IVF is a type of artificial reproductive technique. It stands for In Vitro Fertilisation. It is a step ahead of IUI. In this procedure, the eggs are grown using various medications and once they reach suitable size, they are drawn out of the woman. At the same time, semen is obtained from the male partner. The egg and sperm are made to meet up outside in the Lab and the fertilised egg called as the embryo is put inside the woman for further growth.
Couples who have previously tried IUI and have not attained successful pregnancy, couples with tubal blockages, male partners with low sperm count, male partners with low sperm motility, couples with unexplained infertility (no particular reason for not conceiving) who have not achieved pregnancy with other methods, female partners with severe endometriosis, female partners with difficulty in achieving ovulation are some of the cases where IVF helps.
ICSI is Intracytoplasmic Insemination. In this procedure, the sperm is caught in a special devise and injected inside the egg using special instruments in a Lab. This procedure is useful in couples with previous failure to attain fertilization using just IVF procedure. It is also useful in cases where there is extremely low sperm count or extremely low motility.
ICSI differs from IVF, in IVF the retrieved egg is surrounded by thousands of sperms in a petri dish and they fertilise on their own by the sperm entering the egg; while in ICSI, the single sperm is injected in the egg using various micro manipulative instruments.
Pre IVF workup includes making sure that both the partners are in the best of their health in order to maximise the chance of a successful pregnancy. It includes checking various hormone levels like TSH and prolactin and haemoglobin levels in the female partner, checking the uterus (womb) and ovaries of female partner by ultrasound, checking semen sample of male partner. In certain cases if we feel that the inside of uterus needs to be checked, only in those cases we advise pre IVF Hysteroscopy.
The process of IVF needs a thorough counselling which is done at Ankoor IVF clinic. After doing a pre IVF workup, injections are started from 2nd to 3rd day of menstrual cycle in the female partner and the growth of eggs is checked at regular intervals through an ultrasound. Meanwhile a semen sample of male partner is obtained and frozen and kept for backup in case he is not able to provide semen sample on the day of egg retrieval. Once the eggs reach a particular size, the woman is given an injection for rupture of eggs. Egg (oocyte) pickup is generally done 34-36 hours after the injection for rupture. This procedure is done under general anaesthesia so the woman is put to sleep before the procedure. Once the oocytes are obtained, process of IVF/ICSI is done in the lab. Depending upon the time of embryo transfer, the woman’s uterus is prepared and after growing the embryos for 3-5 days, one embryo is transferred in the woman’s womb and the rest are frozen for next attempt if required.
The injections given during IVF are such that they do not cause much pain, just mild discomfort. We teach you how to take them so that you can administer them by yourself or with the help of your partner. The process of egg retrieval is under anaesthesia so that too is not painful. The process of embryo transfer too is not painful and quite similar to an IUI procedure and does not require anaesthesia.
You DO NOT need to rest after embryo transfer. You will be given certain medications which will help support the pregnancy which you need to take regularly. Apart from avoiding sexual intercourse, there are no special precautions which needs to be taken. This means you can travel like you did before, do your daily activities as before. No special diet restriction is advised, you can eat anything which is healthy and safe. Climbing stairs can be done without any restrictions.
You will be asked to do a blood test to check the level of pregnancy hormone in your body after about 14 days of the transfer process. Depending on the report it will be determined if the procedure was successful.
If the pregnancy hormone level comes negative, then it means that the procedure was not successful. The success rate of IVF/ICSI is around 40% per cycle. This is the time when couples go through utmost emotional turmoil as the anticipation of result for 14 days after the procedure and a negative result thereafter causes great dismay. It is therefore important that one should not overthink about the results post procedure. Keeping oneself busy by doing their daily routine, doing yoga/meditation after the procedure helps. In case of negative result, one can always go for frozen embryo transfer by using the frozen embryos. In case the embryos are not there then unfortunately one will have to go with the entire procedure again.
IVF failure can be because of various reasons. In case of failure to form eggs, usually the injections given for egg growth is reviewed and change of injections is done or in certain cases one can discuss the option of oocyte donation.
In case of failure post embryo transfer, the medications given are reviewed, the quality of embryos is reviewed, the womb lining is reviewed and the entire history of the couple is reviewed and accordingly changes are made in next attempt. However in most cases there is no particular cause of failure that can be pointed at.
The process of IVF/ICSI is extremely safe. There is a small chance of excessive stimulation of the ovary called ovarian hyperstimulation syndrome (OHSS) but utmost care is taken to prevent it from happening and reducing its severity.
There is a small risk of multiple pregnancy in this process. Although most of the times only one embryo is transferred but sometimes twins and triplet pregnancies have been encountered. Care is taken that such pregnancies are managed well and healthy mother and babies are achieved at the end of pregnancy.
Apart from these, there is small chance of injury to surrounding structures during oocyte retrieval and there is risk of anaesthesia but this risk is negligible as you are in experienced hands.
As per the studies done worldwide, babies born via IVF/ICSI are not found to have any extra risk of any genetic or structural abnormalities then babies born via spontaneous conception. Small risk of increase in genetic risk of male babies having low sperm count has been seen if the male partner of couple has genetic cause of infertility.
