Services

Basic IVF

• Included services

  • Ovarian stimulation
  • Medication for stimulation of ovulation:  gonadotropins (Puregon, Gonal, Menopour) 600 IU
  • Folliculometry
  • Hormonal monitoring of stimulation
  • Consultations of reproductive endocrinologist
  • One procedure of intravenous infusion of medication for OHSS (if required)
  • Transvaginal ovarian puncture
  • General anesthesia
  • 2-3 hours stay in day hospital with medical monitoring
  • Identification and evaluation of oocytes’ maturity
  • Preparation of sperm for fertilization using two samples of ejaculate
  • Cultivation of embryos until 5-6 day of development
  • Freezing of embryos
  • Embryo transfer

  Excluded services

  • Additional medicaments
  • Emergency care in case of complications 
  • Assisted hatching
  • Biopsy of embryo
  • Any type of PGD/PGS
  • ICSI/IMSI fertilization
  • Additional consultations of specialists
  • Storage of frozen embryos
  • Usage and thawing of donor gametes
  • Frozen embryo transfer 

Embryo cultivation

• Altravita uses last generation incubators: cells are cultured in low oxygen level (5%), nitrogen gas is provided in addition to carbon dioxide to better mimic conditions in the body. Our experienced embryologists closely monitor each embryo development.

  At Altravita we transfer embryos on the 5th day of cultivation. The ability to grow embryos for five days to the blastocyst stage of development in the laboratory, rather than the traditional three days, allows our embryology team to determine, with greater certainty, which embryos are really the best in terms of their potential for implantation.

  Cultivation of embryos in the sound environment

  In the spring of 2016 specialists developed and implemented a method that allows bringing the cultivation of embryos closer to more physiological conditions.  

  In an artificial environment used in reproductive technologies for the development of embryos before transfering them to the uterus, the conditions are as close as possible to natural, since it is the factor that determines how the embryonic development will proceed. The system of modern incubators and cryobanks maintains constant humidity, temperature and other parameters necessary for the healthy development of embryos and high-quality storage during freezing.

  Dynamic environment

  Scientists keep working to improve cultural environments, but so far there is no one hundred percent understanding of the behavior of embryos in vivo, that is, the mother’s reproductive organs. It is well known that during natural development, an embryo undergoes vibrations that have a positive effect on daily embryonic activity.

  This technique is based on the transfer of musical or other vibrations (for example, from the mother’s body sounds) into a Petri dish with embryos.

  Call your embryo 

  Calling your own fetus from a mobile device is an additional feature of this method. A specific contact number is assigned to the incubator. By dialing it parents can call and transmit their sound vibrations to the embryo.

  This is not only useful for the embryo development, but will also become an indispensable psychological aid for patients who are often in a depressed psycho-emotional state due to the lack of direct connection with their developing offspring. After all, a balanced psychological state of parents is an essential component of successful treatment. 

  Generally, a Petri dish is in a static state, remains in silence and calm, without any sound effects, which is not entirely characteristic of the natural environment where embryos develop. Natural embryogenesis is accompanied by various vibrations (mechanical, acoustic), due to the mother vital activity.

  Scientists examined 1,000 donor eggs, divided into two experimental groups. One group developed in ordinary incubator conditions, the second was exposed to sound vibrations of a certain frequency and volume (up to 80 decibels). To exclude a genetic factor, for two groups the biomaterial of the same parents was used.

  The results of the experiment showed that due to sound vibrations the number of embryos in the blastocyst phase increased by 20%, and the success rate of fertilization rose by 6%. These are excellent indicators, given that each percent of successful fertilization is important.

  Specialists of embryological laboratories conducted many other experiments to bring the artificial microenvironment of embryo development closer to the natural one. So, there were attempts to grow it on an inclined surface that simulates the embryo movement, as if it was in a fallopian tube. However, such methods did not bring the desired result, which cannot be said about the acoustic effects.

Natural Cycle IVF

• What is IVF in natural cycle? IVF in natural cycle uses ultrasound monitoring of growth of the dominant follicle in the ovary of the patients with preserved ovulation.

  With a follicle size of 18 mm, either under the control of an ovulation test, or after the intramuscular injection of an ovulation trigger, a follicle is punctured to obtain an egg. The rest of the IVF program process remains the same.

  To increase the effectiveness of IVF, the program includes the study of egg’s spindle apparatus.

  IVF in the natural cycle: pros and cons

  The reason for the low demand for IVF in the natural menstrual cycle is that it is characterized by a fairly low efficiency. The pregnancy rate is lower than with insemination in the natural cycle, it is about 7% in terms of each started cycle.
  This is due to the fact that not every mature follicle is an egg carrier. In addition, because of the puncture, only one egg is extracted, which may not be able to fertilize. Also, when using this method, there is a risk of canceling the oocyte collection procedure due to premature ovulation.

  The advantage of this method is to minimize the risk of complications such as ovarian hyperstimulation syndrome.

  The undoubted advantages of the IVF method in the natural cycle include the possibility of carrying out the procedure for several menstrual cycles in a row. However, note that a single puncture of stimulated ovaries will do less harm than multiple.

  Another advantage of IVF in natural cycle is that comapered to other programs its cost is usually lower than in programs where superovulation stimulation is performed.

  Also, unlike in other programs, no special preparation for IVF in the natural cycle is not required.

  The package includes (depending on the Doctor’s prescription)

  • Prescribing natural cycle treatment plan;
  • Consultation with Infertility doctor (up to 3 times);
  • Follicle ultrasound (up to 3 times);
  • Hormone level tests for monitoring ovarian stimulation (LH, estradiol, progesterone express-tests – up to 3 times)
  • One of the following medications:
  • Diphereline (0.1)
  • Chorionic gonadotropin (up to 10.000)
  • Ovarian puncture in natural cycle
  • Staying in a hospital ward for 3 hours for monitoring purposes
  • Embryological stage:
  • Oocyte identification and assessment; 
  • 2 sperm specimen preparation for fertilization;
  • In vitro fertilization: ICSI;
  • Embryo culture;
  • Oocyte spindle apparatus assessment.

  The package does not include

  • Medications that are not listed in the program description;
  • Medical assistance in case of emergency conditions;
  • IMSI;
  • Assisted hatching;
  • Embryo biopsy;
  • All kinds of preimplantation genetic diagnosis;
  • Embryo storage;
  • All consultations with related specialists;
  • The use of donor material and its defrosting.

  IVM procedure

  IVM means in vitro egg maturation (in vitro) followed by IVF. The specialists of AltraVita clinic have sufficient capabilities and knowledge to conduct this process with high efficiency, as evidenced by reviews of IVF in natural cycle.

  The combination of IVM and IVF methods makes it possible to simultaneously obtain a mature egg from a dominant follicle and a number of immature eggs from small (antral) follicles. Egg maturation takes place “in vitro”, and a mature egg undergoes fertilization in the standard way. High-quality embryos obtained by both methods are transferred into the uterus.

  Indications for IVF in the natural cycle in conjunction with IVM

  • Polycystic Ovary Syndrome
  • Significant risk of ovarian hyperstimulation syndrome
  • A history of benign hormone-dependent tumors
  • Contraindications to the induction of superovulation
  • Factors Affecting IVM Choice
  • The ability to avoid the risk of developing ovarian hyperstimulation syndrome
  • Lack of hormonal stimulation
  • Affordable cost of the procedure, which is caused by a small amount of hormonal drugs used

Preimplantation Genetic Testing (PGT)

• PGD

  Pre-implantation genetic diagnosis (PGD) refers to genetic profiling of embryos created through IVF prior to the transfer into the patient’s uterus. During PGD the embryos are screened for a number of specific genetic disorders, so as to exclude the possibility of selected embryos having these particular abnormalities.

  PGD enables patients with a chronic disease in their family history to avoid passing it on to their children. A specialist may recommend PGD if patients have a family history of severe genetic diseases or previous miscarriages due to genetic disorders.

  PGS

  The term preimplantation genetic screening (PGS) is used to denote procedures that do not look for a specific disease but use PGD techniques to identify embryos at risk. PGS involves checking the embryos chromosomes for common abnormalities. Chromosomal abnormalities are a major cause of miscarriages and the failure of embryos to implant. They can also cause such serious medical conditions as Down’s syndrome.

  PGS is normally recommended for:

  • older patients ( women over 35 years old);
  • patients with a history of recurrent miscarriages;
  • patients with a history of unsuccessful IVF cycles after the embryo transfer stage;
  • patients with a family history of chromosomal diseases.

IVF with anonymous donor

• Included services

  • Screening, stimulation of ovulation, compensation for anonymous egg donor
  • Scheme of patient’s endometrium preparation for embryo transfer
  • Ovarian puncture with general anesthesia for the egg donor
  • Consultations of reproductive endocrinologist for the patient and the donor
  • Ultrasonic monitor of endometrium for embryo transfer
  • Preparation of sperm for fertilization using two samples of ejaculate
  • ICSI/IMSI
  • Cultivation of embryos until 5-6 day of development
  • Freezing of embryos
  • Fresh embryo transfer to the patient

  Excluded services

  • Additional medication
  • IMSI – if indicated
  • Assisted hatching
  • Embryo biopsy
  • Any type of PGD/PGS
  • Frozen embryo transfer
  • Storage of frozen material
  • Additional consultations of specialists 

IVF after 40 years

• IVF after 40 years

  Pregnancy after 40 is a fairly rare occurrence even if you try to conceive naturally. IVF can be a possible solution to this problem for women over 40.

  The ability to get pregnant, gestate and give birth to a child is determined by the age of woman planning to become a mother.

  How to get pregnant over 40?

  For a woman after 40 years a possibility of the natural conception and normal pregnancy decreases year after year. 

  Modern ART and IVF come to help patients over 40. Such methods are actively used in AltraVita center. Such methods are actively used in AltraVita center. To determine the possibility of getting pregnant with her own eggs for a woman over 40, ovarian reserve assessment is required.

  For this reason the following options are used:

  • Determination of AMH (anti mullerian hormone) - allows you to predict the chances of conception, although it does not affect fertility itself and decreases with age;;
  • FSH (follicle-stimulating hormone) - the ovarian reserve means sufficient if there is a value of 10 mIU / ml and below;;
  • Antral follicles count — the follicles are counted during ultrasound examination.

  At this age IVF is often performed in natural cycle, because a large number of eggs cannot be obtained during a stimulation.

Hatching

Russian birth certificate

Egg Donation

• Whom is IVF suitable for with egg donation?

  Donor egg IVF is generally with significantly diminished egg quantity and quality (poor ovarian reserve). This includes women with:

  • Premature ovarian failure (early menopause)
  • Very poor egg quality
  • Poor response to ovarian stimulation
  • Very low antral follicle counts on ultrasound
  • Advanced female age, such as over age 40

  Donor egg IVF is recommended to the women who are known to be affected or be the carrier of a genetic disease in order to avoid the risk of passing on genetic disorders to her child.

  Our donors

  Altravita IVF clinic has a well-developed egg donation program corresponding to the highest standards and criteria set by the American Society for Reproductive Medicine (ASRM). We only accept egg cells from young (18-32), good-looking, healthy donors.

  We have a large database of active egg donors who underwent a thorough medical and psychological screening. Besides providing a detailed medical history about herself and close blood relatives, the donor undergoes the following examinations:

  • general medical examination (including blood tests, ultrasound scan)
  • ovarian reserve testing  
  • infectious disease screening for a variety of infections
  • genetic screening and karyotyping
  • drug test
  • medical examination by gynecologist, geneticist and psychiatrist.

  Fresh and frozen egg donation programs  

  Both programs are offered at Altravita.

  Fresh egg donation IVF cycles is the way the majority of egg donation is done around the world:

  • The donors are chosen by a recipient couple and stimulated to produce multiple eggs.
  • The eggs are retrieved and fertilized by patient’s partner sperm (or donor sperm) with the resulting fresh embryos transferred to the patient.
  • Remaining embryos would be frozen for future frozen embryo transfer procedures (if needed).

  All the eggs from the donor are available to you for fertilization. This cycle maximizes the pregnancy rates and typically results in additional embryos for cryopreservation.

  Egg freezing has improved significantly over the past several years due to fine-tuning of freezing and thawing protocols. Thawed egg survival and viability is much better than it was previously. A new technology of ultrafast freezing (vitrification) of oocytes was invented. The embryologists at our clinic were early leaders in the field of egg and embryo vitrification. Altravita has a record of successful IVF programs with frozen donor eggs.

  Frozen egg donation does not require synchronization of the cycle between the donor and the patient. Treatment cycles are quicker and treatment cost is lower compared to fresh egg donation.

  Legal aspects of egg donation program

  According to the legislation of the Russian Federation a woman, who gave birth to a child, is considered the mother (except for surrogacy cases). The donor has no legal relations to the child conceived from her egg.
  The law does not set the age limit for this treatment program.

  IVF with egg donation treatment steps

  • Consultation with reproductive endocrinologist; selection of the individual stimulation protocol: preparing the uterine lining for embryo transfer and synchronization of the donor and patient cycles in case of fresh egg donation.
  • Monitoring of the hormonal stimulation under ultrasound.
  • Collection of donor eggs under general anesthesia/thawing of vitrified donor eggs.
  • Sperm collection, analysis and preparation. Semen is prepared for fertilization by removing inactive cells and seminal fluid by so-called sperm washing.
  • Fertilization using ICSI or IMSI methods.
  • Cultivation of embryos. The produced embryos are being cultivated in special incubators for 5-6 days. Their development is closely monitored by experienced embryologists. If necessary, PGS or PGD can be performed to select the embryos free from genetic diseases.  
  • Embryo transfer is a painless transfer of the best embryo into the woman’s uterus. Spare embryos will be cryopreserved by vitrification method.

Cryopreservation