Anusha Women & fertility center

IVF TREATMENT

In vitro fertilisation is also known as IVF. It is one of several techniques to help people with fertility problems, conceive a baby.

IVF process involves, carefully extracting an egg from the woman’s ovaries and fertilising it with a man’s sperm, in a laboratory setting.

After the successfull fertilization, asn egg is formed. This is called an embryo. This embryo is is then planted back into the woman’s womb to grow and develop into a baby.

This IVF process can be done with your eggs and your partner’s sperm; or eggs and sperm from other donors; based on the health of you and your partners’ eggs and sperms.

Who can have IVF?

International guidelines recommend that IVF should be an option to women, if you are not older than 43, and have been trying to conceive from regular unprotected sex for 2 years, or have tried 12 cycles of artifical insemination.

There have been successful cases of women older than 43, who have successfully conceived through IVF, but the probability of success rapidly goes down with age.

What happens during IVF

IVF involves 6 main stages:

Doctor’s control over your natural cycle. Your Doctor needs to have complete control over ovulation once your treatment cycle begins. So you will be put on medication to suppress your natural cycle of menstruation.

Super Ovulation:

You’ll be given fertility drugs – Follicle Stimulating Hormone that will begin a process called stimulation—or superovulation, These drugs will tell your body to produce more than just the normal one egg per month. The more the number of eggs your body produces, higher is your success of a successful fertilization later in the treatment.

Your doctor will conduct regular ultrasounds and blood tests during this phase, to monitor your ovaries and hormone levels. You may also be put on medication to help your eggs to mature.

Oocyte retrieval:

You may receive a hormone injection 24-36 hours before your eggs are scheduled to be picked up from your body.

Then, you’ll have a minor surgical procedure—called follicular aspiration—to remove the oocytes from the follicles in both ovaries.

Your doctor will use an ultrasound to insert a thin needle into each of your ovaries through your vagina. The needle has a suction device attached to it, that suctions out one egg at a time.

You may be given mild sedatives to decrease your discomfort. you may feel slight cramping for a day, after the procedure. After that, you will be completely normal

FERTILIZATION:

After the oocytes retreival, the oocytes and sperms are mixed in a special culture medium and left alone for fertilization to take place.

There are two methods of sperm fertilization.

The method of fertilization used depends on the sperm used. Provided normal sperm is available from the partner, about 50,000 to 100,000 motile sperm are placed into the dish containing the oocytes. This is called standard insemination.

On the other hand, if normal motile sperm are not available, the intracytoplasmic sperm injection (ICSI) technique is preferred. Here, single sperm are picked out using microneedles, and directly injected into the cytoplasm of the oocyte under a high-power microscope.

Sperm may be aspirated directly from the testicular tissue if they are absent in the sperm sample. Such sperm are always used via ICSI for fertilization in IVF because they are immature when retrieved.

intracytoplasmic sperm injection of human egg

After 16-20 hours the oocytes are examined for the success of fertilization. All the embryos formed at this stage are allowed to grow in a laboratory incubator for up to five days. At this stage they have become blastocysts.

Blastocysts are a ball of cells, much larger than the zygote, and which contain fluid. The better they expand, the higher their quality and the more chance there is that implantation will succeed.

Embryo transfer:

One or two embryos are delicately deposited into the uterus by means of a thin catheter. After this painless procedure, you can resume your normal activities.

Any embryos which are not transferred may then be cryopreserved. They may be used subsequently during a thawing cycle. Some data suggest that the pregnancy rates with cryopreserved embryos are equivalent to those with fresh transfer.

Pregnancy:

Sixteen days after egg cell puncture, a blood sample will confirm the onset of pregnancy. If the test is negative, continuation of the treatment will be discussed with you during a consultation.

Chances of IVF success:

The success rate of IVF depends on two main factors:

The age of the woman undergoing treatment
The cause of the infertility (if it’s known).

Younger women are more likely to have a successful pregnancy. IVF isn’t usually recommended for women over the age of 42 because the chances of a successful pregnancy are thought to be too low.

Between 2014 and 2016 the percentage of IVF treatments that resulted in a live birth was:

29% for women under 35
23% for women aged 35 to 37
15% for women aged 38 to 39
9% for women aged 40 to 42
3% for women aged 43 to 44
2% for women aged over 44

These figures are for women using their own eggs and their partner’s sperm, using the per embryo transferred measure.

Maintaining a healthy weight and avoiding alcohol, smoking and caffeine during treatment may improve your chances of having a baby with IVF.

What are the risks of IVF?

IVF doesn’t always result in pregnancy, and it can be both physically and emotionally demanding. You should be offered counselling to help you through the process.

There are also a number of health risks involved, including:

Side effects from the medications used during treatment
Multiple births (such as twins or triplets) – this can be dangerous for both the mother and the children
An ectopic pregnancy – where the embryo implants in the fallopian tubes, rather than in the womb
Ovarian hyperstimulation syndrome (OHSS) – where too many eggs develop in the ovaries