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Overview

In Vitro Fertilization (IVF) is a process of fertilization where an egg is combined with sperm outside the body, in vitro ("in glass"). The process involves monitoring and stimulating a woman's ovulatory process, removing an ovum or ova (egg or eggs) from the woman's ovaries and letting sperm fertilize them in a liquid in a laboratory. After the fertilized egg (zygote) undergoes embryo culture for 2–6 days, it is implanted in the same or another woman's uterus, with the intention of establishing a successful pregnancy.

Starting the IVF treatment process can be an exciting and nerve-wracking experience. Usually, IVF is pursued only after other fertility treatments have failed. You may have been trying to conceive for months or, more likely, for years and years.

But this is not always the case. Sometimes, IVF is the very first treatment tried.

Indications of IVF

Infertility issues for which IVF may be necessary include:

  • Reduced fertility in women over the age of 40
  • Blocked or damaged fallopian tubes
  • Reduced ovarian function
  • Endometriosis
  • Uterine fibroids
  • Male infertility, such as low sperm count or abnormalities in sperm shape
  • Unexplained infertility

Parents may also choose IVF if they run the risk of passing a genetic disorder on to their offspring. A medical lab can test the embryos for genetic abnormalities. Then, a doctor only implants embryos without genetic defects.

Sign & Symptoms

Investigation & Diagnosis

Investigation (For Women)

  • Hormone testing to assess levels of Estrogen, Follicle Stimulating Hormone (FSH), Anti-Müllerian Hormone (AMH), Luteinizing Hormone (LH), Progesterone, Androgens (male hormones), Thyroid Stimulating Hormone (TSH) and Prolactin
  • Transvaginal ultrasound to assess the health of your ovaries, fallopian tubes and uterus – helps your doctor check for ovarian cysts, determine the quantity of eggs in your ovaries, and the health of the uterine lining (endometrium)
  • Hysterosalpingogram (HSG) to check for blockage in the fallopian tubes and to rule out polyps or fibroids
  • Regular pre-pregnancy blood tests for sexually transmitted infections, HIV, Rubella, Hepatitis B, Hepatitis C and Chickenpox
  • Haemogram or Complete Blood Count (CBC)

Investigation (For men)

  • Semen analysis to assess sperm count, sperm motility (the ability of sperm to swim through the female reproductive system) and morphology (sperm shape), and to check for the presence of anti-sperm antibodies
  • Physical examination of the reproductive organs by an experienced urologist to rule out any physical abnormality, inflammation, etc.
  • Hormone testing to assess blood levels of Testosterone, Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH)
  • Ultrasound or X-ray to identify a suspected physical blockage indicated by the semen analysis
  • Reactive Oxygen Species (ROS) test to detect the presence of free radicals in the sperm

Preliminary testing is significant in helping your doctor devise a personalised treatment plan best suited for your condition.


Treatment Modalities

There are five steps involved in IVF:

  • Stimulation
  • Egg retrieval
  • Insemination
  • Embryo culture
  • Transfer

Stimulation

A woman normally produces one egg during each menstrual cycle. However, IVF requires multiple eggs. Using multiple eggs increases the chances of developing a viable embryo. You’ll receive fertility drugs to increase the number of eggs your body produces. During this time, your doctor will perform regular blood tests and ultrasounds to monitor the production of eggs and to let your doctor know when to retrieve them.

Egg Retrieval

Egg retrieval is known as follicular aspiration. It’s a surgical procedure performed with anesthesia. Your doctor will use an ultrasound wand to guide a needle through your vagina, into your ovary, and into an egg-containing follicle. The needle will suction eggs and fluid out of each follicle.

Insemination

The male partner will now need to give a semen sample. A technician will mix the sperm with the eggs in a petri dish. If that doesn’t produce embryos, your doctor may decide to use ICSI.

Embryo Culture

Your doctor will monitor the fertilized eggs to ensure that they’re dividing and developing. The embryos may undergo testing for genetic conditions at this time.

Transfer

When the embryos are big enough, they can be implanted. This normally occurs three to five days after fertilization. Implantation involves inserting a thin tube called a catheter inserted into your vagina, past your cervix, and into your uterus. Your doctor then releases the embryo into your uterus.

Pregnancy occurs when the embryo implants itself in the uterine wall. This can take 6 to 10 days. A blood test will determine if you’re pregnant.

Side effects of IVF

Like all medications and medical procedures, IVF has some risks and possible side effects. These include:

  • Bloating
  • Cramping
  • Breast tenderness
  • Mood swings
  • Headaches
  • Bruising from shots
  • Allergic reaction to medicines
  • Bleeding
  • Infection

IVF can also be difficult emotionally, both for the person having the procedures and for their partner and/or family. Many people doing IVF treatments struggle with depression and anxiety throughout the process.

Talking with people who’ve been through fertility struggles and IVF can be really helpful if you’re feeling overwhelmed or discouraged. Online and in-person communities are also good places to meet people who understand what you’re going through and can offer advice and support. Counselors and therapists can also be sources of comfort.

Procedure & Advantage

In Vitro Fertilization (IVF) is the most commonly implemented Assisted Reproductive Technology (ART), and has helped thousands to realize their dreams of parenthood. The clearest advantage of IVF treatment is that it provides previously infertile couples the opportunity to conceive children of their own, but there are many additional IVF benefits. The doctors at the Fertility Institute can help you understand the procedure and decide if it is the right treatment for you. If you have been having trouble trying to conceive and would like to find a safe and effective treatment that can help you achieve your goal.

Providing Hope for Women and Couples

IVF can provide hope for patients facing many different causes of infertility. Women with damage or blockages in their fallopian tubes have very low chances of becoming pregnant without fertility treatment, but IVF can circumvent this issue.

Men who have a low sperm count or issues with sperm motility may have difficulty fertilizing their partner's eggs. Because the fertilization step takes place outside the body during IVF treatment, it provides a solution that bypasses the need for the male's sperm to navigate the woman's reproductive tract.

The Ability to Choose the Healthier Embryos

For couples who are concerned about passing on genetic disorders or chromosomal abnormalities to their children, IVF allows for Pre-implantation Genetic Screening (PGS). PGS tests the health of the fertilized embryo by sequencing the DNA to determine if an abnormal chromosome is present.

The Highest Success Rates

One cycle of IVF with one embryo transferred and one additional cycle of one frozen embryo transfer has the added effect of having the highest success rate with the lowest multiple birth rate of any ART treatment. IVF may not work for everyone, but the cycle can be repeated to ensure that the procedure is being performed under optimal conditions.

Frequently asked questions

How long does IVF take?

The in vitro fertilization process can last anywhere from four to six weeks prior to egg retrieval. The embryo(s) will then be implanted between two to five days afterwards. Not all patients are successful on their first IVF attempt; in fact, it’s not uncommon for patients to go through multiple IVF cycles before finally becoming pregnant.

Why the Procedure is performed?

IVF is done to help a woman become pregnant. It is used to treat many causes of infertility, including: Advanced age of the woman (advanced maternal age) Damaged or blocked Fallopian tubes.

For how long one can freeze the embryos?

As long as 10 yrs. The results are not affected by the duration of freezing.

If I’m not pregnant, when can we try again?

Normally, patients are asked to wait for one or two full menstrual cycles before resuming another IVF cycle. Certain additional tests may be needed that could delay subsequent IVF cycles.

Am I a candidate for IVF?

There are a number of factors involved in determining if a patient is suitable for IVF treatment. Appropriate candidates often include couples who may experience:

  • Low sperm counts
  • Endometriosis
  • Problems with the uterus or fallopian tubes
  • Ovulation disorders
  • Sperm unable to penetrate or survive in the cervical mucus
  • Other health or unexplained reproductive issues

What Are the Complications Associated with In Vitro Fertilization?

As with any medical procedure, there are risks associated with IVF. Complications include:

  • multiple pregnancies, which increases the risk of low birth weight and premature birth
  • miscarriage (pregnancy loss)
  • ectopic pregnancy (when the eggs implant outside the uterus)
  • Ovarian Hyper Stimulation Syndrome (OHSS), a rare condition involving an excess of fluid in the abdomen and chest
  • Bleeding, infection, or damage to the bowels or bladder (rare).
Is it painful?

In most of the cases, it’s painless.

Is it ultrasound guided process?

Usually not, but in selected cases, like history of difficult transfers, patient request.

Do I need to take leave from work after the procedure?

You may commence work the very same day.

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