In Vitro Fertilization (IVF)
In-vitro means outside the body
In short, IVF or in-vitro fertilisation is a method where the eggs are removed from the ovaries to be fertilized in the laboratory. The eggs are then cultured for approximately 2 days and nights and then the fertilized egg(s) is transferred to the uterus for normal growth. To obtain the best possible results from the treatment, it is important that the patient producesa sufficient number of eggs and that her uterus is able to receive the fertilized egg. If the patient does not produce eggs herself, IVF can be performed with donor eggs. Beginning an IVF cycle is an exciting and anxious time for a couple. Our Center provides couples with the maximum amount of clinical, emotional, and administrative support they will need to complete their "cycle" successfully.
IVF step by step
Below you get a short overview of the steps of the IVF treatment:
Consultation with the doctor: Here we can make sure that you are well informed about your treatment. The couple is examined for causes of infertility. Down regulation: Medication is given which temporarily switches off the messages going from the brain to the ovaries telling them to produce an egg on monthly basis. This is called "down regulation". It also prevents premature release of the egg. The down regulation can be done using injections from day 21 of the previous cycle or day 1 of the IVF cycle. Recently new injections which are known as GNRH antagonist are being given which are usually started from 6 or 7 day of IVF cycle. To ensure that the medication is working, a blood sample is taken to check the level of estradiol and an ultrasound scan of the ovaries and womb is performed on day 3 of the IVF cycle.
Ovarian stimulation and Follicular Monitoring: Drugs called gonadotropins are given to stimulate the ovaries into producing follicles which contain eggs. Gonadortopin treatment last 1-2 weeks and involves a once daily subcutaneous or intra muscular injection usually from day 3 of the cycle. After 5 days of starting the gonadotrophins ovulation study is started with the help of transvaginal ultrasound. After that ultrasound may be performed every day or every 2 or 3 day of cycle. The length of treatment will depend on how your ovaries respond. Usually 10-11 days are required for follicles to mature. Once ultrasound shows that the lead follicle has matured in size HCG will be injected to trigger the release of the egg.
Egg retrieval and embryo observation: Approximately 36 hours after the HCG injection retrieval of the eggs is under taken. The procedure is performed at the centre by a transvaginal route. A needle, guided by ultrasound imaging, is inserted through the vagina into the ovaries, where the follicles containing the eggs are aspirated and the needle is then withdrawn. The eggs are transferred to the lab where their developmental stage is assessed. The procedures takes about 15-20 minutes and you can return home a few hours after it.
Lab procedure: A sperm specimen is then washed and prepared for insemination. Each egg is placed in a dish and a defined number of sperms are added. Each dish is placed in an incubator. The fertilization will be checked after 16-18 hours of insemination under a microscope.
Embryo transfer: If fertilization is successful the embryos can then be transferred to the uterus. The transfer technique is accomplished by placing one or a few embryos inside a narrow plastic tube, which is then placed into the uterus through the cervix under abdominal ultrasound guidance. The process lasts only a few minutes. You may then rest for a couple of hours and return home where you are advised to take it easy for 1-2 days.
After-treatments : You are given certain medication (progesterone) in the form of injection or vaginal pessary to prepare the endometrium to support the pregnancy. Pregnancy test: The pregnancy test is performed 12 days after the embryo transfer.
Results of IVF : Results in IVF depend upon the quality of medication, protocol used for ovulation induction, good quality equipment, high grade culture media, skillful lab work, high class disposables lab ware, needles and catheters.