IVF (In Vitro Fertilization) in Tunisia

IVF (In vitro fertilization) treatment is one of the advanced approaches implemented by couples who are unable to conceive naturally. Difficulty in conceiving by intercourse may be due to several genetic or physiological anomaly. However, advanced measures in medical science have made it possible to conceive a healthy baby through artificial methods. The word, in vitro, means fertilization in a laboratory. The process had first been successful in the year 1977 and has henceforth been implemented all across the world.

What is IVF (In Vitro Fertilization)?

In the IVF (In Vitro Fertilization) treatment, ovum (eggs) from the mother and sperm from the father are collected and made to fertilize in a culture media, in the laboratory. The sperm and the ovum may also be collected from donors, in case one of the parents is unable to produce healthy gametes. After successful fertilization, the embryo is then transferred to the uterus of the mother, where it gets implanted on the endometrial lining. Multiple embryo transfer to the uterus may result in multiple pregnancies and result in the birth of more than one baby.

Factors Affecting the Cost of IVF

The cost of IVF treatment cost may vary from $10,000 to $15,000 per cycle. However, the cost thus mentioned does not include the price of medications required for the procedure. The cost of medication may vary from $1500 to $3000 and depends on the condition and requirement of the candidate. Besides, the key factors on which the cost of IVF treatment depend are:

  • Number of IVF cycles required for a successful pregnancy
  • The extent of treatment required
  • Type of medication required
  • Underlying, serious health issues, if any, should be monitored and treated
  • Healthcare facilities where the treatment is being sought from
  • Experience and proficiency of the medical practitioners involved
  • A country where the procedure is being implemented
  • Involvement of a donor
Treatment and Cost

60

Total Days
In Country

2 No. Travelers

1 Day in Hospital

59 Days Outside Hospital

Treatment cost starts from

USD 5200

Hospitals

About the IVF (In Vitro Fertilization)

The natural process of fertilization involves the conjugation of an egg and sperm inside the woman’s body. In-vitro-fertilization (IVF) is the procedure that involves the conception of an egg outside the body in a laboratory.  IVF comes under assisted reproductive technology (ART) that involves the use of advanced medical technology to help with pregnancy in the woman.

Which conditions may need IVF support?

  • Blocked Fallopian tubes
  • Endometriosis
  • Advanced age of a woman
  • Decreased sperm count
  • Failure of the treatment with fertility drugs

Types of IVF treatment

The different types of treatments available for IVF are:

  • Natural cycle IVF procedure: In this treatment, the fertility drugs are not administered. The egg released during the normal monthly cycle is collected and then fertilized.
  • Mild stimulation IVF procedure: The lower dose fertility drugs are administered and then the eggs are collected and fertilized.
  • In vitro maturation (IVM): The immature ovaries are collected and then allowed to mature in the laboratory.
  • Embryo transfer: The fertilized embryos are taken and transferred to the mother’s womb.
  • Blastocyst transfer: The embryos are cultured in the laboratory until blastocyst stage and then transferred to the mother’s womb.

IVF with Laser Assisted Hatching

Assisted hatching is a technique used in IVF where a gap or a hole is created on the outer shell of the embryo called zona pellucida before transferring the embryo into the mother’s womb. Before the implantation of the embryo, the developing embryo should “hatch” out of its outer shell (zona pellucida).

Sometimes the embryo is thick, which decreases its ability to hatch on its own. Making a hole or thinning the outer layer may help the embryos to hatch, which increases the chances of pregnancy. Pregnancy cannot occur unless the embryo hatches. Thus, assisted hatching IVF success rates are higher than simple IVF success rates.

Because of the use of additional technology, IVF with laser assisted hatching cost is higher than just IVF cost.

IVF with laser assisted hatching is recommended when:

  • The embryos do not have sufficient energy and nutrients to complete the hatching process
  • The woman is older than 37 years as they are more likely to have thick zona pellucida due to increased levels of follicle stimulating hormones
  • The candidate has had repeated IVF failure
  • The quality of the embryo is poor and demonstrated slow cell division and excessive fragmentation

It is performed by using infrared 1.48-μm diode laser. The technique does not cause any blastocyte damage. Laser assisted hatching has several advantages such as minimal handling of the embryo,  fast delivery, and exact control over the drilling of the hole.

It is performed before transferring the embryo into the mother’s womb on day 3, 5, or 6 after fertilization. An opening in the zona pellucida is created by drilling it with acidified tyrode’s solution.

The embryo is held firmly using holding pipette and a microneedle is applied on the area of zona pellucida. The microneedle is preloaded with Tyrode’s acid using mouth-controlled suction before each micromanipulation.

The acid is expelled over a small area of zona pellucida until it is breached. Suction is applied immediately after the breach of zona pellucida to prevent excess acid entering the embryo. The patients should be provided with antibiotics after implanting the embryo to reduce the risk of infections. 

IVF with Egg Donation

This procedure Is exactly the same as the usual IVF procedure with a difference that the egg used for fertilization comes from a different candidate than the one undergoing IVF. This procedure involves a process known as female egg donation in which a suitable candidate donates an egg for successful fertilization with the retrieved sperms.

The egg donation procedure is similar to how the eggs are retrieved from the womb of the future mother. The only difference is that during egg donation process, the ovaries of the donor are stimulated prior to the collection of suitable number of eggs from the ovaries. All the remaining stems in the donor egg IVF process are similar to the rest of the IVF procedure.

IVF with egg donation is mostly performed in the case of women who have insufficient number of eggs or whose eggs are compromised with respect to quality. The IVF specialist advices the woman to opt for donor eggs in case they believe that there are minimal chances of IVF success because of poor quality of her own eggs.

IVF with ICSI

Intracytoplasmatic sperm injection (ICSI) is an IVF variation in which the sperm is directly injected into the egg for fertilization. The resulting fertilized egg is placed in uterus of the woman. It is the most successful infertility treatment used to treat sperm-related conception problems in couples.

ICSI procedure does not require the sperm to penetrate the layers of the egg. It is highly useful to treat infertility problems in couples who suffer because the male partner’s sperms are either not able to get into the egg or are unable to fertilize the egg even when they are able to get through it.

During IVF with ICSI procedure, the eggs are extracted and held in one place with the help of a glass tool. A single sperm is injected into each egg using a small glass tube. The eggs are cultured and checked for fertilization overnight. The fully fertilized eggs are selected. A few fertilized eggs selected are placed in the uterus with the help of a catheter. The leftover embryos are preserved for future use.

While in simple IVF, the eggs and sperms are mixed together and allowed to fertilize naturally, in ICSI, a sperm is forced into the sperm for fertilization.

ICSI success rates largely depends on the quality of sperms used for fertilization. Overall, the success rate of ICSI is greater than any other technique used as a variation in the IVF procedure.

IVF with ICSI and Donor Sperms

IVF with ICSI is also performed when the sperms come from a suitable donor and not from the male partner of the female undergoing IVF procedure. ICSI IVF treatment is the same when conducted with donor sperms as it is with sperms that come from the male partner.

ICSI treatment involves the injection of a single sperm directly into the egg from the female partner or a donor. In the case of ICSI with donor sperms, a semen sample from a suitable donor is retrieved. The sperm sample is processed and viable and good quality sperms are extracted from for further procedure.

Next, the entire ICSI procedure is conducted in a similar manner. ICSI success rates are the same whether the sperm comes from a donor or the actual male partner. ICSI treatment cost is separate from the cost of IVF.

 

IVF with ICSI and Optical Spindle View

Optical spindle view is a specialized technique used at the time of IVF and ICSI. This technique helps the fertility specialists view the division of cells carefully to ensure that the entire process goes on smoothly.

The optical spindle view technique is used after the fusion of the eggs and the sperms is complete using ICSI as a part of the IVF procedure. The use of this technique helps ensure that the ICSI procedure is successful and that no DNA damage taken place around the site of injection of the sperm.

 

IVF with ICSI and Testicular Biopsy

Sometimes during IVF and ICSI, the fertility specialist may order a testicular biopsy to assess testicular function in the male partner before using his sperms. During testicular biopsy procedure, a small sample of tissue from just one or both the testicles is removed and examined under a microscope. The specialist confirms whether the male partner is fertile or not and accordingly donor sperms are arranged for IVF and ICSI.

 

How is IVF (In Vitro Fertilization) performed?

The steps through which IVF procedure occurs are:

Step 1: Over-stimulation of ovulation

Stimulation of the ovaries occurs with the administration of fertility drugs. The natural process involves the production of one egg per month, but the fertility drugs hyperstimulate the ovaries to produce more number of drugs.

Step 2: Retrieval of eggs

Removal of the eggs from the woman’s body is done through a minor surgery called follicular aspiration surgery. Pain medications are given to the woman and with the help of ultrasound, a thin needle attached to the suction pump is inserted into the vagina. The needle is directed towards the follicles containing eggs and suctions the fluid and the eggs.

Step 3: Insemination

The inactive cells from the semen are removed. The ovum and the sperms are incubated in the ratio of 1:75,000.

Step 4: Fertilization

The sperm enters the egg and fertilization takes place. If the sperm is found to be weak, then Intra-cytoplasmic sperm injection (ICSI) is performed which involves direct injection of sperm into the ovum.

Step 6: Culture of the embryo

After fertilization, the egg divides forming an embryo. The embryo rapidly divides within five days after fertilization.

Genetic diagnosis is performed after 3-4 days of fertilization to rule out the genetic disorders.

Step7: Transfer of the embryo

The embryos are transferred into the mother’s womb after 3-5 days of fertilization. This transfer is done with the help of a thin tube containing embryos. The tube is inserted through the vagina, cervix, and to the womb. Pregnancy is resulted if the embryo starts growing.

Recovery from IVF (In Vitro Fertilization)

Care to be taken after the procedure

  • You can perform your daily living activities from the next day.
  • Continue to take Progesterone pills for 8 to 12 weeks as decrease in progesterone levels may cause miscarriage.

If you have experience symptoms such as fever, pelvic pain, bleeding, and blood in urine, consult your physician immediately.

Patient Stories

Frequently Asked Questions

What is the health care infrastructure of Tunisia / Why should opt for Tunisia as a destination for your medical treatment?
Hospitals in Tunisia are developing and trying to meet the international standards of healthcare. Although there is a basic set up in most of the hospitals for treatment in Tunisia, one can still expect scope for improvement. The Ministry of Health, along with the Government of Tunisia is making effective changes for the healthcare sector. The private hospitals in Tunisia are also undergoing a robust change to provide effective healthcare and treatment in Tunisia.

Like most other countries, hospitals in Tunisia have a private and public healthcare system. Hospitals in Tunisia include three levels of care: primary, with a network of 81 clinics and 2091 basic health centers; secondary, with 109 district hospitals; and tertiary, with 33 regional hospitals and 24 modern CHUs, according to MoS figures.
What are the conditions of the hospitals in Tunisia? Are they JCI certified? What is the quality of the support staff in the hospitals?
The Joint Commission International (JCI) is a global leader in health care accreditation. JCI accreditation is considered a gold standard in worldwide health care. It provides the most skilled and experienced healthcare professionals in the medical industry, as evaluators of the rigorous international standards in healthcare quality and patient safety.
In Tunisia, there are no JCI accredited hospitals but 4 private hospitals are certified ISO and OHSAS (Occupational Health and Safety Assessment Series).
Are the doctors/surgeons in Tunisia of the best quality?
The hospitals in Tunisia have seen a constant change in terms of development and technology. Most doctors that are trained in the country understand the needs and requirements of people and are able to diagnose and treat them well. There are various surgeons that fly in from other countries as well to treat patients. This was brought about due to the economic reforms and various expats residing there. The varying levels of health organizations provide reasonable means of treatment for any patient. There are also trained paramedical and emergency service staff in this country.
What is the process for obtaining a medical visa in Tunisia?
Patients who wish to visit Tunisia for medical purposes must contact the Embassy of Tunisia in their home country. One is required to have a valid passport. Those applicants must submit their visa application forms in person together with the following documents:
  1. A duly completed application form with one picture (within a white background).
  2. Original biometric passport and one copy. Passports should have a validity of at least one year from the date of your visa application submission.
  3. Medical certificate stating the type of illness and the treatment to be carried out. This document has to be in English or Spanish language.
  4. Letter from the hospital in Tunisia stating the appointment date and whether the treatment expenses have been already paid in full.
  5. Proof of financial means which enable the applicant to meet life needs while in Tunisia (salary certificate if working, bank statement for the last six months, property deeds, commercial license, other sorts of income).
  6. Travel insurance.
  7. Proof of accommodation (hotel reservation, etc)
  8. Applicants are advised that ALL PASSPORTS HAVE TO REMAIN at the Embassy premises while the visa application is under process (between 10 and 15 days), and therefore cannot be retrieved unless very special and urgent circumstances might arise.
  9. The Embassy has the right to require from the applicant any document that it may deem relevant in order to resolve the visa file.
What support services does MediGence provide in Tunisia?
MediGence enables you to plan and manage your medical decisions better. These are some of our services offered:
  • Expert Opinion
    We help you seek an Expert Opinion on your diagnosis and treatment from an experienced team of doctors at MediGence and specialists from a reputable hospital.
  • Hospital Recommendation
    We recommend a hospital or a healthcare institution that is best suited for you, based on your ailment and its criticality.
  • 360-degree Hospital Review
    We give you a transparent and holistic view of the hospital and its infrastructure, accreditation, facilities, and expertise to give you confidence.
  • Doctor Validation and Communication
    We share a comprehensive profile of the treating doctor and also arrange a call to clear queries regarding treatment if needed.
  • Options to Choose From
    Based on your choice of destination and other preferences, we provide you multiple options with respect to hospitals and doctors to choose from.
  • 24X7 Patient Care Support
    A dedicated patient case manager stays in constant touch with you to help you at every step of the decision-making process and resolve queries that you may have.
  • Transparent Treatment Cost and Other Expenses
    We give a clear and accurate indication of the total cost of treatment including treatment, stay, meals, and other expenses.
  • Visa Assistance
    We provide and help prepare documentation for visa approval and coordinate with the embassy to expedite the visa process.
  • Accommodation Arrangements
    We propose to you a choice of accommodation based on your preference such as long stay, short stay, or luxury properties.
Which are the best cities in Tunisia for medical treatment?
Tunis is the largest country and capital of Tunisia. This country is located in the northern region of Africa and is the best city for treatment in Tunisia.

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