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IVF AND ICSI TREATMENT

What is IVF?

In Vitro Fertilization, abbreviated as IVF, is a type of Assisted Reproductive Technology (ART). “In Vitro” means “In the glass” Colloquially called “test tube experiments” Thus, in the IVF procedure, the eggs and sperms are combined in a controlled environment inside a laboratory in the glass.

The fertilised eggs after growing and developing into embryos are transferred into the womb of the female partner. Because the fertilisation occurs in the laboratory, the babies born through IVF procedures are also referred to as test-tube babies.

What is ICSI?

ICSI stands for Intracytoplasmic sperm injection. ICSI is also a type of an IVF procedure where a single sperm is injected directly into the egg. Of all the available sperms, the embryologist picks up the healthiest one that is then used to fertilise the selected egg in the laboratory.

After successful fertilisation, the embryo is transferred into the uterus in the same way as in an IVF procedure. ICSI differs from IVF in the only way that the sperm does not itself penetrate the egg but is injected into it.

Who needs IVF / ICSI?

IVF or ICSI treatment procedure is recommended to couples for whom natural egg fertilisation inside the body of the female partner isn’t feasible or hasn’t happened. This may be due to male or female fertility disorders as mentioned below:

Female :
1. Damaged or blocked Fallopian tubes
2.Previous tubal sterilisation
3. Women who have PCOD / PCOS
4. Problems in ovulation
5.Patients with endometriosis
6. Uterine fibroids
7.Previous multiple unsuccessful IUIs

Male :
1. Poor sperm quality
2. Low sperm count
3. The inability of sperm to penetrate or survive the cervical mucus
4. The inability of the sperm to fertilise the egg
5. When the semen or ejaculate has no sperms but sperms can be taken directly from the testes

IVF procedure is also suggested in cases of unexplained infertility in the male or female partner. It is also recommended for couples who present with genetic disorder in the family or their previous child where preimplantation genetic testing PGT-A or Preimplantation genetic diagnoses PGD is performed

What happens during IVF / ICSI?

IVF is a procedure that uses a combination of daily hormone injections followed by a minor surgical procedures to help the sperm to fertilise an egg and then subsequent implantation of the embryo into the womb to achieve pregnancy.

IVF has many steps. Let us have a look at the IVF treatment procedure steps in detail below:

1. Initial Assessment –

We at Genesis make a detailed note of the medical and fertility history of the couple and perform the necessary blood tests. 3F Ultrasound scan for the female partner and semen analysis for the male partner are also done.

After thorough analysis of the examination reports, the doctors evaluate if IVF is the right treatment procedure for the couple to be able to conceive and deliver a baby.

Doctors at Genesis then go ahead and discuss the IVF procedure in detail with the couple. They also take consent from the couple before commencing the IVF treatment.

2. Hormone Stimulation –

The IVF cycle begins on the first day of your periods and ultrasound scans are conducted to track the follicular growth. Starting from the day you begin your menstrual cycle, you will be given hormone injections that will help your ovaries to produce a large number of mature eggs that can be easily fertilized. This is also called controlled ovarian stimulation.

During this, regular ultrasounds and blood tests are conducted to examine the hormone levels and check the follicular growth. If you have a poor ovarian reserve and fail to produce a good number of eggs, we discuss about using the donor eggs. In that scenario, instead of the patient, the egg donor will be prescribed hormonal injections.

3. Egg Retrieval –

As and when the follicles grow to an optimum size of 17mm and above, you are injected with trigger injection that helps separate the eggs from the follicular wall. This will make the eggs float freely in the follicular fluid.

After about 36 hours of this injection, you are admitted to the hospital for egg retrieval. Egg retrieval is a minor surgical process. You are given anaesthesia and a thin needle is inserted into the vagina to extract the follicular fluid from the ovaries under ultrasound guidance.

This aspirated fluid is handed over to the embryologist who then separates the eggs from the follicular fluid and places them in the culture dish in an incubator.

4. Sperm Preparation –

The sperm sample from the male partner is obtained and we select the best appearing sperms that are most probable of fertilising the egg. The best quality sperms are those which are neither too thin nor too fat and have a medium-sized tail and moving at a good speed.

5. Egg Fertilisation –

In the IVF procedure, the sperms and eggs are kept together in a special container where they have high chances of finding each other as they naturally would within the female body. They are then continued to culture to grow into embryos in the incubator.

In the ICSI process, preferred when sperms have low motility or low count, the sperm is injected into the egg which is then continued to culture to grow into embryos in the incubator.

6. Embryo Transfer and Implantation –

After 3 to 5 days following egg retrieval, embryos grown are ready to be transferred into the uterus. Of all the embryos, the fertility experts embryologists select the best appearing embryo and place it inside a tiny catheter (plastic tube) which is passed through the cervix to transfer the embryo into the womb under ultrasound guidance. We freeze the remaining healthy embryos that may be required later on in another IVF cycle.

Pregnancy only occurs when the embryo attaches itself to the lining of the uterus. You are advised rest for the day when the embryo is transferred. You can resume your daily activities from the next day. You are advised to avoid long journeys and lifting heave weights. Routine activity is allowed. All medications should be taken regularly and hormonal medication on clock. Pregnancy test is arranged 14-16 days after the embryo transfer.

7. Routine Check-up and Medications –

Once pregnancy is achieved, you are advised to continue progesterone hormone as it supports the embryo to grow and survive in the uterus. You should continue rest of the medication too.

Are there any side-effects of IVF?

Like most other medications and surgical procedures, IVF also has a few side-effects like:
1. Bloating
2. Cramping
3. Headache
4. Breast tenderness
5. Mood swings

All are mild and short lasting. They do not have any long term continuing side effects. Please speak with the doctor when you experience any side effects.

Following are the points to be remembered and considered when you go for an IVF procedure:
1. Approximately 40% chance of Multiple births if more than one embryo is transferred at a time
2. Risk of premature delivery and low birth weight, again, with multiple pregnancy I.e twins.
3. Ovarian hyperstimulation syndrome, where numerous follicles develop in women with polycystic ovaries where there are large ovaries, fluid in the abdomen, bloating and discomfort
4. Bleeding, infection or damage to bowel and/or bladder during the egg retrieval procedure, but the chances of such happening is very rare.
5. Approximately 2% to 3% of women have ectopic pregnancy where the embryo implants outside the uterus, in the tube, which very likely need laparoscopy and removal of the tubes. Sometimes it can be managed with injections.

Other than the physical pains, IVF procedures can also be emotionally draining. Most couples get quite anxious especially because of the built up expectations. We at Genesis Fertility and Laparoscopy Centre, always ensure to keep the couple informed at all stages of the IVF process and this helps them be at comfort throughout the treatment. We also inform them to be prepared with realistic expectations and every couple is clearly informed of the success rate.

Are there any alternatives?

Yes, there are alternatives for every situation. There are couples who get pregnant naturally  while they are waiting to start IVF. There are also couples who naturally get pregnant after unsuccessful IVF cycles. This mag happen due to optimisation of the couples reproductive health status during IVF treatment such as cutting down weight, correcting thyroid hormone levels, stopping smoking and alcohol etc.  IVF cuts short the time to get pregnant. IVF increases the success rates

Alternative depends on the reason for IVF. Natural pregnancy, IUI, adoption are alternatives. However, your fertility expert can explain which alternative is suitable for your situation.

If you are struggling to have a baby, get in touch with the fertility experts at Genesis Fertility and Laparoscopy Centre. They will help you with your medical check-up, diagnose the underlying fertility disorders, and address your concerns before suggesting a genuine treatment to help you conceive and deliver a healthy baby.

Genesis Fertility and Laparoscopy Centre has state-of-the-art infrastructure, the latest medical equipment, and experienced fertility experts. There is a huge array of satisfied patients who have been able to witness parenthood care at Genesis Fertility and Laparoscopy Centre.

Experience the joy of holding your little one in your arms, schedule an appointment at Genesis Fertility and Laparoscopy Centre today!

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