In Vitro Fertilization (IVF)


In vitro fertilization (IVF) is a series of procedures used to treat fertility or genetic problems and assist with the conception of a child. During IVF, mature eggs are collected (retrieved) from your ovaries and fertilized by sperm in a lab. Then the fertilized egg (embryo) or eggs are implanted in your uterus. One cycle of IVF takes about three weeks.

IVF is the most effective form of assisted reproductive technology. The procedure can be done using the woman’s own eggs and her partner's sperm.

Your chances of having a healthy baby using IVF depend on many factors, such as your age and the cause of infertility. In addition, if more than one embryo is implanted in your uterus, IVF can result in a pregnancy with more than one fetus (multiple pregnancies).

We can help you understand how IVF works, the potential risks and whether this method of treating infertility is right for you.

Who Can Have IVF Treatment?

Fallopian tube damage or blockage. Fallopian tube damage or blockage makes it difficult for an egg to be fertilized or for an embryo to travel to the uterus.

Impaired sperm production or function. Below-average sperm concentration, weak movement of sperm (poor mobility), or abnormalities in sperm size and shape can make it difficult for sperm to fertilize an egg. If semen abnormalities are found, your partner might need to see a specialist to determine if there are correctable problems or underlying health concerns.

Unexplained infertility. Unexplained infertility means no cause of infertility has been found despite evaluation for common causes.

Endometriosis. Endometriosis occurs when the uterine tissue implants and grows outside of the uterus — often affecting the function of the ovaries, uterus and fallopian tubes.

Ovulation disorders. If ovulation is infrequent or absent, fewer eggs are available for fertilization.

Premature ovarian failure. Premature ovarian failure is the loss of normal ovarian function before age 40. If your ovaries fail, they don't produce normal amounts of the hormone oestrogen or have eggs to release regularly.

Uterine fibroids. Fibroids are benign tumours in the wall of the uterus and are common in women in their 30s and 40s. Fibroids can interfere with implantation of the fertilized egg.

Previous tubal sterilization or removal. If you've had tubal ligation — a type of sterilization in which your fallopian tubes are cut or blocked to permanently prevent pregnancy — and want to conceive, IVF may be an alternative to tubal ligation reversal.

A genetic disorder. If you or your partner is at risk of passing on a genetic disorder (such as Thalassemia) to your child, you may be candidates for preimplantation genetic diagnosis (PGD) — a procedure that involves IVF. After the eggs are harvested and fertilized, they're screened for certain genetic problems, although not all genetic problems can be found. Embryos that don't contain identified problems can be transferred to the uterus.

Fertility preservation for cancer or other health conditions. If you're about to start cancer treatment — such as radiation or chemotherapy — that could harm your fertility, IVF for fertility preservation may be an option. Women can have eggs harvested from their ovaries and frozen in an unfertilized state for later use. Or the eggs can be fertilized and frozen as embryos for future use.

Where pregnancy couldn’t be achieved using other treatment methods. Such as patients who haven’t responded to impregnation method.

Certain hormonal disorders

Tests You Should Do Before IVF Treatment

It is critical that an assessment of any potential obstacles to achieving a pregnancy be reviewed before initiating an IVF cycle. This involves testing on both the male and female partner. The following is a description of commonly performed IVF pre-screening tests. Not every test is done on every person. Your doctor will determine which tests need to be performed before initiating a cycle. 

TESTS FOR FEMALE

  • Hormonal Tests and Other Blood Tests If Required
  • Ovarian Function Tests
    An essential aspect of the IVF cycle is the ability to recruit and retrieve multiple follicles. A variety of drug regimens can be used. This choice is individualized, based on the level of ovarian function which is determined by evaluating several hormone levels.
  • Evaluation of the Uterine Cavity
    The embryos that develop in the lab during an IVF cycle will ultimately be placed into the uterine cavity. Therefore, it is critical that the cavity is normal. This is evaluated by a Hysterosalpingography or a hysteroscopy. These tests are scheduled between the end of menses and the onset of ovulation.
  • Radiologic Screening Tests – These tests show the flow of dye through the uterus and the tubes. These tests are usually performed in the Radiology Department in the hospital.
  • Infectious Disease Testing and Immunity Screening
    Blood testing on both partners is required to rule out Hepatitis and HIV exposure. Negative infectious disease results must be documented every twelve months.
    • Hepatitis B surface antigen
    • Hepatitis C antibody
    • HIV
    • RPR (serology)
    • Rubella titer (one time only)

TESTS FOR MALE

  • Hormonal Tests and Other Blood Tests If Required
  • Semen Analysis and Wash
    A semen analysis must be completed prior to the IVF cycle. You may schedule this through the front desk.
  • Infectious Disease Testing
    • HIV
    • Hepatitis B surface antigen
    • Hepatitis C antibody
    • RPR (serology)

Stages of IVF Treatment

  • The patient starts to use birth control pills on the first day of menstruation as from the moment she has decided to start the treatment with doctor’s guidance. The aim of taking birth control pills is to regulate menstrual cycle of the patient and eliminate the risk of formation of an ovarian cyst until the next menstrual cycle when the treatment will be started.
  • In the next menstrual cycle, the ovaries are stimulated by taking medications containing hormones. These medications help the development of multiple egg cells and increase the likelihood of pregnancy.
  • The growth of the stimulated eggs is monitored by ultrasound.
  • Close to a time when the stimulated eggs have reached a certain size, “trigger shot” is made.
    • Within about 36 hours as from trigger shot, egg retrieval is performed in the IVF centre.
    • Sperm samples are taken from man on the day of egg retrieval procedure.
  • In the laboratory, retrieved egg cells are fertilized using conventional IVF or microinjection method depending on sperm cell quality. By courtesy of this fertilization, the embryo which is the cornerstone of the baby developing in the womb is created. In microinjection method, it is ensured that sperm directly enters into the egg and success rate increases where sperm quality is low.
  • Fertilization detected under a microscope takes about 12 to 15 hours. Embryo transfer is performed within 2 to 4 days.
  • After the embryo transfer, there is a waiting period of 12 days for its implantation.
  • On the 12th day after the transfer, the result is obtained by a pregnancy test.