- Indication for IVF
- Pre-Cycle Evaluation For IVF / ICSI
- Ovulation induction for IVF / ICSI
- Sperm Preparation For IVF / ICSI
- Tesa | Mesa | Pesa
- Oocyte (Egg) Retrieval
- Insemination /Sperm-injection
- Embryos Culture / Blastocyst Culture
- Embryo Transfer
- Pregnancy Test
- FAQ on IVF (In Vitro Fertilization)
FAQ on IVF (In Vitro Fertilization)
Physical restriction :
- Heavy exercise like aerobics, jogging, weight lifting are prohibited during ovarian stimulation until the pregnancy test results are known.
- Smoking / alcohol consumption should also be avoided during stimulation.
- If a lady is under some medical treatment , please consult the doctor whether prescribed medicine are safe during stimulation protocol. As some medications may interfere with the fertility medication.
Emotional issue :
- As IVF cycle may be an emotional and stressful time for some couple, it may be helpful for a lady to talk to a supportive person like friend or a close family member. She can also take a help from counselor from the fertility clinic.
On the day before ooycte pick up media in which oocyte need to be kept in CO2 incubator for equilibration. Media for sperm preparation and for follicular rinsing are also kept for equilibration.
- Percentage of CO2 in Incubator and temperature is checked with the fyrite kit and thermometer respectively.
- The pH of the media & osmolarity is also checked.
- Oocyte identification and grading are always done in laminar hood, under microscope having a hot plate with temperature 37°C.
- Once the oocyte identification is done, it will be kept in special endotoxin free disposable petridish in special media. These petridishes are labeled with patient name and ART identification number.
- A special needle is used to aspirate the follicle under ultrasound guided scanning machine.
- The male partner are asked to collect the semen in a special container with his identification number. Semen is proceeded to get motile spermatozoa for insemination.
- Embryology lab is a restricted entry area with a special air modules fixed to have a complete particle free area
If pregnancy test shows negative result, couple can wait one or two complete menstrual cycles before beginning another ART cycle. Some times tests are required, that may delay subsequent cycles.
- Spermatogenesis or sperm production cycle takes about 3 months time. Sperm quality on the egg retrieval day is often related to what happened in the male’s body 3 months ago. Listed below is guide lines to help ensure that semen specimen on oocyte pickup day is of best possible quality.
- A fever more than 101°C within 3 months prior to ART treatment may adversely affect sperm quality, sperm count and motility may appear normal, but fertilization may not occur. Body temperature should be maintained below 100o C with medicine during or before ART cycle.
- Keep the use of alcohol or cigarettes to a minimum before and during ART cycle. Do not use any ‘recreational’ drugs.
- Any other medicine use should be brought into notice of fertility specialist doctor.
- Avoid hot tubs, spas, jacuzzis, or saunas during 3 months prior to ART cycle.
- Avoid heavy exercise, physical activity at a moderate level is acceptable and encouraged.
- Refrain from ejaculation for 2-3 days, but not more than 5 days prior to semen collection on oocyte pick up day.
- Yes, woman can also be a mother after tubal ligation operation. We offer tow procedures for that.
- Tubal Recanalization : This minor surgical procedure is done of outpatient basis with a success rate of about 80%. The other option is
- IVF-ET : In this procedure eggs are fertilized outside the body and resultant embryos are transferred to the uterus , thus bypassing the fallopian tube.
- Poor egg quality
- Premature ovarian failure
- Previous multiple IVF failure
- Genetic cause
In this procedure eggs are retrieved from recipients either known or unknown donor, fertilized with husband’s sperm and resultant embryos are transferred to recipient’s uterus. Success rates are extremely high with this process.
Following are the indication for IVF consideration.
- Tubal problem
- Male factor
- Uterine problems
- Unexplained infertility
- Previous IUI failure
- Ovulatory problems
- Antibody problems that harm sperm or eggs
- Cervical inhospitality
- ovulation induction :- injectables medicines is used to stimulate development of multiple mature follicles
- Egg retrieval : when the follicles are mature, the egg aspiration procedure is performed to remove the eggs. An ultrasound guided vaginal aspiration with special ovum pick up needle is simple and easy procedure.
- Fertilization and embryo culture: sperms are either mixed or injected into an oocyte on various times interval depending upon the maturity of the oocyte. The resultant embryos are cultured for 3 or for 5 days.
- Embryo transfer : with the help of embryo transfer catheter embryos are delicately transferred near the top of the endometrial cavity.
- Pregnancy test : About 11 days after embryo transfer a blood test is done for pregnancy hormone
In PGD one or two cells from an embryo are removed and tested for he presence of specific faulty gene. Only the embryos free from condition will then be transferred.
Many scientific studies demonstrated a dramatic increase in sperm DNA fragmentation in obese man, leading to the significant reduction in sperm quality. There may be an increase in the miscarriage rate for men with high-level fragmented DNA damage. Increased sperm DNA fragmentation due to oxidative stress may be due to many reasons
- Age more than 50 years, smoking, heat exposure, obesity and environmental toxins. Some of this sperm DNA fragmentation may be reversed. Use of antioxidants may improve sperm count, motility and possibly morphology before an IVF cycle.
Increased TSH [Thyroid Stimulating Hormone ] production by the pituitary adversely affects the pituitary’s production of FSH [Follicle Stimulaitng hormone], which normally regulates ovarian hormone production thus leading to infertility and / or miscarriages.
Hypothyoridism can be treated with oral thyroid supplementation. If pregnancy occurs, due to increased metabolic demand more supplementation of oral thyroid medicine is require
– High level of FSH hormone
– No ovaries
– Premature ovarian failure
– previous IVF failure
– Benign or malign formation on ovaries [increased level of oncomarker Ca-125] – Genetic disease
– sperm concentration
– overall motility
– total motile count
Classical surrogacy :- It involves the insemination of a surrogate with the sperm of the father to be. The surrogate – contributes here genes to make up of the child, carries baby to term and then gives baby to intended parents after birth.
Gestational surrogacy :- embryos are created from the egg from the egg donor sperm from father to be, those embryos are transferred to the gestational surrogate.
The main procedure involved in IVF is the egg retrieval and this is performed through the vagina with ultrasound and a fine needle. Patients at our center are asleep during this procedure and are cared for by a team of anesthesiologists. Patients have no pain with this procedure and they wake up very quicly with the egg retrieval lasting 10-15 mins. The embryo procedure is again a very simple one. A very light anaesthesia is required when there are specific problems with the cervix.
The other simple and best option is “egg donation” by any younger lady.