Hormone stimulation is aimed to stimulate ovaries to produce follicles with egg cells. Usually, between several to less than 20 follicles are produced as a result of stimulation. The success of the in vitro procedure depends mainly on the fact whether it was possible to obtain simultaneously a larger number of follicles, followed by mature egg cells.

ISP – Individual Stimulation Protocol

The Individual Stimulation Protocol prepared individually for each patient allows to reduce the risk of hyperstimulation and to obtain an appropriate number of egg cells as well.
The programme is conducted based on the latest knowledge regarding the effects of hormone levels, including AMH, on the women’s body, as well as clinical experience.

The quality and number of egg cells depend on many factors, such as a method to perform hormone stimulation and a method used to perform a procedure of egg cell collection. The collection procedure is performed under general anaesthesia, under ultrasound monitoring and by experienced specialists. At the same time, physicians cooperate with embryologists who constantly work together in order to obtain the best possible material from each patient.

OQA – Oocyte Quality Assessment

The whole procedure is performed according to a unique standard – OQA – Oocyte Quality Assessment – that has been prepared by a team at the INVICTA In Vitro Laboratory managed by Dr Joanna Liss.

At INVICTA Clinics, embryologists are constantly communicating with a physician who collects cells during a procedure , and they monitor the presence of a cumulus in an ovarian follicle. Then, the quality of a cumulus is assessed and it should contain an egg cell. The assessment of an egg cell is performed after separation of granulosa cells. The following parameters are mainly assessed at INVICTA Clinics: cell maturity, structure of the egg cell cytoplasm, thickness of the zona pellucida, thickness of the space below the zona pellucida, morphology of the first polar body, cell size.

If we know that fertilisation of egg cells was poor in the previous cycle, it is possible to stimulate internal mechanisms helping the introduction of the sperm into an egg cell to facilitate fertilisation – oocyte activation using calcium ionophores.

The quality of performance of an in vitro laboratory that is responsible for the assessment of egg cells, selection of a sperm for fertilisation and process of fertilisation plays a key role for the success of in vitro fertilisation programmes. At the INVICTA Laboratory, we are aware that we work with extremely delicate genetic material – therefore, apart from internal standards, ISO standards, recommendations of international scientific associations, we culture and monitor embryos under special conditions – for example, low oxygen pressure and high hyaluronate levels.

The In Vitro All Inclusive Programme contains recommended procedures performed at an in vitro laboratory. These include techniques that may have a significant impact on the Programme success – including among others: ICSI, embryo culture up to the blastocyst stage and AH (assisted hatching). Additionally, if it is medically indicated (male factors), we use FAMSI or IMSI-MSOME techniques.

A key element affecting the success of embryo transfer procedures and implantation may include preparation of female mucosa membrane and presence of appropriate endometrial receptivity. Thanks to our experience in this field, we are able to introduce our own methods for transfer preparation – and consequently, the risk of a failure is minimised. After embryo transfer, the patient is monitored – it is the so-called implantation supervision.

Implantation supervision

It is an extremely important stage of in vitro fertilisation programmes at INVICTA Clinics. According to our studies, when implantation supervision is performed correctly, it may increase the efficacy of an in vitro programme by approximately 8% on average.

During patient’s supervision after transfer, a physician constantly monitors lutein dosage and introduces necessary modifications depending on the test results and the patient’s medical condition. At the same time, the patient is provided with psychological comfort as she knows that there is a person who supervises programme outcomes during these most important weeks.

Implantation supervision at the INVICTA Clinics has also diagnostic benefits. In case of a programme failure, our specialists obtain invaluable information that can be used when planning the next in vitro fertilisation programme. A management strategy may be drastically changed during the next patient’s attempt, often thanks to information obtained after embryo transfer. Our specialists are aware of that and, therefore, they are responsible for appropriate implantation supervision until week 5 after embryo transfer.

As part of the In Vitro All Inclusive Programme, patients receive medications that help prepare the endometrium for transfer, and medications taken after transfer – lutein.