In vitro fertilization (IVF) is an assisted reproductive method which helps in fertilization, embryo development, and implantation, so that a woman can get pregnant.
How does IVF Work
The first step in IVF is taking fertility medications for several months to help your ovaries produce several eggs that are mature and ready for fertilization. This is called ovulation induction. You may get regular ultrasounds or blood tests to measure your hormone levels and keep track of your egg production.
Once your ovaries have produced enough mature eggs, your doctor removes the eggs from your body (this is called egg retrieval). Egg retrieval is a minor surgical procedure that’s done at your doctor’s office or at a fertility clinic.
You’ll get medicine to help you be relaxed and comfortable during the procedure. Using an ultrasound to see inside your body, the doctor puts a thin, hollow tube through your vagina and into the ovary and follicles that hold your eggs. The needle is connected to a suction device that gently pulls the eggs out of each follicle.
In a lab, your eggs are mixed with sperm cells from your partner or a donor — this is called insemination. The eggs and sperm are stored together in a special container, and fertilization happens. For sperm that have lower motility (don’t swim as well), they may be injected directly into the eggs to promote fertilization. As the cells in the fertilized eggs divide and become embryos, people who work at the lab monitor the progress.
About 3-5 days after the egg retrieval, 1 or more embryos are put into your uterus (this is called embryo transfer). The doctor slides a thin tube through your cervix into your uterus and inserts the embryo directly into your uterus through the tube.
Pregnancy happens if any of the embryos attach to the lining of your uterus. Embryo transfer is done at your doctor’s office or at a fertility clinic, and it’s usually not painful.
Plan on resting for the rest of the day after your embryo transfer. You can go back to your normal activities the next day. You may also take pills or get daily shots of a hormone called progesterone for the first 8-10 weeks after the embryo transfer. The hormones make it easier for the embryo to survive in your uterus.
IUI (Intra-uterine Insemination)
IUI is the process of placing processed semen sample containing motile sperms through the cervix into the uterine cavity around the time of ovulation. IUI is generally the first line of treatment when medication and timed intercourse does not succeed. It is recommended for patients with mild to moderate decrease in sperm count and/or motility, or if there is mild endometriosis. For women who do not ovulate regularly, ovulation induction maybe combined with IUI. Also, for some couples who don't have any apparent cause for infertility (unexplained infertility), IUI may be advised.
IVF (In Vitro Fertilization)
IVF refers to a procedure where the woman's eggs are removed from her ovaries and fertilized with the man's sperm in a laboratory. The embryos formed are then put back into the uterus to achieve a pregnancy. IVF was initially offered to patients with bilateral tubal block. Today, its indications include mild to moderate male factor infertility, couples who are unable to conceive after first and second line procedures like ovulation induction (OI) and intra-uterine insemination (IUI), patients with endometriosis, Polycystic Ovarian Syndrome (PCOS) who have not conceived with routine treatments and those with unexplained infertility. IVF is also the treatment option for couples requiring donor oocytes.
Intra Cytoplasmic Sperm Injection (ICSI)
ICSI is based on the insertion of a selected sperm into the oocyte, overcoming the limitations that conventional IVF faces with poor semen samples and deficiencies in the interaction between the gametes. Because of this, ICSI has become the most commonly used IVF technique. With the help of an advanced micromanipulation station (including microscope, microinjectors, and micropipettes) the sperm has to be individually selected and immobilised. During the microinjection, the oocyte has to be held while the sperm is inserted and released inside the inner part of the oocyte. The day after the microinjection, signs of proper fertilization will be checked in each oocyte.
Not all cases of childlessness arise due to problems with the woman. In many cases the reason for infertility is due to male infertility issues. Nova IVF Fertility offers comprehensive andrology services through its consultant andrologists and state-of-the-art andrology laboratory. This begins with evaluation of factors causing male infertility and male sexual problems. Andrology services include Semen analysis, Hormonal evaluation,Doppler ultrasound evaluation for varicocele,Treatment of anejaculation by vibrator or electro-ejaculator,Sperm function tests – DNA fragmentation, HOS test, Sperm viability testing—MACS (Magnetic Activated Cell Sorting),Surgical sperm retrieval by PESA/TESA/TESE/microdissection TESE, and Assessment and medical treatment for male sexual problems
Embryo adoption or donor embryo transfer
Some couples have a severe egg and sperm factor. If they have been unsuccessful with self-gametes or wish to opt for a donor egg and donor sperm for medical reasons, this can be offered to the couple and is rightly called embryo adoption or more commonly embryo donation (the latter term is actually a misnomer). In this procedure, a healthy anonymous donor’s eggs are fertilized with anonymous donor sperm from a sperm bank and one or two of resultant embryos are placed in the intending mother’s womb at an opportune time. This leads to a high pregnancy rate. However, it is essential for the couple to understand, grasp and accept the fact that resultant offspring will not be their genetic child but will be their biological child. It is a pre-requisite that the couples undergo thorough counseling and are mentally ready for this form of treatment.
In a conventional IVF treatment cycle, embryos are transferred to the uterus within 2 or 3 days of insemination. The term blastocyst culture refers to an embryo that is artificially developed in the laboratory instead of inside the woman’s womb. Blastocyst culture significantly increases the chances of pregnancy, especially in couples who have had repeated IVF failures. This is because most embryos transferred in conventional IVF may not have the quality to develop into a blastocyst in the womb. By carefully monitoring the embryo past its blastocyst stage, experts can pick the most viable ones and implant it in the womb. Also, the number of embryos transferred are lesser than in conventional IVF, thus reducing the risk of multiple pregnancies.