IVF-In Vitro Fertilization
In Vitro Fertilization is the well preferred reproductive technology (ART) commonly referred to IVF. IVF is a fertilization process by extracting eggs, retrieving a sperm sample. In the process, an egg and sperm manually combining in a laboratory dish. The embryo (or embryos) is then transferred to the uterus through transvaginal route.
In Vitro Fertilization (IVF) is commonly known as ‘test-tube baby’. IVF is a fertilization process by extracting eggs, retrieving a sperm sample. It is a process in which the egg is fertilized by sperm outside the body. The woman’s eggs are removed from the ovaries and fertilized in a fluid medium in laboratory. The fertilized egg is cultured for three to five days and then transferred to the woman’s uterus through transvaginal route. This course of action is done in IVF centers by qualified doctors.
In the following cases IVF technique is used to treat infertility.
- Blocked or damaged fallopian tubes
- Women with premature ovarian failure, ovulation disorders
- Women having uterine fibroids
- Individuals with a genetic disorder
- Unexplained infertility
- Male factor infertility include decreased sperm count or sperm motility
- Women who have had their fallopian tubes removed
Stimulation of Egg Growth
A woman with regular menstrual cycles ovulates one egg each month. In order to increase the chance of obtaining pregnancy, doctors made an effort recruit as many eggs as possible. It is done by fertility drugs (Gonal-F(R)). With the help of repeated ultrasound studies as well as blood tests for hormone levels (Estradiol and Progesterone) the growth and development of the eggs is monitored closely. The optimal timing for ovulation is determined with the information obtained from these tests. Ovulation itself is triggered by an injection (Human Chorionic Gonadotropin) that is followed by the egg retrieval.
Retrieval of Egg
After about 36 hours of triggering ovulation using HCG-Human Chorionic gonadotropin injection retrieval of Egg is scheduled. The process is carried out at the hospital by a transvaginal route. A needle guided by ultrasound imaging, is inserted through the vaginal wall into the ovaries. The follicles containing the eggs are punctured and aspirated with needle. The released eggs are then transferred to the lab.
In Vitro Fertilization process
Eggs selected for fertilization are kept in dishes. Sperm is added at the proper concentration. The dishes are kept in an incubator that is carefully monitored for the environment like humidity, temperature, gas composition. The eggs are assessed for fertilization, and subsequent divisions. The fertilized egg divides into two daughter cells and continues to divide.
In 2-3 or maximum 5 days after fertilization, an embryos are transferred to the uterus. It is simple and painless process and does not require sedation or anesthesia. The embryos are placed on a small plastic catheter and are carefully introduced into the uterus through the cervix. Catheter is withdrawn after releasing embryos in the uterine cavity. She can go home after taking rest of few hours.
No complete bed rest is needed. She is advised to take it easy. Medications are prescribed to support the young embryos hormonally. If pregnancy is established, monitoring is kept continued till the ultrasound imaging gives a direct visualization of the developing fetus as well as the heart beat at day 28 following embryo transfer.
Advanced Artificial Reproductive Technology
Recent years have witnessed a rapid advancement in the treatment of the “male factor infertility”, that is, those couples where the husband cannot produce good quality sperm in the required concentration. Noble techniques have been developed with which a single sperm is injected into the egg. This procedure, referred to as ICSI (Intra Cytoplasmic Sperm Injection) can accomplish fertilization with only minimal number of viable sperm. ICSI has been one of the scientific finds of the century and has helped millions of infertile couples from across the globe to become parents.
ICSI- Intra Cytoplasmic Sperm Injection
ICSI is an acronym for Intracytoplasmic sperm injection. It is an assisted reproductive technology (ART) and used to treat male infertility problems. It is used to augment the fertilization phase of in vitro fertilization (IVF) by injecting a single sperm into a mature egg using micro-manipulators.
ICSI treatment is advised in following cases:
- The sperm count is very low.
- Motility of the sperm is poor or if there is a high percentage of abnormally shaped sperms (morphological issues).
- The sperm has been micro surgically recovered from the epididymis or testes
- Male partner has problems with getting erection and ejaculating.
- Previous failed or poor fertilisation during IVF.
- The male partner is affected with HIV, Hepatitis B or C.
This process is an extension of the IVF and not a substitute. ICSI is believed very successful treatment for male infertility issues. This technique is very useful in male infertility cases. It is useful in such cases where the man’s sperm is unable to get to the egg or is able to reach the egg but is unable to penetrate and initiate fertilization.