IVF – In Vitro Fertilization

Overview:

IVF is one of the most commonly used fertility treatments that have been around for more than 30 years now. In this process, the eggs are taken out from the ovaries and intermingled with sperms in a culture dish. Since the first launch of this technique in 1978, hundreds and thousands of babies have been born using this technique. It was introduced for the treatment of women with blocked or damaged fallopian tubes. The term “in vitro” meaning “in glass” is used for the biological experiments that take place outside of the human body. In vitro fertilization, as the name suggests, fertilization takes place in a dish.

History:

Babies born using this method have always been called “test tube babies”. Louise Brown was the first successful baby born in 1978 as a result of In Vitro Fertilization treatment. The physiologist Robert G. Edwards was given the Nobel Prize in Medicine/Physiology in 2010 for IVF research. Robert G. Edwards showed that women who are in the menopausal state and can’t get pregnant can still conceive with the help of IVF and egg donation. A case has been recorded of the oldest women, Adriana Iliescu, who gave birth to a child at the age of 66 in 2004 using the In Vitro Fertilization technique.

ICSI, the intra-cytoplasmic sperm injection, was another important milestone achieved in IVF by Gianpiero D. Palermo et al. This method helps men with minimal sperm count get the best out IVF technique to have a baby. Men with Klinefelter’s syndrome or infertile have been able to fertilize the eggs using this technique. Therefore, In Vitro Fertilization has become the ultimate solution for almost every fertility problem.

Who might benefit from IVF?

You might benefit from IVF if you have following fertility problems:

  1. Women with blocked or damaged fallopian tubes can use this method to conceive,
  2. Men having minor problem with sperm are likely to benefit from IVF. However, major problems can be better treated with ICSI,
  3. If you have been unsuccessful with other fertility drugs, like clomiphene,
  4. If you have been trying for past 2 years and haven’t been successful, and the problem is still unknown,

IVF process:

IVF has helped many couples around the world to fulfill their dreams of becoming parents. The process involves joining the egg and sperm together in a laboratory where embryos are built which are then placed back into the woman’s uterus.

In Vitro Fertilization can be categorized into five stages starting from initial IVF consultation through the pregnancy test understanding the procedure better. Whether you are just planning for IVF or already a patient seeking IVF services, knowing more about this method and stages can prove to be very helpful in your journey.

Fertility drugs:

As a first stage, you are given some fertility drugs to control your natural menstrual cycle, or to excite your ovaries to evolve more mature eggs ready for fertilization. Women produce one egg per month during normal menstrual cycle. However, with the help of fertility drugs your body produces more mature eggs, and thus your chances of getting pregnant get better with more eggs. This fertility drug treatment lasts for about two weeks.

Hormone Injections:

Once your natural menstrual cycle has been controlled, you will then be provided with a daily hormone injection known as a gonadotrophin. These excite your ovaries to produce a larger number of mature eggs than normal.

Different women respond differently to these hormones, and they might have strong side-effects. Our doctors are aware of this fact, and thus closely examine you to ensure that you are treated if this ever happens.

To track the number of mature eggs released by your ovary, blood hormone tests and ultrasound scans are offered. These tests are simply to keep a track of your mature eggs.

Sperm collection and egg acquisition

Ultrasound is used to check whether or not your eggs are ready to be acquired. If they are ready, a hollow needle connected to ultrasound probe is inserted to acquire the eggs from the follicles of your ovary. The acquisition might cause moderate discomfort, or you may even experience a little bleeding from the vagina. A proper medication will be prescribed in the form of gel, injection, or pessaries to assist and prepare your womb for embryo transfer.

Your partner will be asked to give a fresh sample of semen. The egg is then combined with the sperm in vitro (a test tube or a culture dish) and left to fertilize.

Fertilizing the Eggs and Embryo Transfer:

After a day of combining the sperm and egg, the dish is checked for any signs of fertilization. Eggs that have been fertilized are kept in the laboratory for between two and six days. The embryologist keeps a check on the development of the eggs and chooses the best one for transfer. Any more embryos eligible for embryo transfer can be stored for future use.

There are certain clinics that offer a CCS (comprehensive chromosome screening), a pre-implantation test. This monitors embryos before they are moved to the blastocyst stage. Embryos that have a full set of chromosomes are chosen.

By now your doctor should be giving you progesterone that thickens the lining of the womb and prepares it for embryo transfer. If the lining of your womb is too thin, your IVF cycle is likely to be abandoned. Otherwise, one or two embryos are moved into the uterus with the help of a thin tube (catheter). Not more than three embryos are moved due to the danger associated with multiple births.

Repeated IVF cycles:

In case the first IVF cycle is unsuccessful, or you want a second child, the extra embryo that was frozen for future use is used for the subsequent cycle. Many clinics provide blastocyst transfer to almost every patient depending on the number of qualitative embryos available.

However, certain clinics provide blastocyst transfer only if:

  1. you are 40 or under 40
  2. you’ve had normal In Vitro Fertilization treatment with healthy embryos, but embryos could not be implanted
  3. you have chosen eSet

 

Once you have had a successful embryo transfer using IVF, you must have an ultrasound scan at about six weeks. This scan is required to analyze that the embryo has successfully been embedded in your uterus.

Length of IVF treatment:

One cycle of IVF takes about four to six weeks to complete. A couple has to spend about a day at the clinic for egg acquisition and fertilization process. You then have to wait for another two to five days for your embryo to develop and be inserted into your uterus. However, you can go back home on the very same day.

Success rate:

The result of IVF treatment varies significantly depending on the couples’ age and fertility problems. Younger couples normally have healthier and mature eggs, and thus have greater success rates. On an average, a woman under 40 has 35% chance of conceiving a baby and a 28% chance of delivering a healthy baby.