IVF with ICSI technique in San Sebastián de los Reyes

To start an In Vitro Fertilisation treatment with ICSI technique in Spain, the first thing you must do is to go for an assessment consultation with the the Team of Ginefiv San Sebastián de los Reyes at the Clínica Ginefiv San Sebastián de los Reyes. This is a free and immediate consultation that you can request through our website or by calling us directly on +34 91 141 33 56.

Assess your case with our fertility experts in San Sebastián de los Reyes

Request a free and immediate consultation with our specialists in Assisted Reproduction

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After the request, one of our personal patient service advisors will contact you to welcome you, confirm that the date of the consultation is suitable for you, and to solve any questions you may have. 

Once you have come to the consultation and have made the decision to start the In Vitro Fertilisation treatment with ICSI technique, our Patient Service team will arrange with the Clínica Ginefiv San Sebastián de los Reyes the previous appointments to start with the first part of the procedure.

Before starting the first phase, a semen sample is taken from the man for analysis to determine its viability and capacity. This sample is then used to inseminate the woman's egg.

Once the insemination is complete, a transvaginal ultrasound is performed on the woman to determine her uterus and ovaries, repeating this test several times throughout the ovarian stimulation process to monitor the number and size of the follicles.

After these preliminary steps, if the specialist considers that all is well enough to continue the in vitro treatment, the4-stage process begins:

Ovarian stimulation

The start of ovarian stimulation must coincide with the arrival of the woman's menstruation in order to produce an increase in the number of follicles.

The main objective of this first phase is to stimulate the patient's ovaries in order to obtain a certain number of eggs to maximise the chances of pregnancy. 

This part of the treatment consists of a daily injection to increase the size and number of follicles produced in order to achieve multiple ovulation for in vitro fertilisation.

During this period (12-14 days) an ultrasound follow-up is carried out to control and monitor the evolution of the number of follicles until the required number is achieved.

After the last injection of the ovarian stimulation phase, the egg retrieval procedure is scheduled for approximately 36 hours later.

Ovarian puncture

Once the ovarian stimulation stage is over, 36 hours after the last injection, the eggs are removed through an intervention known as ovarian puncture or transvaginal follicular puncture.

It is an outpatient procedure, simple and quick. Below we detail the steps followed by the medical team to perform the egg retrieval.

On the day of the egg retrieval, the couple comes to the clinic with the documentation required for admission. The patient is escorted to a waiting room where she will be asked to undress and put on operating theatre clothes. It is important to bear in mind that no jewellery or piercings should be worn for the operation.

Once in the operating theatre, the patient will meet the medical team that will perform the puncture: the specialist, the anaesthesiologist and an ATS who will assist during the surgery:

• First, the specialist will give the patient instructions on how to position herself on the examination table, with the necessary posture being the same as for a conventional cytology.
• Next, the anaesthesiologist will apply sedation to the patient. In this type of procedure, only local or regional anaesthesia is used, never general anaesthesia.
• Once the patient is sedated, the specialist begins the extraction.
• He first introduces a needle via the transvaginal route, guided by an ultrasound scanner that allows him to visualise the inside of the pelvic cavity, to pass through the wall of the vagina and thus reach the ovaries.
• The follicles are then aspirated and the follicular fluid is collected in tubes, which are kept in order to preserve the fluid and then sent to the laboratory. 
• In most cases, there is a possibility that during the puncture, the fluid will come out red. This blood will be removed in the laboratory to facilitate fertilisation.
• Once all the follicular fluid has been extracted, the procedure is completed and the patient is awakened.

This procedure lasts approximately 15 minutes. After the puncture, the patient is transferred to a recovery room where she remains until she recovers from the anaesthesia.

The next phase of the in vitro treatment is insemination and fertilisation in the laboratory.

Fertilisation and embryo culture

After completing the extraction, the samples are taken to the laboratory where any blood that may have been extracted with the liquid and could affect the oocytes is first removed.

The eggs are then washed and sorted. This procedure is very important and requires precision, which is why it is necessary to contact the best possible medical and technological team, as is the case with the team of professionals that make up our collaborating clinics, which have professionals with more than 30 years of experience in assisted reproduction. 

After classification, the oocytes are left in a culture medium. While the oocytes are being prepared, the specialists begin to prepare the man's sperm sample in order to isolate the sperm to be used for fertilisation.

Two different forms of insemination can be carried out using the in vitro technique:

• In vitro fertilisation by microinjection (ICSI): in this approach, the eggs are fertilised by means of microinjections in which a sperm is introduced directly into each egg.

• Classical in vitro fertilisation (IVF): this technique consists of placing approximately 25,000 spermatozoa (previously treated and selected) in contact with each recovered oocyte using a suitable culture medium, and then incubating them at 37ºC until fertilisation occurs by itself.

In this case, the specialists will approach fertilisation through the ICSI technique, using sperm microinjections directly injected into the egg.

After insemination, it is necessary to wait a few hours or even a whole day to check how many eggs have been fertilised. The next step is the culture of the embryo.

Once fertilised, these eggs become pre-embryos for the next 5-6 days, during which the lab team will monitor them regularly to make sure they are growing properly and their cells are actively dividing.

The lab team will carry out this monitoring of the entire embryo culture, and then select the embryos that are most likely to be viable and increase the patient's chances of pregnancy. 

Once the embryos are ready, the embryo is transferred to the woman 3 to 5 days after the egg retrieval surgery, depending on the case of each patient.

Embryo transfer

Between three and five days after fertilisation, the last phase of the treatment is performed: the embryo transfer or introduction of the embryo into the uterus.

This process is performed on an outpatient basis and does not require anaesthesia. For this procedure, it is advisable for the patient to come with a full bladder to facilitate ultrasound visualisation.

The embryo transfer procedure is performed by the gynaecologist using a fine cannula that is inserted through the vagina until it reaches the end of the uterus. Through this catheter the embryos are channelled and placed in the uterus.

After implantation, the patient is always advised to rest for the rest of the day and resume her daily activities the following day. 

If one of these embryos implants in the lining of the uterus (endometrium) and begins to grow, the desired pregnancy occurs.

The remaining embryos are preserved in state-of-the-art banks designed to avoid cross-contamination. The cost of the treatment covers preservation for the first two years (but does not include freezing).

After completing the embryo transfer and implantation, the patient must follow the specific indications to favour the successful implantation of the embryo in the uterus.

After 12 to 14 days following the last phase of the in vitro treatment, the patient should visit the Clínica Ginefiv San Sebastián de los Reyes for a pregnancy test to check whether the treatment has been successful.

What happens if there are leftover embryos?

During the in vitro fertilisation process, a maximum of 2-3 embryos are implanted in the uterus, which is why there are always viable embryos left over. The patient can decide to preserve them by cryopreservation, in order to make use of them in a future in vitro process.

However, this cryopreservation treatment is not included in the fixed price of the treatment. 

When should I contact the doctor after IVF?

The patient has a series of control and revision consultations that the the Team of Ginefiv San Sebastián de los Reyes at the Clínica Ginefiv San Sebastián de los Reyes will indicate during the post-IVF treatment process. 

Despite these consultations, it is always recommended that if the patient notices any of the following situations at any time, she should see a doctor immediately: 

• Fever temperature higher than 38 ºC 
• Pain in the pelvic area
• Vaginal bleeding
• Blood in the urine

• Fixed, all-inclusive price: When you carry out your In Vitro Fertilisation Treatment with Operarme the advantages are many. Firstly, the price of the treatment is all-inclusive, which means that there are no surprises at the end. In addition, Operarme provides you with a medical service contract in which it guarantees the price and everything included in the in vitro fertilisation treatment.

• The best assisted reproduction team: All fertility and assisted reproduction treatments provided by Operarme throughout Spain are carried out by the specialised team of the best national clinics in Assisted Reproduction, with more than 30 years providing this service.

• Personalised attention: In addition to the personal, close and attentive treatment that couples will receive in the clinics where we provide the service, the couple will have a personal Operarme patient service advisor who will help them throughout the process.

• Hospital environment: Maximum security by guaranteeing that the entire process is carried out in a hospital environment, with the entire process being carried out in the main private hospitals in the provinces in which we work.

• Partial refund clause: Another important aspect of Operarme's medical services contract is the inclusion of a partial refund clause in the event that the couple, or due to medical advice, decides to interrupt the in vitro fertilisation process. The amount refunded will depend on the point in the process at which it is decided to stop. If you have any doubts about this, you can contact us through a contact form or by calling at +34 91 141 33 56.

• No waiting: the consultation with the the Team of Ginefiv San Sebastián de los Reyes through Operarme is free and immediate. In addition, when the couple decides to undergo In Vitro Fertilisation Treatment (IVF/ICSI) it begins immediately.

The cost of In Vitro Fertilisation (IVF) with ICSI technique in San Sebastián de los Reyes is 4.250 € being an all-inclusive fixed price.

The IVF + ICSI treatment includes: 

• First assessment consultation
• In Vitro treatment by microinjection (ICSI technique)
• Cycle controls during the treatment through ultrasound monitoring.
• Ovarian puncture with sedation
• 2 years of embryo maintenance, in case of cryopreservation.
• Pregnancy confirmation control

The price does not include the medication necessary for the stimulation and/or the rest of the phases of the process, the cryopreservation of the surplus embryos, or the complementary techniques to IVF that the specialist may recommend during the process.

However, as a patient of Operarme you will have preferential prices for any service related to In Vitro Fertilisation that is not included in the price.