Many couples willing to have their own child are still unable to become pregnant after first line therapy such as ovulation induction, intrauterine insemination, or reproductive surgery. For these couples, the next logical step is to explore the Assisted Reproductive Technologies (ART) like In Vitro Fertilization (IVF) popularly known as Test Tube Baby.
IVF is a technological process where several eggs are retrieved from a woman’s ovaries and then fertilized by the husband’s sperm outside the body in a controlled environment of the laboratory. The fertilized eggs then develop into embryos and these are returned to the woman’s uterus, by a procedure called embryo transfer.
Indications for ART
Both Fallopian tubes are absent, blocked or hopelessly diseased.
The husband has a reduced sperm count(Oligozoospermia)
Sperms antibodies in wife’s and /or husband’s serum.
Endometriosis i.e. the presence of endrometrium (lining of womb) outside the uterus.
Unexplained Infertility(refer to couples in whome no obvious pathology is found but who can not conceive.
IVF also helps women who have absent ovaries or where there are no eggs in the ovaries provided any young member of the family with proven fertility is willing to donate her oocytes.
We – at Fertility Clinic- have a dedicated team with more than 25 years of experience in the field of infertility and ART. We encourage you to learn as much as you can about the IVF program at our centre. This section of the Web site offers an overview of medications, procedures, success rates and financial issues related to IVF. You will also have the opportunity to tour our state-of-the-art medical facilities, post your querries you may have related to infertility.
The Preliminary Investigations are:-
1) Hysteroscopy & measurement of utero cervical length.
2)Ultrasound Examination of uterus and ovaries. To exclude uterine pathology and cyst in ovaries.
3) Hormonal Profile (TSH, Prolactin, FSH & LH on 3rd day of the period).
4) CBC, ESR, Blood VDRL, Blood Sugar PP, Blood group Rh factor, Australia Antigen/HIV /HCV antibodies Bleeding Time & Clotting Time, X-Ray chest & Chlamydia antibodies
1) Semen analysis.
2) Semen culture and antibiotic sensitivity test.
3) Anti sperm Antibody test for husband and wife.
4) Sperm Survival test and semen harvesting.
5) Blood for Australia Antigen, HIV Antibodies, HCV Antibodies.
The couple should bring along their records of infertility workup that they possess, such as hysterosalpingogram films, semen analysis report, basal body temperature chart, previous laproscopy test results. The IVF team physician will counsel the couple about the program and some further investigations may be necessary to establish the chances of success. The woman may have to be scheduled for a screening laproscopy, hysteroscopy, and ultrasonography, if needed to assess the pelvic anatomy and accessibility of the ovaries for egg retrieval.
1) Hormonal regularization and stimulation:
The woman is taken into the program from her previous cycle for down regulation. Medication is given to the patient during the early phase of her next cycle to increase the likelihood of developing more than one egg.
2) Monitoring the maturity of the Eggs:
Blood tests are drawn frequently from the onset of stimulation to determine the progress of stimulated ovaries.
Serial Ultrasound examinations are conducted several times to visualize the developing follicles. The size of the follicles and result of the blood testes will determine the time of egg collection.
3) Egg Collection:
Eggs are retrieved transvaginally by needle aspiration guided by ultrasonic imaging. This requires local / general anaesthesia. The eggs thus obtained are immediately placed in a cultured dish that contains a special nourishing fluid. The patient can leave the IVF centre soon after egg retrieval.
4) Semen Specimen Collection:
Semen sample is collected preferably by masturbation in the morning of collection of the eggs. There is a facility of freeing the semen sample before the day of egg collection if required. The sperm cells are separated from the seminal fluid, mixed with the eggs and then are placed in incubator unit till such time, as the eggs are ready to be fertilized.
5) Fertilization and Cleavage:
Fertilization is the process of sperm penetrating the egg. The egg being fertilized is now called an embryo. These are observed further to be certain that they are dividing (cleaving) normally.
6) Embryo Transfer:
Embryo transfer is done between day 2 to day 5 depending upon number and quality of embryos available The embryos are placed into uterus using thin tube (catheter) through the mouth of the womb (Cervix). The procedure is done on outpatient basis. The patient leaves IVF centre soon after transfer procedure. When indicated, blastocyst stage transfer is offered. Generally 2 to 3 embryos are transferred and spare embryos, if any, are cryo preserved for future use with patient’s consent.
7) Luteal support:
In order to improve implantation of embryo in uterus, pure progesterone is given as luteal support in the form of.vaginal pessaries, or gel or injectables.
8) Blood Tests:
Blood test for beta HCG titre is performed to confirm pregnancy approximately 10 days following embryo transfer