IVF and Fertility Treatment at Rambam Hospital
In 2017, the first child ever conceived with the help of in-vitro fertilization turned 39 years old.
What was a sensation at the time is today a routine medical procedure that allows thousands of couples worldwide to realize their dream of having a baby.
Every year, 15,000 cycles of IVF are performed in Israel, the highest percentage of IVF procedures per population in the world. This indicates Israel's serious attitude towards the problem of infertility.
The IVF clinic at Rambam Hospital employs the latest treatment protocols and pharmaceutical drugs and the most advanced equipment, and its high percentage of successful outcomes attracts thousands of couples from all over the world to Rambam.
The scope of the in-vitro fertilization clinic, which also encompasses a sperm bank, includes the diagnosis of various causes of both female and male reproductive dysfunction, as well as medical and surgical interventions aimed at eliminating pathologies that impede fertilization.
The following types of procedures are carried out at the IVF clinic:
- In-vitro fertilization
- Treatment of impaired sperm function
- Intracytoplasmic sperm injection (ICSI)
- Surgical interventions aimed at eliminating pathologies that impede fertilization
- Testicular biopsy
- Preimplantation genetic diagnosis (PGD)
- Preservation of female and male fertility prior to undergoing chemotherapy
- Egg and sperm donation
- Procedures related to surrogate motherhood
Notable achievements of the Rambam IVF clinic:
- Development of its own protocol for stimulation of ovulation, which completely avoids such side effects as ovarian hyperstimulation syndrome
- Achievement of the first successful pregnancies in Israel after preimplantation genetic diagnosis of embryos
- Implementation of the first successful fertilization in Israel within the framework of the surrogacy motherhood program
- Israel’s first-ever preservation of ovarian tissue by freezing before running a course of chemotherapy, in order to preserve fertility
The IVF procedure
The idea of extracorporeal (artificial) fertilization arose in the early 1970’s. The basis of the idea was the fertilization of an egg in the laboratory, outside the mother's body, and the subsequent transfer of the embryo into the uterine cavity. This medical technology was first implemented in 1977 by British specialists, which resulted in the 1978 birth of Louise Brown, the first person ever to be born as a result of artificial insemination.
Today, there are about 3 million children worldwide who were conceived through IVF.
According to estimates, 10 to 15 percent of couples who want to have a child face the problem of infertility.
These statistics include couples who are infertile due to existing diseases in one or both spouses, as well as couples whose cause of infertility is not evident.
"Ultimately, we manage to help in 90 percent of cases," says Professor Zeev Wiener, head of the obstetrics and gynecology department at the Rambam Medical Center.
The ICSI method
A group of Rambam's specialists made a breakthrough in the field of artificial insemination, using the technology of micromanipulation (ICSI - the introduction of the spermatozoon into the cytoplasm of the oocyte) for the very first time.
ICSI has been used in Israel to treat male infertility since the early 1990’s. The ICSI method allows fertilization to be performed despite pronounced male infertility (caused by a reduction in the quantity and quality of spermatozoa).
Spermatozoa for ICSI are obtained either surgically or via ejaculate. The embryologist then chooses the most viable spermatozoon according to mobility and appearance and, with the help of a microneedle, introduces it directly into the cytoplasm of a mature ovum.
Preimplantation genetic diagnosis (PGD)
The method of preimplantation genetic diagnosis (PGD) allows the analysis of a specific embryo for chromosomal or genetic abnormalities, and also makes it possible to determine its sex before placement in the uterine cavity.
This method is carried out within the framework of the IVF procedure and is recommended to couples who have a higher risk of conceiving a child with a hereditary disease.
To perform PGD, embryos consisting of 6-8 cells (3 days after fertilization) are required. At this stage of development, all cells of the embryo are equivalent and interchangeable; thus, extracting one of them for the purpose of examination does not affect the further development of the embryo.
Assisted hatching (pecking)
Assisted hatching is a micromanipulation procedure consisting of cutting the outer envelope of the embryo (the zone of the pellucida).
This technique is performed immediately before embryo transfer to the uterine cavity and increases the likelihood of implantation.
The procedure is recommended in cases of a thickened embryo envelope, as well as for women over 40 years of age.
Prevention of ovarian hyperstimulation syndrome
Ovarian hyperstimulation syndrome is one of the most common and dangerous complications of the IVF procedure. Normally, one, or, in rare cases, two eggs, ripen within a single cycle.
In the treatment of infertility, however, using IVF with the help of hormonal drugs stimulates the growth of a large number of follicles.
One of the most frequent side effects of these drugs is "excessive" stimulation - a significant increase in the size of the ovaries.
Fortunately, with the help of the latest developments in the field of pharmacology, as well as an individualized calculation of the dosage of drugs, Israeli doctors have managed to completely eliminate the likelihood of this complication.