IVF/ICSI in Milan

IVF (In Vitro Fertilization and Embryo Transfer) and ICSI (Intracytoplasmic Sperm Injection) are advanced techniques of medically assisted procreation (PMA) used to treat various forms of infertility. These procedures are defined as second-level and are often used when other methods such as stimulated cycles or intrauterine insemination have not been effective or are not applicable.

IVF/ICSI is a term that encompasses a therapeutic path described in:

Ovarian Stimulation: The woman receives controlled ovarian stimulation to produce as many eggs as possible. The drugs that are used are gonadotropins (FSH with possibly LH) from synthetic drugs or purified gonadotropins. The aim is to obtain a high number of oocytes, without incurring the risk of ovarian hyperstimulation syndrome (OHSS), an iatrogenic syndrome that has a spectrum from mild to very severe. Throughout the ovarian stimulation process, the patient will receive serial ultrasound and hormonal checks to assess the correct time for ovulation induction with recombinant Bhcg or GnRH (gonadotropin-releasing hormone) agonist.
Oocyte collection or Ovarian Pick-Up: Mature eggs are collected directly from the ovaries using an ultrasound-guided needle. This procedure is performed 36 hours after ovulation induction in the operating room. The execution time is generally a few minutes and the patient’s recovery is rapid enough to require hospitalization in day surgery or outpatient.
FIV/ICSI: The collected eggs are put in contact with the partner’s spermatozoa in the laboratory to allow fertilization. The difference between in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) depends on the choice of the gynecologist and biologist based on the couple’s medical history and the fertility parameters identified. In the first case, the oocytes are placed in culture with the seminal fluid. In the second case, a single sperm is injected directly into the egg with a micromanipulator to overcome male fertility problems such as low motility or sperm count.
Embryo Culture: The resulting embryos are cultured in the laboratory for a few days until they reach the cleavage embryo stage (or embryo on day II/III) or, preferably, blastocyst stage (embryo on day V/VI).
Embryo Transfer: One or more embryos, depending on the choice previously agreed with the gynecologist, are selected and transferred into the woman’s uterus. This procedure is outpatient, painless and performed in a few minutes with the aid of ultrasound control. The procedure takes place a few days after the oocyte retrieval, at the end of the desired growth of the embryos. In some cases, at the discretion of the gynecologist and biologist, it is preferable to cryopreserve the embryos to perform the embryo transfer at a later time.

IVF/ICSI is of fundamental importance in the following cases:

Overcoming Fertility Problems: They are particularly useful in cases of tubal obstructions, serious male fertility problems, endometriosis, or repeated failures of other assisted reproduction techniques.
Preimplantation Diagnosis: They offer the possibility of performing genetic screening on the embryos before the transfer, increasing the chances of a pregnancy. The use of preimplantation diagnosis occurs after appropriate consultation with the gynecologist expert in infertility in particular and selected conditions.

All IVF and ICSI treatments are tailored to the specific reproductive needs of the couple and, therefore, fall within the scope of personalization of therapy. IVF and ICSI represent the frontier of technology in reproductive medicine, offering hope to many couples who face complex challenges on their journey to parenthood. Although they are more expensive and complex procedures than other methods of assisted reproduction, their success rates and the possibility of personalization of treatment make them valuable options for many couples with infertility problems.