IVF (In Vitro Fertilization)
Commonly known as “Test Tube Baby”, IVF is an advanced technique of artificial reproductive procedures. IVF means fertilisation and culture of an ovum (egg) outside the body and consequently transfer of the fertilised ovum (embryo) into the uterus of the women. IVF is probably the most widely practised assisted conception procedure In the world. The procedure usually does not need admission at any step & is conducted on outpatient basis.
The procedure is indicated for irreparably damaged or blocked fallopian tubes and when other modes of treatments has failed in conditions such as:
- Unexplained infertility.
- IUI failures.
- Ovulatory dysfunction.
- severe form of Sperm disorders.
- Immunological problems.
- recurrent pregnancy loss.
- couple with known genetic disorders that can be transmitted to the offspring.
- surgically obtained sperm ( TESA/TESE/PESA)
Steps involved in IVF procedure
Step 1 – preparatory phase
The couple is advised to undergo couple of blood tests ( hormonal and routine tests), vaginal scan and semen analysis to assess and detect the fertility potential and any pre-existing medical conditions that need treatment. The woman is prescribed medicine like antioxidants, hormonal drugs and other medicine as required 1 to 3 months before the actual ivy treatment cycle commences. In case of a long protocol for ovarian stimulation, the female partner is required to take daily agonist injections from day 22 to day 23 of the cycle just prior to the stimulation cycle.
▪ Step 2 – Controlled ovarian stimulation by hormonal injections
ovarian stimulation starts on the 2nd or 3rd day of menstrual cycle .A vaginal scan is performed to assess the uterus and follicle count in the ovaries and few hormonal blood tests are performed. Under favourable conditions,Ovarian stimulation is started by administering hormone injections like highly purified or Recombinant FSH, HMG or LH .
There are various stimulation protocols for ovarian stimulation namely Antagonist , Agonist ( Long or Short protocols),minimal stimulation IVF, and natural cycle IVF. After a thorough workup , the most suitable protocol for the woman is chosen by the doctor.
▪ Step 3 – monitoring of response to stimulation
The ovarian response to stimulation is monitored with the help of serial vaginal scans and hormone testing like E2 AND LH levels and the dose of hormones is adjusted accordingly. The stimulation period typically lasts between 7 to 15 days and varies from woman to woman.
• Step 4 – oocyte (Egg) retrieval or collection
Once the follicles reach appropriate size, a trigger injection ( HCG or AGONIST) is administered and the procedure of egg collection is scheduled after 35 to 36 hours later. The procedure is carried out under general anaesthesia under ultrasound guidance through the vaginal route with the help of a long pickup needle. The entire procedure takes around 15 to 30 minutes and the woman is usually discharged on the same day after a reasonable period of observation.
▪ Step 5 – IVF or ICSI AND EMBRYO CULTURE
IVF – The collected eggs and her husband’s processed sperms are mixed in a culture dish and are left for fertilisation in an incubator. Fertilization check is carried out at around
Transfer of the resulting embryo(s) into the uterus of the woman on D2/D5.
Blood test performed 15 days after embryo transfer to assess the establishment of pregnancy. If the treatment procedure is successful, one or more embryos will implant in the uterus and the pregnancy will result, Just as it happens in the natural process of conception. The specific stages involved in IVF treatment will be explained in detail to each individual who comes in for treatment at ‘Lush Fertility ’.
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