What is IVF?

WHAT IS IVF? (In-vitro fertilization) or "test tube baby treatment"

IVF (In-vitro fertilization) / ART (Assisted reproductive technology) is a procedure to overcome the issue of infertility. "In vitro" means ‘outside of the body’. In the IVF technique, fertilization of eggs is done with the sperm sample, and the embryo(s) is prepared in a laboratory dish. After that, the embryo(s) is transferred to the uterus of the mother so that it can mature, you may also call it a test tube baby treatment.

Who can Qualify for an IVF/ART (test tube baby) Treatment?

Infertility has limitless causes in both women and men. Treatment usually involves rectifying the primary problem with medication or surgery. But sometimes, conventional treatment proves challenging, and instead, couples turn to assisted conception methods like IVF. Most cases of female infertility are caused by problems with ovulation. Without ovulation, there are no eggs to be fertilized. Some signs that a woman is not ovulating normally include irregular or lacking menstrual periods. Ovulation problems are often caused by Polycystic Ovarian Syndrome (PCOS). PCOS is a hormone imbalance disorder which can interfere with normal ovulation. PCOS is the most common cause of female infertility. Primary Ovarian Insufficiency (POI) is another cause of ovulation problems. POI occurs when a woman's ovaries stop functioning routinely before she reaches her 40th year. Primary ovarian insufficiency is not the same as early menopause.

Less common causes of fertility problems in women include:

• Blocked fallopian tubes due to
• Pelvic inflammatory disease
• Endometriosis
• Surgery for an ectopic pregnancy
• Physical problems with the uterus
• Uterine fibroids - non-cancerous clumps of tissue and muscle on the walls of the uterus

Similarly, IVF procedures are common if the man has a low sperm count (oligospermia) or a lack of sperm (azoospermia). In some rare cases of male factor infertility, Intracytoplasmic Sperm Injection (ICSI) can be used to support the procedure.

STEP-BY-STEP THROUGH AN IVF CYCLE

An IVF ‘cycle’ is how we describe a single round of IVF treatment starting with the 1st day of your period. As part of your fertility plan, you may start medication or injections before the first day of the cycle.

Step 1: Day 1 of Your Period

The first official day of your IVF treatment cycle is day 1 of your period. Each person body is different, and our skilled nurses will help you understand how to classify day 1.

Step 2: Stimulating Your Ovaries

The stimulation phase starts from day 1. In a natural monthly cycle, your ovaries normally produce 1 egg. You will be taking medication for 8-14 days to boost the follicles in your ovaries (where the eggs live) to produce more eggs. Your specialist prescribes medication specific to your body and treatment plan. This is usually in the form of injections which can vary from 1-2 for the cycle, or 1-2 per day. It can be unnerving, but your fertility nurse will be there to show you exactly how and where to give the injections. You can get your partner involved too and watch and learn together to get it right. It quickly becomes a habit and you’ll be an expert in no time.
We keep an eye on your ovaries and how the follicles are developing with blood tests and ultrasounds. Your medication will be adjusted if needed. You will have some transvaginal ultrasounds (a probe is inserted internally). Our team will support you through these processes and make you as comfortable as we can. We’ll track you more frequently towards the end of the stimulation phase to time the ‘trigger injection’ perfectly. The trigger injection gets the eggs ready for ovulation – the natural process where eggs are released and you have your period. Your fertility nurse tells you exactly when to do the trigger injection. Your fertility specialist will schedule the egg retrieval before you ovulate.

Step 3: Egg Retrieval

Egg retrieval is a hospital day procedure where the eggs are collected from your ovaries. An anesthetist will get you ready for a general anesthesia. You will be asleep, and the procedure takes about 20-30 minutes.
Your fertility specialist uses the latest ultrasound technology to guide a needle into each ovary. It is delicate work where every millimeter counts, and this is where the experience of our specialists pays off. You can’t see an egg with the naked eye; they’re contained in the fluid within the follicles in your ovaries. The specialist removes fluid from the follicles that look like they’ve grown enough to have an egg inside.
Your fertility specialist should have a fair idea from your ultrasounds of the number of eggs available before retrieval. The average number of eggs collected is 8-15. Recovery takes about 30 minutes and you’ll be able to walk out on your own. It is a good idea to have a support person with you as you will not be able to drive after the procedure.

Step 4: The Sperm

If you are a couple planning on using fresh sperm, the male will produce a sample the morning of the egg retrieval. If you are using frozen or donor sperm, our specialists will have it ready in the lab.
The sperm is graded using 4 different levels of quality. It is washed in a special mixture to slow it down so our scientists can spot the best ones under the microscope. A perfect, healthy sperm is not too fat or thin, with a tail that’s not too long or short. The best sperm are selected, and are ready and waiting in the lab to be introduced to the eggs.

Step 5: Fertilization

Your fertility specialist gives our scientists the retrieved eggs, still in the fluid from the follicles of the ovaries. The scientists use powerful microscopes to find the eggs in the fluid so they can be removed.
It’s important that the eggs are fertilized quickly. The eggs and some sperm are placed in a dish. They have the chance to find each other and fertilize like they would naturally within your body.

Step 6: Embryo Development

If the sperm fertilizes the egg, it becomes an embryo. Our scientists place the embryo into a special incubator where the conditions for growth and development are perfect. We create the best growing conditions using a mix of amino acids, just like your body would use to nurture the embryo.
Our scientists keep an eye on the embryos over 5-6 days. What we want is a two- to four-cell embryo on day 2 and a six- to eight-cell embryo on day 3 (called the cleavage stage).
We know implanting embryos at the blastocyst stage into the uterus boosts your chances of a successful pregnancy.
Unfortunately, not all eggs will fertilize and reach embryo stage. The eggs might not be mature or the sperm not that strong enough. We know you’ll be waiting on news, so we’ll keep you up to date with the progress of your egg, sperm, and embryo development.

Stage 7: Embryo Transfer

If your embryo develops in the lab, you’re ready for it to be transferred into your uterus.
Your fertility nurses will contact you to explain what you will need to do to prepare.
The embryo transfer is a very simple process, like a pap smear. It takes about 5 minutes, you’ll be awake, there’s no anesthesia, and you can get up straight away. You can continue with your day, the embryo can’t fall out if you stand up or go to the toilet.
A scientist prepares your embryo by placing it in a small tube called a catheter. It is critical this is done by an expert to disturb the embryo as little as possible. Your fertility specialist places the catheter through your cervix and into your uterus.
Step 8: The final blood test.
Approximately two weeks after your embryo transfer, you’ll have a blood test to measure your levels of the hormone HCG (human chorionic gonadotropin). HCG in your bloodstream usually means a positive pregnancy test. Your nurse will let you know exactly when you need to have your blood test, as it may vary for some patients.

Voilà! Congratulations! You are on your way to motherhood!

What Are The Chances Of Success?

The live birth IVF success rate for women under 35 who start an IVF cycle is 40%. However, women over age 42 have a 4% success rate. It is not uncommon to try more than one cycle to make sure the chances of conception are successful.

Even miracles take a little time!

How Long Does The Treatment Take?

One cycle of IVF takes between 4 and 6 weeks to complete. The couple can assume to spend about half a day at the clinic for egg retrieval and fertilization procedures.

Step by Step to IVF Treatment

The live birth IVF success rate for women under 35 who start an IVF cycle is 40%. However, women over age 42 have a 4% success rate. It is not uncommon to try more than one cycle to make sure the chances of conception are successful.

Step by Step to IVF Treatment

• Preliminary checkup of husband & wife
• Baseline hormone levels of wife
• Drug treatment (injections) to stimulate egg growth
• Ultrasound monitoring of treatment
• To measure the growths of follicles
• To adjust dose of drugs
• Prevent serious side effects (Ovarian Hyper Stimulation Syndrome)
• Monitoring is carried out:
• By trans-vaginal ultrasound scanning (TVS)
• By measure hormones in blood
• Egg pickup
• Semen collection & processing
• Review of eggs after 24 hours for fertilization and division
• Embryo transfer (ET)

Policy Governing IVF

We strictly use husband’s spermatozoa (male sperm) and wife’s egg. Donor’s spermatozoa (male germs), egg, and surrogacy facilities are not available in any of our clinic/center.