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IVF stands for In-Vitro (glass) Fertilization. It is a fertility treatment and a laboratory process in which a woman ovum or ova (egg) is fertilized by male sperms. The fertilized egg is kept under control for a few days until it is transferred to the same or another woman’s uterus, with the purpose of establishing a successful pregnancy. Before moving the embryo to the womb, a geneticist who is skilled in this field is able to separate one of the cells and do a sex selection, then the conceived fetus is transferred to the mother’s womb.

Why IVF?

Due to medical problems, some couples face what is called female infertility. In some cases, infertility is caused by the male partner, where there is a defect in sperm quality or when sperm numbers are very low. By IVF, these couples will have the chance of having children and enjoy family life.

However, the success of an IVF surgery depends on factors such as the age of the wife, causes of infertility, whether hether the problem is on the part of the male or female partner, the embryo and also, individuals lifestyle. Nevertheless, with advances made today, the success of these surgeries has been highly increased.

babies coming out of eggs symbolizing fertility treatment

Intracytoplasmic sperm injection or ICSI

There are different ways in which the sperm can fertilize the ovum. For example, as sperms are introduced into a specific culture medium to allow motility, form, and physiology of the sperm to fertilize the ovum, this method is called IVF. But if the appropriate sperm is selected and inoculated into the ovum using a microinjection device, it is called Intracytoplasmic sperm injection or ICSI.

Risks involved in IVF

Although by sperm washing, the risk of transmission of chronic diseases from the male to the female and infection of the female uterus, could be lowered, yet in males with hepatitis B or HIV/AIDS, transmission of the disease to the fertilized egg or to the female could occur. This has caused some countries to force rules and take precautions for these types of surgery. This highlights the importance of pre-implantation diagnosis (PGD) and exams before going for a fertilization procedure.

IVF procedure

Egg removal is usually performed under a light anesthetic (sedative and analgesics). In general, eggs are removed before ovulation begins. To this end, a vaginal ultrasound scan is usually used. In this method, an ultrasound probe attached to a needle enters the vagina. The specialist uses ultrasound to inspect the ovaries and locate the follicles. The oocytes are then removed from the follicles through a needle attached to a suction device.

egg retrieval in IVF

If an anesthetic is performed, it is likely that the patient be asked to stop eating and drinking something about eight to ten hours before surgery, also not wearing any pieces of jewelry, makeup or nail polishing.

After extracting the egg, the patient may be prescribed to undertake Progesterone supplements in forms of oral pills, injections or vaginal suppositories. For this purpose, the uterus wall is ready to be implanted.

Post-operative embryo transfer and side effects

After embryo transfer operation, the woman can resume her daily activities. However, the ovaries may still be larger than usual. It is better avoiding intense activities.

Common side effects include:

  • Disposing of some clear or bloody fluid after a short period of operation, which is due to cleaning the cervix before embryo transfer.
  • Inflammation of breasts and their sensitivity if touched
  • Mild bloating
  • Constipation
  • mild muscle cramps

Patients should contact their physician if a severe or moderate pain occurs after surgery. Other factors such as infection, ovarian rotation, and excessive ovarian stimulation syndrome should be considered. A blood test should be performed about 10 to 14 days after embryo transfer

In general, the following instructions are advised:

  • Do not use bathtub or swim for 48 hours after embryo transfer
  • Avoid vaginal shower or tampon
  • Avoid sexual intercourse as long as the heartbeat of the fetus is seen via ultrasound.
  • Avoid intense physical activity such as running, aerobics or playing sport such as tennis
  • Avoid lifting heavy objects
  • take 24 hours of absolute rest in bed (other than getting up for a bath or having meals).
  • Two to three days after the operation, the patient would be able to travel. However, depending on patient’s situation, some doctors prescribe absolute rest following embryo transfer.
mother holding the little hand of her asleep baby

Fertility / IVF in Iran

Iran historically has been ahead in medicine and medical treatments. Iranian institutes are pioneer in conducting research in pregnancy and IVF.

Health centers in the capital city Tehran, as well as Esfahan, Shiraz, and Yazd have a long history in infertility treatment and research. These centers are well-equipped and ready to offer their services to needy patients.

In regard to IVF, health clinics in Iran such as Royan Fertility Clinic and Avicenna Fertility Clinic are well-known in the region with enormous research equipment and labs, providing patients with a variety of treatments and options.

IVF clinics in Iran

Services are including, gender selection, stem cell biology and technology, reproductive biomedicine, endocrinology & female fertility, embryology, reproductive genetics, epidemiology & reproductive health, reproductive imaging, etc.

IVF cost in Iran

Egg fertilization in the laboratory is costly. Costs are varied depending on medications advised, also vary depending on what treatment needs to be undertaken. The price will also vary from one clinic to another.

Main costs include pre-implantation diagnosis (PGD) costs and surgery and post-surgery cares. Some couples need an ovule or a donation that increases the cost of treatment. The cost of IVF in the UK is approximately around £5,000 per cycle of treatment or more. In some countries, the price will drastically increase. Nevertheless, the cost of IVF in Iran is sometimes 1/3 (or less) compared to institutes in the region or western countries.

Sex selection

Sex selection in IVF is a procedure aimed at assigning an embryo’s sex to help couples have a baby of the sex they like. Sex selection is often referred to as gender selection, which is incorrect. Some fertility clinics offer sex selection option to IVF candidates but as there are some considerations in this treatment, they also give the patients a thorough consultation before the procedure.

sex selection in Iran

There are two sex selection techniques in IVF, pre-implantation genetic diagnoses (PGD) and microsorting.

PGD Sex Selection

One of the main methods for sex selection is PGD. In an IVF cycle, many embryos are created and then the highest quality one is selected to be transferred to the woman’s uterus. PGD is typically aimed at preventing genetic defects in babies who are going to be born using IVF method but it can be also used to identify the baby’s sex thus creating the chance to implement the embryo with the sex the parents wish.  The success rate of PGD is almost 100%, that is to say, the chance that the baby would be born with the desired sex, while the chance of the birth of a baby in an IVF is around 30-35 percent.


Another sex selection method in IVF (as well as in IUI) is called microsorting or microsort. In this sperm sorting procedure, extracted sperms are sorted out one by one using a laser flow cytometer based on whether they contain X or Y chromosome. Microsorting is said to have a high success rate for girls (around 90%) and a lower rate for boys (75%).

Is sex selection safe?

PGD for sex selection is uncommon and it is mainly used for medical reasons to prevent the conception of embryos with genetic disorders. The reason is that although it prevents genetic diseases, it has some other risks for the baby and mother alike. In many countries including the UK, Australia and Canada, sex selection is illegal. Apart from medical reasons, the use of sex selection is controversial.

Sex selection in Iran

In Iran, artificial sex selection is offered by Iranian hospitals and fertility centers through PGD and microboring, but it is mostly recommended to those who already have children and want to have another child for family balancing.

Sex selection cost in Iran

Sex selection cost varies from country to country and clinic to clinic. The IVF is itself a costly procedure and the additional option of sex selection also adds a significant expense to the treatment. The average cost of a PGD in Iran is around $1,000 while Microsorting cost is approximately $700, which is added to the IVF cost.

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