In Vitro Fertilization (IVF)
IVF is an option if your initial fertility treatments fail. Here are the step-by-step procedures involved in an IVF treatment and what you need to know before you decide on using IVF.
What is In Vitro fertilization (IVF)?
IVF or “test-tube baby” is where the processed sperm is mixed with the eggs in a Petri dish in a laboratory and after a few days a fertilized embryo is transferred back into the womb(Uterus).
The first test tube baby was born in 1978 and since then thousands of babies have been conceived worldwide.
Who will benefit from IVF treatment?
- Couples with unexplained infertility
- Couples with Male factor infertility-low sperm count
- Women with bilateral tubal blockage or tubal surgery
- Women with severe Endometriosis/PCOS
What is the procedure in IVF?
The main procedure in IVF treatment is to stimulate the ovaries with drugs (hormones) to produce multiple eggs (follicles).
These eggs, when matured, are retrieved in the operating theatre and mixed with processed sperm in the IVF lab to produce embryos (babies). After a few days (3-5), the fertilised embryos are transferred back into the uterus. Pregnancy test is done in 2 weeks to ascertain the success of the treatment.
What to expect during IVF treatment?
Step by Step:
- Initial Visit: Ultrasound and blood tests are done to determine the number and quality of the eggs available. Following which a treatment protocol (long or short) is discussed with you and your husband, including the financial aspect as well as the psychological aspect of the IVF treatment.
- Stimulation of Eggs: To stimulate the ovaries to produce as many follicles (eggs) as possible, the woman will be given daily hormonal injections (sometimes 2 or 3) for about 12-14 days.
These injections are administered either by yourself or your husband in the your thigh or over the stomach region. During these period, you will need to visit the doctor about 4 to 5 times for blood test and ultrasound monitoring to assess the development of the eggs. The ultrasound monitoring is usually done vaginally to assess the uterine lining as well as the number and size of the eggs.
When the follicles (eggs) reach 18mm size or more and the uterine lining is thick (7-8mm), another injection( HCG), is given for the final maturation process of the follicles (eggs).
These matured follicles are then ready for collection and fertilization after 36 hours.
- Collection of Eggs: Egg collection is usually preformed after 36 hours after the HCG injection. These eggs are collected vaginally, under ultrasound guidance, in the operating theatre, under either sedation or general anaesthesia.
A needle attached to the vaginal probe of the ultrasound is inserted through the vagina, into the ovaries to aspirate the follicles (eggs). The aspirated fluid containing the follicles (eggs) are then handed over to the embryologist/scientist for assessment.Trans-vaginal collection of the eggs is a relatively safe procedure and takes about 30 minutes. It is usually done as a day care procedure.
- Semen Collection: The husband is expected to produce fresh semen on the same day as the eggs are collected.
- Fertilization: The eggs and the processed sperm are mixed in a cultured medium and placed in a Petri dish in an incubator in the IVF Lab. The dish is checked daily by the embryologist for fertilization and maturation of the embryos. Depending on the number of embryos available and the age of the patient, the best embryos are transferred after 3-5 days.
- Embryo transfer: It is usually done in the IVF lab, where the embryologist loads the embryos on to a catheter and the doctor gently introduces the catheter through the vagina into the uterine cavity under ultrasound guidance, and deposits the embryos. The patient is also given some progesterone supplements to support the implantation.
- Pregnancy Test: Blood test to assess the successful outcome of the IVF procedure is done 2 weeks (14 days) after the egg collection.
Consultant Obstetrician & Gynaecologist