In Vitro Fertilization (IVF)

Life comes full cycle with In Vitro Fertilization

A complex series of procedures used to help with fertility issues and prevent genetic problems, and assist with the conception of a child, In vitro fertilization (IVF) collects mature eggs from ovaries, fertilized by sperms and retrieves them in a lab.

Then the fertilized egg (embryo) or eggs (embryos) are transferred to a uterus. A full cycle of IVF takes about three weeks, sometimes the steps are split into different parts and the process may take longer.

Why choose IVF?

One may go in for Intrauterine Insemination (IUI) in the following cases:

  • Tubal diseases like blocked or damaged tubes
  • Endometriosis
  • Unexplained infertility
  • Immunological problems
  • Male factor infertility
  • PCOD
In Vitro Fertilization (IVF)

Checklist for Patients

Choose nothing but the Best IVF Treatment in Chennai

  • Patients will be given hormone injections for superovulation. Each patient has their own way of responding to the treatment, meaning they are unlikely to respond in the same way as others. They also respond differently from one cycle to the other. Therefore, the dosage of hormone injections will be regulated for every patient.
  • The patients are advised not to compare the test results and medication plans with others with whom they may speak, as the treatment is individualized and may not be the same for everyone.
  • The schedule given here is only to guide the patients and to explain the treatment plan. Time changes and other adjustments will be frequently made in order to individualize each patient’s requirement according to their response.

Preliminary Investigations & Counseling

The Best IVF Counseling you could ever get

After choosing an IVF treatment, patients are advised to attend our hospital for preliminary investigations during the 18th – 21st day of their cycle for:

  • Ultrasound scanning of the uterus and ovaries
  • Basic preliminary blood investigations
  • Counseling

During this period, the patient is advised to work closely with the fertility specialist who will explain the treatment plan and the proposed medications, financial implications, etc. They may also stay in touch with the doctor for doubts and clarifications.

The patients are also advised to give consent forms separately for IVF, embryo freezing and micro manipulation before starting their IVF treatment.

The IVF / ICSI Treatment Plan

Planning for miracles is now just a breeze!

After initial counseling and preliminary investigations the patient will be asked to report to the hospital for starting the treatment. The patient will have to come between the 18th and 21st day of their cycle.

An ultrasound examination will be done to evaluate mid cycle development of the uterine lining and a trial embryo transfer to determine the direction and length of the uterine cavity.

The IVF/ICSI treatment involves the following stages:
  • Stage 1 : Follicle stimulating hormone injection is used to stimulate growth
  • Stage 2 : Stimulation to produce more eggs, which are removed from the ovaries.
  • Stage 3 : Eggs are transferred to the lab dish, where the sperm and eggs are combined.
  • Stage 4 : Good embryos are put into the uterus.
  • Stage 5 : Progesterone support is provided for 2 weeks.
  • Stage 6 : βhCG on Day 15
In Vitro Fertilization (IVF)

Superovulation

Hormonal drugs are given over a period of 10 to 12 days from Day 2 by Dr. Mala Raj. During this procedure, the growth of the ovarian follicles is assessed by means of ultrasound scanning. Blood samples are also drawn to measure the estrogen and LH levels. If estrogen and LH levels are not satisfactory and the follicular growth is not optimum, then treatment will be stopped.

During the process of superovulation, transvaginal ultrasound examination will be done. This procedure is not painful and the patient may experience some vaginal discharge as transmission gel is used on the vaginal probe. It is very important for patients to come to the hospital on time in the morning so that the lab results will be available for the doctor to review the results early in the afternoon.

By this the exact date and time will be determined for harvesting the eggs. When the ovarian follicles mature to the maximum size, the patient is given an HCG injection for maturing the eggs. Before ovulation takes place, the eggs will be retrieved.

  • Egg – Retrieval :
    Pre-Egg Retrieval Instructions - The patient should not eat anything seven hours prior to egg retrieval, since short general anaesthesia is administered for egg retrieval.
  • Recovery from anaesthesia is very fast and rapid. Nausea is very minimal. A vaginal probe is introduced into the vagina and the eggs are retrieved with a needle inserted through the vaginal wall under the guidance of ultrasound.
  • As soon as the patient arrives at the assigned time, they have to report to the doctor.
  • If the follicular growth and the hormonal levels are satisfactory (E2/LH), than HCG injection is given approximately 35 – 37 hours prior to the oocyte retrieval. The timings given to the patients should be strictly followed. The HCG injection ripens the developing eggs and initiates ovulation.
  • Two-day abstinence is needed before egg retrieval for getting a good quality semen sample for inseminating the oocytes.
  • The patient can go home after egg retrieval and attend to normal work.
  • The eggs are aspirated along with follicular fluid into a test tube and sent to the embryology lab for examination by an embryologist under a stereo zoom microscope. So, the quality of the oocytes is assessed (Maturity). The patient should contact the doctor if any of the following conditions occurs.
  • Fever higher than 100 degrees Fahrenheit.
  • Excessive vaginal bleeding.
  • Unusual and increasing pelvic area discomfort.
  • Difficulty in urination or change in bowel activity.
  • Nausea, vomiting or diarrhoea.
  • Sharp and shooting pains.
  • Pain or burning urination.
  • Abdominal swelling.
  • Unusual back pain.

Fertilization of Eggs

On the day of egg retrieval, the husband should provide semen sample through masturbation. The sperms will be separated from the seminal plasma and washed to inseminate the eggs. An optimum number of spermatozoa will be placed with each egg in a separate dish containing IVF media. In the case of ICSI, the sperm will be injected inside the egg.

The eggs and the sperms will be kept in a Co2 incubator at 37 degree Celsius. Normally it would take about 18 hours for fertilization. Later, the embryo divides into two cells and further into four and eight cells. After 48 hours of incubation, the embryos will be ready for transfer into the uterus.

Embryo Transfer

The patient will be informed about the time and date of embryo transfer. The embryo transfer is a simple procedure and no anaesthesia is used normally. The embryos are transferred with a catheter along with a few drops of culture media. The entire procedure takes about 10-20 minutes.

During the procedure, a speculum is introduced into the vagina and a catheter is passed into the cervical canal and the embryos are placed into the uterus. The embryologist then examines the catheter under a microscope to make sure that all the embryos were transferred. Following the embryo transfer, we keep the patient in the hospital for 24 hours for extra safety. At home, the patient has to take rest for the next 2 weeks, and should get up only to use the bathroom.

Following the transfer, some patients may experience a small quantity of blood like fluid or air from the vagina. The Progesterone tablets should be continued until the pregnancy test is done. These tablets should be introduced deeply into the vagina, for them to dissolve and for absorption to take place.

Post Transfer Guidelines:
  • Complete abstinence of intercourse till the pregnancy test is done
  • No jogging, aerobics, exercises or heavy physical activity
  • Avoid non-prescribed medications or other prescribed ones without the approval of the doctor
  • Try to keep yourself busy with books or music, so that you are mentally distracted from the tension of anxious waiting for 14 days.
  • The Progesterone tablets should be used through the vagina till confirmation of the pregnancy, followed by the blood test

Pregnancy Testing

A Quantitative ß HCG pregnancy test will be done after 14 days of embryo transfer. Blood will be drawn from patients between 8.30 am and 11.00 am and serum will be tested for HCG.

Most of the tests will either reveal positive or negative. However, in some patients we see a test that is weakly positive. Such results are usually seen in the following conditions.

  • Late but normal implantation of the embryo
  • Discontinuing the pregnancy
  • Ectopic pregnancy

In such cases, a second test will be carried out to determine whether or not the pregnancy is progressing. If the pregnancy is positive, usage of Progesterone tablets should be continued. After 14 days of pregnancy tests, ultrasound scanning will be done to determine the status of the pregnancy. Single or twin pregnancy, etc.

The IVF Procedure with the Highest Success Rates

Here are some factors influencing the success of IVF procedures.
  • Choose the best IVF treatment in the city
  • Treatment should be made available whenever there is a need
  • More than one egg must develop
  • Blood hormone levels should rise sufficiently. Eggs should mature
  • Premature ovulation should not occur
  • Aspiration of eggs should be successful
  • Sperms should fertilize more than one egg
  • The fertilized egg should divide and grow healthy for final implantation in the uterus
  • Ultimately a good egg and sperm will produce an embryo of good quality
What are the limitations of an IVF procedure?
  • In older women, poor quality eggs limit the success factor of an IVF treatment.
  • In such patients, the chances for pregnancy are poor
  • Men with a low sperm count
  • Women with a damaged uterus with poor chances of implantation of the embryo
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