Riga to perform the actual procedure.
The final stages in the program, i.e. oocyte retrieval, cultivation of the fertilised eggs and oocyte reinsertion, take place over the course of a 3-5 day stay in Riga, just a short plane trip away. During that time, you will be staying at our partner hotel Clarion Hotel Valdemar, and SMC Assistance will provide you with all the personal help you need. You will be well looked after by a Swedish-speaking SMC assistant who will keep you informed every step of the way, coordinate your schedule, and help you travel to and from each appointment at our partner clinic. There is no waiting list, and you will save both time and money.
How does IVF work?
When a woman is being prepared to undergo an IVF procedure, initially a nasal spray or injection is used to “reset” her menstrual cycle and to prevent her natural ovulation. After a time, hormone injection treatment is commenced. This causes several eggs to mature, which can then be removed from the ovaries simultaneously. This process is monitored with the help of blood tests and vaginal ultrasound. When enough ovarian follicles (and the eggs in them) have matured, the eggs are removed using a thin needle inserted through the vaginal wall. The procedure is performed under mild anaesthesia.
The eggs are then incubated in a special liquid in a heating cabinet. Motile sperm of good quality are selected from the partner. To begin with, the eggs are incubated alone, but after a few hours the sperm cells are added, and the cells are left to incubate for another 12-18 hours. Once fertilisation and division of the oocyte have occurred, the cells are examined with a view to selecting the best embryo for reinsertion. This is done 2-3 days later, and involves returning an embryo (in isolated cases two embryos) to the uterine cavity. The embryo is introduced via a soft catheter. Reinsertion is generally performed once the embryos have divided 2 to 3 times (4-8 cells) or when what is referred to as a blastocyst has formed (5 days of culture). It is often possible to freeze embryos and blastocytes for future use.
In the past, multiple embryos were reinserted simultaneously in order to increase the chances of pregnancy. In 90% of cases these days, only one embryo is reinserted, as this has been proven to increase the chances of a lasting pregnancy, while also minimising the risk of multiple pregnancy. A previous miscarriage is not in itself a sufficient indication that two or more embryos should be reinserted. No anaesthetic is required when reinserting the embryo. After the procedure, the woman may continue to lead her normal life. A pregnancy test is performed 12-14 days later.
Intracytoplasmic sperm injection (ICSI) is a fertilisation method involving the injection of a sperm cell into an oocyte using a microneedle. This can be an option in cases of male infertility owing to a variety of causes, but it is increasingly being used (50% of all treatments are performed using ICSI) in cases where the cause of infertility does not lie with the man.
In some cases, it is necessary to remove sperm cells by means of testicular sperm aspiration (TESA) or percutaneous epididymal sperm aspiration (PESA). TESA involves extracting sperm cells from the testicular tissue for use in ICSI. This procedure is performed under local anaesthesia. PESA involves the introduction of a fine needle into the epididymis under local anaesthesia. The epididymis is the part of the testicle where mature sperm cells are stored. These methods are always used for men who do not have any sperm cells in their semen, and for men with a blocked vas deferens or who have undergone sterilisation. In some cases it is not possible to find any viable sperm for ISCI during these procedures.
Egg donation involves “programming” the surrogate with hormones so that her endometrium becomes receptive to a fertilised egg. This is done in order to “reset” the surrogate's own hormones, so that she does not ovulate and so that no folliculogenesis occurs. After that, the endometrium is built back up using hormones that make the endometrium receptive to a fertilised egg and to the further development of the embryo. The egg donor is synchronised with the surrogate in such a way that the donor ovulates while the surrogate’s endometrium is receptive to the fertilised egg. The synchronisation of the surrogate with the donor is carried out using a special hormonal regimen administered and monitored by a specially-trained gynaecologist. Egg donation may also involve frozen/thawed eggs. In this case, no synchronisation with the donor is required as above, but simply the build-up of the surrogate’s endometrium using hormone therapy.