In Vitro Fertilization (IVF)
In Vitro Fertilization (IVF)
IVF involves fertilization of woman’s eggs outside her body by mixing them with the man’s sperm in the Laboratory. The fertilized embryo is then gently placed in the woman’s womb where it will implant if conditions are favourable. Normal pregnancy then follows.
Indications
- Absent or damaged Fallopian Tubes
- Moderate to Severe Endometriosis
- Moderate to Severe polycystic ovaries
- Tubal and pelvic Adhesions
- Sperms antibodies in female and / or male serum
- Male factor infertility
- Previous IUI failures
Phases of IVF
Ovarian Stimulation
Fertility drugs in the form of injections are administered to female partner for Controlled Ovarian stimulation to produce multiple good quality eggs. For IVF there are basically 3 very commonly used ovarian stimulation protocols depending on case to case.
- Long Protocol that involves down regulation with GnRH agonist starting from day 21 of the cycle preceding menstrual cycle. After achieving down regulation GnRH agonist need to be continued in reduced dose to start gonadotropin injections such as FSH and or hMG injection to stimulate the ovaries to produce multiple follicles
- Antagonist protocol involves use of the GnRH antagonist. In this protocol ovarian stimulation begins on day 2 of menses with use of gonadotropins either HMG or FSH followed by addition of antagonist on day 5 of stimulation (Here there is no need for down regulation with GnRh Agonist)
- The short protocol involves use of GnRH agonist from day 2 of menses along with gonadotropin injections such as FSH and or hMG injection till leading follicles are 18mm in diameter
- During ovarian stimulation a regular monitoring of follicles and egg development is done with the aid of trans-vaginal sonography and estimation of Estradiol (E2) / LH / progesterone hormones. When leading follicles are 18mm in diameter HCG injection, (Human Chorionic Gonadotrophins) is administered.
At Orrchid Fertility Centre after detailed assessment of individual patient a custom made protocol which is patient specific is designed so that optimum success rates can be attained
Egg retrieval
Egg retrieval is done under short general anesthesia, between 34 to 36 hours of HCG injection administration. Oocyte / Egg retrieval(Ovumpick up) is done by inserting a needle through vagina into the ovaries under ultrasound guidance.Fertilisation and embryo development
A semen specimen is obtained from the male partner by masturbation after 2-5 days of abstinence from ejaculation. The semen is "washed" in the laboratory (called sperm processing or sperm washing) and the best quality sperm are separated from the other components.The processed sperms are incubated along with the eggs for fertilization. Fertilization & Embryo growth is checked on a daily basis.
At Orrchid we have the best Culture Mediums. Incubators and Techniques for culturing good quality embryos.
Embryo transfer
After fertilization two to five days later, embryos are transferred into the uterus by passing a thin embryo transfer catheter through cervix which is usually done under the guidance of ultra sonography. Usually anaesthesia is not required for this procedure. Good quality embryos are transferred and excess embryos can be cryopreserved for use in later IVF cycles if required for optimizing cost.Luteal phase support
After embryos are transferred, medications (Progesterone) are prescribed to the female partner for 14 days which can be in the form of Oral, vaginal suppository / gel or by intramuscular injections. After an initial 3-4 days resting period, routine life can be resumed by the female partner.
A blood pregnancy test (Serum Β HCG) is advised on day 14 post embryo transfer, for pregnancy confirmation. An ultra sound is done approximately one week after positive pregnancy test.