The journey a couple faces when deciding to have a child through assisted fertilisation

CLINICAL PHASE

1First visit

Once the appointment has been made at the CMR, the couple will make an initial visit, during which there will initially be an interview with an expert in reproductive Medicine, before moving on to the initial examination.

This is a specialist gynaecological examination with a transvaginal ultrasound scan, which is immediately followed by a consultation for case analysis. If one already has recent examination results, it is always a good idea to bring them in so that the overall situation can be thoroughly assessed.

After a comprehensive evaluation of the patient's medical history, previous diagnostic examinations and any previous MAR treatments, the doctor explains the procedures, success rates, possible risks, and the details of the proposed course of action to the couple.

During the first visit, blood tests and instrumental tests are prescribed if appropriate.

2 Diagnostic procedure

In order to access the programme, the couple must perform the laboratory and instrumental tests that were prescribed during the first visit.

Depending on the outcome, further assessments may be requested if necessary, such as specialist consultations (andrological, genetic, endocrinological, psychological...).

The required assessments make it possible to determine the most appropriate MAR method and thus maximise the chances of a positive outcome for the couple.

3 Examination check and choice of MAR treatment procedure

Once the diagnostic process has been completed, the couple undergoes a check-up to evaluate the test results, and at this point a decision is made on the treatment plan to be followed, which may be constituted by:

– targeted intercourse on a spontaneous cycle or with mild hormonal stimulation.
– intrauterine insemination (Level I treatment)
– in-vitro fertilisation (level II treatment)

Afterwards, the natiure of the procedure as well as any risks are explained. After the couple's questions have been answered, they are asked to sign an informed consent form, which is also signed by the doctor who conducted the interview and the facility manager.

Finally, the appropriate customised treatment protocol to be carried out is illustrated.

4 Ovarian stimulation and monitoring

The first step of the treatment involves the customised pharmacological stimulation of multiovulation in accordance with the chosen procedure.

Ovarian stimulation, or multiple ovulation induction as it may be called, is aimed at obtaining more oocytes in order to increase the likelihood of pregnancy.

During the stimulation phase it is essential to monitor follicular growth, which is done by means of blood samples for hormone dosages and transvaginal ultrasound examinations. The purpose of the monitoring phase is to determine the best time to carry out intrauterine insemination (IUI), if the chosen treatment is level I, or an egg retrieval (Pick- Up) if the treatment is level II (IVF- ICSI).

OPERATIONAL PHASE

1stlevel (IUI)

In conjunction with ovulation, the male partner must collect semen, which is then processed in the laboratory and used for intrauterine insemination.

Approximately two weeks after insemination, the pregnancy test is carried out by checking for the β-HCG hormone in the blood, which is produced by the embryo once it has been implanted.

If positive, about three weeks later an ultrasound will follow to check for the presence of the gestational chamber. Once observed, the pregnancy will be continually monitored over the following months.

In the event of a negative outcome, the couple will still consult with the doctor to assess how to proceed.

2nd level (IVF/ICSI)

Once follicular maturity has been reached, the following steps are taken:

- gamete collection (oocyte pick-up and semen collection)
- semen treatment
- insemination and embryo culture
- embryo transfer and/or cryopreservation
- pregnancy test (B-HCG)14 days after Pick-Up
- final check following the outcome of the examination

If the couple has decided to carry out Preimplantation Genetic Testing (PGT), on the fifth/sixth day of embryo culture (blastocyst), a sample for analysis will be taken by biopsy from the embryos considered morphologically suitable.

After the biopsy, there are several further steps:

- cryopreservation of biopsied embryos and sending of the biopsy sample to the Genoma molecular genetics laboratory in Rome
- awaiting genetic analysis report
- thawing and transfer of the embryo found suitable for transfer
- pregnancy test (B-HCG) 9 days after transfer
- final check following the outcome of the examination

The couple's assisted fertilisation journey

When a couple turns to the CMR Centre, they are followed by a multidisciplinary team of professionals whose work is coordinated by Dr Maurizio Sodano, the director of the clinic. When embarking on IVF, one goes through a process consisting of several stages, which are as follows:

CLINICAL PHASE

1First visit

2 Diagnostic procedure

3 Examination check and choice of MAR treatment procedure

4 Ovarian stimulation and monitoring

OPERATIONAL PHASE

1stlevel (IUI)

2nd level (IVF/ICSI)

Here is the journey that a couple wishing to embark
on a MAR programme will face

CLINICAL PHASE

OPERATIONAL PHASE

The couple's assisted fertilisation journey

When a couple turns to the CMR Centre, they are followed by a multidisciplinary team of professionals whose work is coordinated by Dr Maurizio Sodano, the director of the clinic. When embarking on IVF, one goes through a process consisting of several stages, which are as follows:

CLINICAL PHASE

1First visit

2 Diagnostic procedure

3 Examination check and choice of MAR treatment procedure

4 Ovarian stimulation and monitoring

OPERATIONAL PHASE

1stlevel (IUI)

2nd level (IVF/ICSI)

Here is the journey that a couple wishing to embark on a MAR programme will face

CLINICAL PHASE

OPERATIONAL PHASE

Here is the journey that a couple wishing to embark
on a MAR programme will face