• Usually we start stimulation on Day 2 of a woman’s period and stimulation means administration of Gonadotropin injections usually for a period of 10 days.
• The dose and the choice of the Gonadotropin injection will be based on the age of the patient, the ovarian reserve and the hormone parameters. And then we monitor the growth of follicles over this duration.
• Follicles are fluid filled sacs which contain the eggs and we monitor the response to stimulation by doing serial scans as well as doing intermittent hormone tests.
• Usually rupture of the follicles occurs about 36 hours after the trigger injection. So we time the egg pick up at about 35 hours, so that we’re able to get mature eggs which have still not ruptured.
• So these eggs are then collected and then the sperm is also collected on the same day. Sperm is specially prepared, so the semen is washed and there are various methods by which we can fertilize the egg with the sperm. One is In Vitro fertilisation or IVF where the egg is incubated together with a certain number of sperms so that natural fertilisation can occur.
• We nowadays tend to do ICSI more commonly, ICSI is intracytoplasmic sperm injection where the best sperm is picked and injected into the egg. We at Jananam use a more refined procedure called PICSI which is Physiological ICSI, by which we are able to determine or pick up the sperm which is less likely to have DNA fragmentation and therefore better DNA integrity.
• The sperms are picked and then injected into the egg. So once fertilisation is completed then the fertilised or injected eggs are incubated and their development is monitored.
• Usually, on Day 3 or Day 5 the transfer is planned. It can be done when the embryos are still in the cleavage stage or when they have reached a blastocyst stage on Day 5. Embryo transfer may be done in the same cycle, more often we tend to do embryo transfers in a later cycle as a frozen embryo transfer.
• Now this is the process, and looking at the success rate it depends very much on the women’s age, on the quality of her eggs and on the quality of the man’s sperm.
• So results can vary, but usually in women who are less than 35 years and produce a reasonable number of good quality eggs, the success rate usually tends to be around 55 to 60%.

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