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IN VITRO FERTILIZATION
What is IVF ?
IVF is a process wherein an egg cell is fertilized with a sperm cell outside of the human body. IVF involves everything from fertilization to culturing of human gametes (egg and sperm cells) in the IVF Lab. It is an umbrella term used for a wide range of services performed in the IVF lab. IVF is also a method of fertilization where sperm is placed in the close vicinity of eggs within a petridish.
The internet is flooded with queries like :
- What is IVF treatment ? or
- What is IVF procedure ?
- What is IVF Pregnancy ?
- What is Test Tube Baby procedure?
- How is IVF done ?
We are sure that there is no dearth of information on google that explains the procedure in details. In our attempt today, we will try to cover a brief history of the following:
- Why IVF is needed or who needs IVF ?
- What is the cost of IVF ?
- How IVF procedure done ?
- What is the success rate of IVF ?
In some other blog we also try and cover about how is IVF pregnancies different from natural pregnancies.
What is IVF treatment or IVF Procedure ?
IVF or In vitro (Vitro is Latin for glass) fertilization (IVF) is a form of assisted reproductive technology (ART) during which the process of fertilizing eggs with sperm is done outside of the human body. During the IVF procedure, the eggs are fertilized, and the resulting embryos are placed in the woman’s uterus, hoping for a successful pregnancy. The entire process of retrieving eggs from the human body, fertilizing them, and culturing it into an embryo is done within an IVF Lab of an IVF Clinic.
Since the function of the fallopian tube, which is to provide a site for fertilization and an environment suitable for the growth of the first few days of the fertilized zygote, is performed in an IVF lab, this process was also called the Test Tube Baby process. However, these days it is called IVF.
IVF Labs require state of the art equipment and good embryologists. Thankfully, our IVF centre in Indore is among the best in the city and is equipped with a high-end lab and excellent Embryologist.
What is Test Tube Baby Procedure ? Is it same as IVF ?
When is IVF procedure recommended ?
IVF is not the first line of infertility treatment for patients who suffer from fertility issues.
The first step of infertility workup for a couple includes a basic fertility screening test for both partners. Such tests are usually available in any IVF Clinic. in Indore. However, many IVF Centers in Indore outsource such fertility tests to other pathology or sonography center. Try to get the fertility test done at any standard IVF Center so that the reports are standard.
Our center is one of the best IVF centers in Indore regarding fertility testing, reporting on time, and IVF results. People have rated us one of the best IVF centers in Indore due to our past performance and the overall rating on Google and other channels.
For men, the basic fertility test is Semen Analysis or Semen test, often colloquially called Sperm Test. Semen Analysis is done at any IVF center to assess the sperm count or sperm concentration along with sperm motility and sperm morphology. If your city does not have any good IVF center or IVF Clinic, try to get the test done in a nearby city with a good IVF facility.
Main Fertility Test for Men:
The basic fertility test for men is Semen Analysis or Semen test often colloquially called Sperm Test.
Semen Analysis is done at any IVF center to assess the sperm count or sperm concentration along with sperm motility and sperm morphology.
If your city does not have any good IVF center or IVF Clinic, try to get the test done from a nearby city with good IVF facility.
Main Fertility Test for Women :
Baseline pelvic ultrasound, preferably transvaginal scan.
An ultrasound is performed to assess ovarian reserve status as well as uterine structure of the female. The findings of the USG will reveal if there are any visible uterine anomalies/defects.
Tubal Patency Test for Women
Some females will also be asked to get their tubal patency assessed using either HSG or diagnostic laparoscopy test.
Tubal Patency test is performed to assess if fallopian tubes are open or closed.
This test is usually not done in most IVF Clinics in Indore as it requires X-Ray machine. You may be asked to visit any Pathology lab with X-Ray facility for the test.
Diagnosis on basis of Test Results:
Once the infertility test results are out, IVF is suggested by the IVF specialist for the following causes of infertility:
- Damaged or blocked fallopian tubes (can be caused by Pelvic Inflammatory Disease or prior reproductive surgery or if tubes are tied previously – tubal ligation )
- Severe Endometriosis or mild to moderate Endometriosis not responding to IUI.
- Advanced reproductive age, as a time to conception, is critical and pregnancy rates with other therapies are low.
- Severe male factor infertility (sperm counts or sperm motility is low)-ICSI is recommended.
- Severe Asthenozoospermia – very poor motility of sperms leading to male infertility.
- Azoospermia – Nil Sperm report. IVF needs to be done with ICSI and TESA
- Unexplained fertility problem in which other modalities have not been successful, including multiple (3 to 4) cycles of IUI.
How is IVF Procedure done?
IVF treatment is not just one simple procedure, but a series of steps interlaced with each other and done over several weeks (usually 6 weeks). The steps involved in IVF treatment that are typically followed by IVF doctor are:
- STEP 1 – Stimulating the ovaries – Super Ovulation
- STEP 2 – Collecting the eggs – Egg Retrieval
- STEP 3 – Fertilization of eggs – Insemination and Fertilization
- STEP 4 – Embryo Culture
- STEP 5 – Embryo Transfer
STEP 1: STIMULATING THE OVARIES
Hormones (Fertility Drugs) are usually given by the IVF Specialist to stimulate the ovaries to produce more than the usual one egg per cycle. This is done to enable the collection of several eggs.
The development of the eggs is monitored by blood tests and Trans Vaginal Ultrasounds that ensure eggs are collected by at precisely the right time.
These drugs used to stimulate the ovaries are one of the main contributors to IVF Cost. There are many manufacturers of IVF drugs and it is not fair to compare one manufacturer to the other. However all standard companies produce high quality IVF injections and can be administered safely.
Our IVF center in Indore specialized in highly personalized stimulation protocols for the patient, depending on their medical history, age and previous IVF cycle results.
STEP 2: EGG RETRIEVAL
During the IVF Cycle, at the time of ovulation the eggs are collected in a process called Ovum PickUp or Egg Collection. An ultrasound probe is placed within the vagina while the woman is under light sedation. The ultrasound monitor shows where the follicles are within the ovaries.
The needle is connected to a suction device, which pulls the eggs and fluid out of each follicle, one at a time. The procedure is repeated for the other ovary. The woman may have some cramping after the procedure, but it usually goes away within a day.
If a woman does not or cannot produce any eggs, donated eggs may be used.
The Ovum Pickup if done by experienced and best IVF doctors, results in collecting of all the mature follicles within the ovary. This skill needs good amount of surgical acumen and practice. If done by inexperienced IVF specialist, it may lead to collection of less number of mature eggs and hence impact the IVF success rate. Try to locate an IVF specialist in Indore who has decent amount of experience in terms of IVF cycle as the skill of Ovum pick up gets better with practice.
STEP 3: INSEMINATION AND FERTILIZATION
On the day of egg collection, the male partner provides a sample of semen. As a precautionary measure a semen sample of the husband is taken at the onset of stimulation and Cryopreserved.
The best IVF center in Indore prefer to cryopreserve the husband’s sample before the day of OPU.
This safeguards the couple from any mishap in producing semen sample on day of OPU. In a standard IVF treatment, the semen and best quality eggs are placed together in an environmentally controlled chamber called the incubator. This process of mixing the egg and sperm is called insemination. The sperm usually enters (fertilizes) an egg a few hours after insemination.
STEP 5: EMBRYO TRANSFER
Once the embryos have grown to a predetermined size in the IVF Lab, one to a maximum of three embryo’s will be transferred back to the woman’s womb 3 – 5 days after egg retrieval and fertilization. During this procedure your IVF Doctor will pass a very fine plastic tube (catheter) through the cervix and into the uterine cavity under ultrasound guidance. Pregnancy results if an embryo implants in the lining of the womb and is able to grow successfully.
Embryo transfer is very similar to a Trans Vaginal Ultrasound, is generally painless and usually involves no anesthetic. More than one embryo may be placed into the womb at the same time, which can lead to twins, triplets, or more. The exact number of embryos transferred is a complex decision that depends on many factors, especially the woman’s age. It is best to have this discussion with your IVF specialist before the day of Embryo Transfer.
The best IVF clinic will most frequently transfer a single Blastocyst to a patient. There are many benefits of transferring a single blastocyst. Please read our blog to understand the process of Elective Single Embryo Transfer better.
Unused embryos may be frozen and implanted during a later Frozen Embryo Transfer Cycle or donated at the will of both partners at a later date.
Two weeks after the Embryo transfer, blood is taken and tested to determine if the woman is pregnant.
The blood test that is done to confirm pregnancy is called Quantitative Serum b-HCG test. Make sure that you get the quantitative test done that mentions the quantity of bHCG in blood.