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Gynecology & Obstetrics

IVF – In Vitro Fertilization

The greater the experience – the better the results
Family and parenthood are main pillars in Israeli's tradition and culture. This explains the over 20 IVF units, that are functioning in Israel, a country of less than seven million citizens. Several hundreds highly skilled professionals, are committed to the goal of achieving the longed for children. Yes indeed, we are actually one of the world leaders, both in number of treatment cycles per capita/per year, and also in successes' rates. Over 40% of fresh embryos and 30% of thawed embryos that are re-planted (transferred) result in pregnancies, all depending on several factors, including the woman's age, and the quality of sperm. The Israeli results are among the top five world-wide! This is no wonder, since the greater the experience, the better are the results.

The Miracle of Reproduction

IVF is the major treatment in infertility which brought happiness to many thousands of childless couples during the thirty years since it has been applied by the British researchers Steptoe & Edwards.

In vitro fertilization (IVF) is used when other methods of assisted reproductive technology have failed, in both cases of either male or female infertility. Egg cells (ova) are retrieved from the woman's ovaries after having been hormonally stimulated, then fertilized by sperm outside the woman's womb, in the laboratory. A day after, the fertilized eggs – FRESH EMBRYOS – that have properly developed, are  transferred to the future mother's uterus in the intent to establish a successful pregnancy. 10-12 days after the re-implantation a blood test for HCG would hopefully result positive. Since several egg cells are fertilized during the process, in many cases some are kept deeply frozen in liquid nitrogen for many years, to be thawed when the family wishes to expand, or if the first transfer failed. Once pregnancy is achieved and holds the first trimester, it is treated as any other pregnancy, yet the baby is considered "very precious", because of the complicated procedure, following years of disappointments and frustrations many times. In some cases, since more than one embryo was transferred, a multiple pregnancy develops. Occasionally, if necessary and at the couple's request, in cases of triplets or more, the specialists might suggest to reduce the number. Fetal reduction, leaving just two babies to develop further, improves their chances to arrive safely to birth after full-term pregnancy, but creates a new risk – premature delivery or even abortion. In order to avoid these risks, in some countries (England for instance) only two embryos are re-planted by law. We do not have such law, but couples can always decide with the professional staff on the number of transferred embryos.

Further professional details

ICSI – Intracytoplasmic Sperm Injection

In cases of impaired sperm structure and/or motility, available now is a newly developed micromanipulation technique – ICSD. Under a super power microscope the slow sperm is helped directly into the egg cell. This method is a huge break-through in the treatment of male infertility, enabling pregnancies that were impossible to achieve before hence. Sperm is now retrieved even in cases of aspermic ejaculate – a complete lack of sperm cells in the ejaculated fluid, either from the sperm ducts, or directly from a testicular biopsy (tissue sample). In fact, it is our pride that an Israeli team, headed by Prof. Shlomo Mashiach, one of the greatest researchers of infertility, to have firstly achieved pregnancy from testicular tissue in the world! Once retrieved, one sperm is used in each ICSI and the rest are kept deeply frozen for further trials if and when needed. ICSI is a procedure performed by specially trained and exceptionally skilled doctors, using ultra expensive state-of-the-art equipment.

ZIFT - Zygote Intra-fallopian Transfer

Considered the most invasive of all infertility treatments - zygote intrafallopian transfer (ZIFT) - is the choice of less than one percent of people who turn to assisted reproductive technology. Still, the method can work well for some couples — over 1,000 ZIFT babies are born each year. ZIFT involves invasive techniques, such as deep general anesthesia and laparoscopy – a surgical procedure used in order to plant the zygotes into the tubes, located deep in the lower abdomen. But when everything else has been tried and failed, the embryos are transferred directly into the fallopian tubes, with considered success rates. Among the pioneers who firstly dared using this method, were some of our leading teams in this field too.
 
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