Everything You Need to Know About In-Vitro Fertilization (IVF)

Infertility can be caused by several factors associated with the male or female reproductive system and affects millions of people across the world. You may be considered infertile if you have been trying to have a baby and failed to achieve a pregnancy even after 12 months of regular, unprotected sex. The good news is that there is no need to worry if you are diagnosed with fertility problems, as there are many treatments that help to manage these fertility problems.

In-vitro fertilization (IVF) is one such method that is considered most effective. In-vitro fertilization is a type of assistive reproductive technology that involves a series of procedures where a couple’s own eggs and sperm are fertilized outside the body. The fused egg and sperm (embryo) is then implanted into the woman’s uterus to check for pregnancy.

A series of tests are carried out before deciding if you are an ideal candidate for IVF. These include assessment of:

• Ovaries
• Ovulatory function
• Uterine cavity
• Fallopian tubes
• Previous medical history
• Blood tests
• Semen analysis

Step by step procedure of IVF

Here is a general IVF procedure step-by-step breakdown.

Medications for boosting egg production

In the first step, you will be prescribed drugs to stimulate the production of eggs. This process is known as superovulation. These drugs contain ‘stimulating follicle hormone, which instructs your body to release more than one normal egg in a month. The more eggs produced, the higher your chances of successful fertilization. Various tests are performed during this step to monitor your ovaries and hormone levels.

Retrieval of eggs

Once your eggs are scheduled to be retrieved from your body, you will be given a hormone injection for your eggs to mature faster. Then, the eggs are retrieved through a minor surgical procedure called follicular aspiration. Using ultrasound guidance, a thin needle is inserted through the vagina into your ovaries to suction out one egg at a time.

Collection of sperm from partner/donor

During your egg retrieval procedure, a sperm sample is collected from your male partner or a male donor that you choose. The sperms undergo a wash and spin cycle to determine the healthiest ones that can be used for the IVF procedure.

Fusing the sperm and the egg (fertilization)

The sperm may be directly injected into the egg through a process known as the intracytoplasmic sperm injection (ICSI).

Assessment of embryo quality

After fertilization, the fused egg and sperm (embryo) undergoes a quality check based on several factors to determine which embryos can be transferred. The embryos will be evaluated by an embryologist and a physician based on appearance and rate of development.

Embryo transfer

Now, you will receive another medication to prepare your uterus lining for transferring the chosen embryos. Using ultrasound guidance, the embryos are placed in your uterine cavity through a catheter. One or two embryos may be placed with a hope that at least one of them begins to develop.

Pregnancy test and follow-up

Fifteen days later, the woman undergoes a pregnancy test to determine if the IVF procedure has been successful. These tests may include blood work to determine progesterone levels. These tests may be continued every few days. Once your pregnancy test is positive, your doctor will follow-up with blood tests and ultrasound to monitor your pregnancy.

Indications of IVF

IVF may be indicated in the following conditions:

• Blocked fallopian tubes in women: Fallopian tubes are a pair of tubes through which eggs reach the uterus from the ovaries. When these tubes are blocked or removed in some women, for various reasons, IVF is considered ideal.
• Ovulatory dysfunction in women: It is a condition where women have abnormal/irregular cycles. IVF can stimulate the production of eggs in these women.
• Endometriosis in women: Endometriosis is the development of a tissue similar to the uterus lining, which grows outside the uterus. This interferes with the normal function of the ovaries, and IVF can be helpful when endometriosis is causing your infertility.
• Polycystic Ovary Syndrome (PCOS) in women: A condition in which ovaries are surrounded by fluid-filled sacs (cysts), affecting the release of eggs from ovaries. IVF can be considered in such cases.
• Male factor infertility: Low sperm production and concentration, weakened sperms, and abnormal structure, size and shape of sperms in men is referred to as male factor infertility.
• Others: Unexplained fertility and failure of other conventional fertility treatments.

IVF success rates depend on various factors such as age, cause of infertility, and quality of eggs and sperm. The rate of successful pregnancies increases to 45-53% with three full cycles of IVF, and IVF success rates further increase with more embryo transfers.

Click here to find out more about IVF Treatment here at Gleneagles Global Health City.

Dr Padmapriya Vivek

MBBS, MS, DRM (Germany)

HOD - Department of IVF, Obstetrics & Gynaecology