In Vitro Fertilization

ABOUT I.V.F

In vitro fertilization or IVF is the most effective type of assisted reproductive technology (ART) to help women become pregnant.


HOW DOES IT WORK?

First, the injectable medicines are given to women. These medicines help the eggs in the ovaries to mature and get ready for fertilization. Then a fertility doctor takes the eggs out from the ovaries under anaesthesia and ultrasound guidance. Eggs retrieved are fertilized with sperm in a specialized embryology lab. After fertilization is done, the eggs develop into embryos. After 3-6 days, the doctor transfers the embryos back into the uterus. Pregnancy happens if any of the embryos implants in the uterus.


IVF has many steps involved. It may take one to a few months to complete the whole process.


WHAT'S THE PROCESS?

There are five basic steps in IVF and embryo transfer process:

1. Suppressing the natural menstrual cycle

The women receive a drug, usually in the form of an injection to suppress their natural menstrual cycle.


2. Superovulation

Fertility drugs containing the fertility hormone Follicle Stimulating Hormone (FSH) and/or Luteinizing Hormone (LH) are given to women. These medicines stimulate the ovaries to produce several eggs. Having several eggs available for IVF increase the chances of pregnancy. Vaginal ultrasound scans (TVS) are carried to monitor the follicular growth in ovaries.


3. Retrieving the eggs

Egg retrieval is done at the IVF clinic 34 to 36 hours after the final injection. The eggs are removed from the follicles under ultrasound guidance through a needle connected to a suction device. This process is repeated with each ovary. Donated or frozen eggs may also be used in cases with poor ovarian reserve.


4.Fertilisation and ICSI

For fertilisation, the eggs that have been collected are mixed with the male sperm in a laboratory petri dish and stored in a CO 2 incubator. Sometimes the sperm is directly injected into the egg in severe cases of male infertility. This is known as an Intracytoplasmic Sperm Injection (ICSI). Frozen sperm, which is retrieved through testicular biopsy (TESA/TESE/MESA) can be also used. This is believed to be as effective as fresh sperm in achieving a successful pregnancy. The Petri dishes are checked after 12-18 hours for fertilisation. Once this occurs the fertilized eggs are considered embryos.


5. Embryo transfer

Embryo transfer is done at the IVF clinic and usually takes place three to six days after egg retrieval. The transfer of the embryo is done using a thin catheter. It enters the womb through the vagina. If successful, an embryo will implant in the lining of the uterus. Fourteen days after embryo transfer, urine pregnancy test (UPT) or serum Beta HCG is done to confirm pregnancy.


What can be the side effects of IVF?

Like all other medications and medical procedures, IVF has some possible side effects.

    These include:
  • Breast tenderness: This occurs due to the high estrogen level in the body.
  • Mood swings: These are likely caused due to the changing levels of hormones, demands of motherhood or due to the reality of pregnancy ending in women.
  • Mild bloating: Bloating occurs due to the changes in hormonal levels which slows down the digestion leading to gas formation.
  • OHSS: In some rare cases ovaries respond to fertility medicine more than usual and this leads to ovarian hyperstimulation syndrome (OHSS) . In such cases, IVF cycles may need to be carried out in a segmented fashion.

If you experience any of the above, consult your doctor immediately.