IN VITRO FERTILIZATION (IVF)

In IVF, the eggs and sperms are mixed in a laboratory to produce an embryo. The fertilization of egg can be done in two ways:

  • Traditional: More than 50,000 sperms are placed close to an egg in a laboratory dish. One of the sperm will enter the egg on its own and fertilize the egg to form an embryo.
  • Intracytoplasmic sperm injection (ICSI): due to certain reasons, the sperm may not be able to enter the egg on its own. Therefore, using a small needle, a single sperm is injected inside the egg. If fertilization occurs, an embryo is formed.

The embryo is allowed to grow in the lab for 1 to 5 days and is then placed in the woman’s uterus for implantation and successful pregnancy.

This is a ‘cycle’ treatment with several steps; One cycle of IVF can take 3 to 6 weeks. The doctor will conduct initial tests to assess if this is the right choice for you. The 4 steps of IVF are:

  • Ovarian stimulation
  • Egg and sperm removal
  • Fertilization
  • Embryo transfer

Ovarian Stimulation

This is also known as ovulation induction or superovulation.

Medicines are injected in the woman for 8 to 14 days to stimulate the ovaries to make more than one mature egg in 1 cycle (normally 1 egg is released during 1 ovulation cycle).

Your doctor will monitor the development of eggs through transvaginal ultrasound (TVS).

When the eggs are mature, a trigger shot of the hormone hCG is start the ovulation process. Eggs are removed 34 to 36 hours after the trigger shot.

Egg and Sperm Removal

The mature eggs from woman’s ovary are removed. An ultrasound probe is inserted into the vagina to see the ovaries and eggs, then a needle is inserted and suction is applied to remove the eggs from the ovaries.

This process is done under mild sedation and painkillers and usually takes up to 30 minutes.

Sperm is collected through ejaculation or via TESA/PESA procedure.

Fertilization

The egg is fertilized with the sperm in the laboratory. The eggs are placed in a dish along with the sperms and fertilization occurs on its own. Sometimes, the sperms are not able to fertilize the eggs on their own. In this case, intracytoplasmic sperm injection (ICSI) method is used in which 1 sperm is injected inside the egg

Embryo Transfer

After successful fertilization, embryo development takes 2 to 6 days. Best quality embryo is selected and transferred in the woman’s uterus in a doctor’s office. The embryo is injected into the woman’s uterus using a long, thin tube. The embryo should implant into the uterus lining on its own.

Either the implantation is timed with your natural ovulation cycle. Otherwise, the doctor may administer estrogen and progesterone injection to prepare the uterus for implantation.

The number of embryos transferred in the uterus depends on the age. Since the rate of implantation is lower in older women multiple embryos may be transferred. Consult with your doctor before the transfer procedure.

If more than one embryo is transferred, it can result in multiple pregnancy.

The medicines used for ovulation can cause mild pain, bloating, and nausea. This is called Ovarian hyper stimulation syndrome in which the ovaries become swollen and painful.

If multiple, good quality embryos are created, you can freeze them for use at a later stage.

The success of the treatment depends on the woman’s age and cause of infertility. In India, the chances of becoming pregnant with each IVF cycle is between 30% to 35% and can increase up to 40%. Remember, IVF is an invasive procedure that is time-consuming and expensive. Consult your doctor to figure out if this is the right choice for you.

In the end, do not lose hope. With the new and advanced technologies there are many treatment options for infertility. Consult with your doctor to choose the one that best suits you.

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