- WHAT IS IVF?
The term In vitro fertilization, IVF, literally means fertilization “in glass” and refers to the process where a woman’s eggs are fertilized outside of her body in the laboratory. The resulting embryos are then transferred back into the uterus a few days later.
IVF is specifically recommended for women with absent, blocked or damaged fallopian tubes. It is also often used in cases of unexplained infertility, in some cases of male factor infertility and can be used in combination with ICSI (intracytoplasmic sperm injection) in cases of severe male factor infertility.
These steps are described more fully below:
- Stimulation of the ovaries to encourage development and maturation of the eggs
Under the care of a consultant gynecologist, the woman is given fertility medications to stimulate her ovaries to produce many follicles. Follicles are the small fluid filled structures which develop on the ovaries, each of which will hopefully contain an egg. The number and size of the developing follicles is measured by trans-vaginal ultrasound scans. The exact number of follicles which develop varies between patients, but the average is about 10. The final preparation for egg retrieval involves a hormone injection which mimics the natural trigger for ovulation. Egg retrieval will take place 35-36 hours after this injection.
- Retrieval of the Eggs
Egg retrieval is a minor theater procedure which is carried out on an outpatient basis under General anesthesia. The trans-vaginal ultrasound probe is used to visualize the ovaries and a needle attached to the probe is passed through the vaginal wall into the follicles. The fluid within each follicle is aspirated and then examined in the IVF laboratory for the presence of an egg. After identification, the eggs are washed and transferred into special culture medium in Petri dishes in an incubator.
- Fertilization of the eggs and culture of the embryos
While the egg retrieval is proceeding, the sperm is also prepared. A semen sample is provided by the male partner and, in the laboratory, a concentrated preparation of the best motile sperm is extracted from the semen sample. This sperm preparation (containing approximately 150,000-200,000 sperm) is added to the dishes containing the eggs, and they are incubated together overnight.
In some couples an alternative form of insemination is required called ICSI, which involves injecting a single sperm into each egg using a very fine needle, rather than mixing the eggs and sperm in a dish.
Irrespective of the method of insemination used, on the morning after egg retrieval, the eggs are examined to see which have fertilized.
Fertilized eggs (zygotes) are then routinely cultured in the IVF laboratory until day 5, at which time the best 1-2 embryos are selected and transferred back into the woman’s uterus. Any additional good embryos that are not transferred on either day 5 can be frozen.
- Embryo Transfer
Embryo transfer is a simple theatre procedure that does not routinely require anaesthesia. The embryos are placed into the uterine cavity by the doctor/IVF nurse by means of a fine catheter inserted through the cervix. The correct positioning of the embryos is confirmed by abdominal ultrasound, so the woman is required to have a full bladder for the procedure.
- WHO NEEDS IVF?
Previously IVF was used in conditions, such as tubal factor. IVF is also recommended if simpler treatment fails. Below is a list of common indications for IVF treatment.
- Fallopian Tube Damage / Tubal Factor
- Male Factor Infertility
- Age Related Infertility
- Unexplained Infertility
- WHAT ARE THE CHANCES OF SUCCESS?
Generally at good center all over the world average chance of success is 40%. Having this perspective may help you think about trying more than one cycle, and feel less discouraged if the first one doesn’t work to.
- HOW LONG THE TREATMENT TAKES?
One cycle of IVF takes between four weeks and six weeks to complete. The couple can expect to spend about half a day at the clinic for egg retrieval and fertilization procedures.
- STEP BY STEP IVF
- Preliminary checkup of husband & wife
- Baseline hormone levels of wife
- Drugs treatment (injections) to stimulate egg growth
- Ultrasound monitoring of treatment
- To measure the growths of follicles
- To adjust dose of drugs
- Prevent serious side effects (Ovarian Hyper Stimulation Syndrome)
- Monitoring is carried out:
- By trans-vaginal ultrasound scanning (TVS)
- By measure hormones in blood
- Egg pickup
- Semen collection & processing
- Review of eggs after 24 hours for fertilization and division
- Embryo transfer (ET)
- USE OF DONOR’S SPERM
We strictly use husband’s spermatozoa (male sperm) and Wife’s egg. Donor’s spermatozoa (male germs), egg and surrogacy facilities are not available in our clinic.