What is In Vitro Fertilization or IVF?
IVF is commonly known as ‘test tube baby’. It involves stimulating the ovaries to make multiple eggs grow and then taking the eggs out of the woman, fertilizing them in the laboratory with her partner’s sperm and transferring embryos back to her uterus. Egg + sperm form an embryo. The embryo implants in the uterus to grow into a baby.
The first IVF baby in the world (Louise Brown) was born in July of 1978 in England. Louise Brown was 28 when she delivered her own baby in 2006. Her baby was conceived by IVF. Hundreds of thousands of children are now born annually as a result of the IVF technique.
IVF is the process by which the sperm fertilizes the egg outside the uterine cavity, outside the Fallopian tube in the lab and that is the reason why it’s called in vitro fertilization.
This procedure is advised after simple fertility treatments have failed and sometimes we tend to advise it directly in patients who have or in women who have both tubes blocked or in men who have a total motile sperm count of less than 5 million.
Process of IVF Video
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.
Once the follicles have reached the desired size, then we administer the trigger injection. Now this trigger injection helps the egg within the follicle or the eggs within the follicles to mature.
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 fertilization or IVF where the egg is incubated together with a certain number of sperms so that natural fertilization 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 fertilization is completed then the fertilized 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%.