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In Vitro Fertilization

In Vitro Fertilization - NU Fertility

FAILED IVF: Reasons and What to Do Next?

In-vitro fertilization is the process of fertilization where an egg is combined with a sperm under in vitro or laboratory conditions. This technique is a boon for all those childless couples who have failed to conceive and give birth to a baby through the natural process. IVF is especially beneficial in case of PCOS, blocked uterine tubes, fibroids, endometriosis, low ovarian reserve, and poor egg or sperm health. However, sometimes this procedure may not work out as planned and result in a failed IVF.

Common reasons for IVF failure

Dressed Asian Women - NU Fertility

This section talks about the many reasons that can contribute to a failed IVF procedure. Each of these causes of failure are dealt with in detail as mentioned below:

  • Age of female:

Women above the age of 35 often find it difficult to conceive. The quality and quantity of the egg also deteriorate with advancing age, making your chances of becoming pregnant less. It is noted that live birth rates for IVF are only 40% for women above the age of 35 years.

  • Quality of embryo:

This is one of the leading causes of IVF failure. The embryos may appear to be healthy under laboratory conditions but they fail to get implanted into the uterus as they do not get the right environment to grow.

  • Ovarian response:

IVF treatment requires a woman to daily inject a fertility hormone called follicle stimulating hormone (FSH). This hormone is responsible for increasing egg production. Sometimes, the woman’s ovaries do not respond in the way expected and thus, fail to produce multiple eggs for collection. Older women are more prone to have this condition of low ovarian reserve.

  • Implantation failure:

If the egg fails to get implanted in the uterus, the IVF fails. Several reasons could contribute to the failure of implantation including a premature increase in progesterone levels, infection of the uterus, presence of uterine polyps, or an endometrial lining that is too thin.

  • Autoimmune disorders:

An autoimmune disorder can also cause the embryo implantation to fail as the antibodies may start attacking healthy cells or tissues. In the case of IVF (embryo implantation), the immune system may mistakenly recognize the embryo as invading tissues and attack it.

  • Chromosomal issues:

It is characterized by the presence of an extra or missing chromosome and is often, one of the major causes for IVF implantation failures. Women in their mid or late 30s are most likely to develop chromosomal abnormalities. Therefore, women who have had multiple implantation failures, are generally advised to undergo preimplantation genetic screening.

  • Sperm abnormality:

Any irregularity in the structure of the sperm will lead to an unfertilized egg as the sperm fails to penetrate the egg’s outer membrane. This results in the failure of the IVF procedure.

  • Lifestyle:

Unhealthy lifestyle practices such as smoking that fertility specialists advise to get rid of in case of natural pregnancies, also apply to women who undergo an IVF. Consumption of alcohol and having a bad nutritional diet are also contributing factors to multiple conception failures. IVF cycle outcomes can also be affected if the woman undergoing IVF is underweight or overweight.

After IVF failure: What next?

In Vitro Fertilization Process - NU Fertility
If your first IVF cycle has failed, it may be useful to find out the reason behind its failure. It may have been due to the woman’s maternal age, cause and duration of infertility, history of previous pregnancies, male factor (sperm count and quality), and lifestyle influence. The younger the age of the woman, the greater is the possibility of an IVF to succeed. A woman in her 20s has 60-70% higher chances of conceiving in the very first in-vitro cycle. In case of a first-time IVF failure, your fertility specialist would generally recommend you to undergo another cycle because with every cycle, the chances of a woman to conceive become more.
In case of two failed in-vitro cycles, the couple needs to undergo another cycle, after determining the cause of failure during the previous two cycles. However, a third-time IVF failure can only mean an underlying condition that is disrupting the in-vitro implantation, leading to repeated failure. In such cases, it is advisable to opt for a more specific and advanced pregnancy treatment.

Advanced treatments after multiple IVF failures

Prefilled Pen Syringe - NU Fertility

Despite having recurrent IVF failures, there is still hope of conceiving with the other advanced treatment options now available. These pregnancy procedures can be carried out once your fertility specialist has analyzed your previous cycles to rule out the reason behind the IVF failure.

  • Frozen embryo transfer:

FET is a procedure in which healthy embryos (blastocysts) from a previous in-vitro cycle are frozen and preserved for use at a later time. This technique is fast gaining popularity over conventional in-vitro cycles.

  • Intracytoplasmic sperm injection:

Often abbreviated as ICSI, this is an advancement in the conventional IVF procedure. During this procedure, the egg is directly fertilized by injecting with a single live sperm. ICSI is a good option for couples where the male suffers from male factor infertility.

  • Intracytoplasmic morphologically-selected sperm injection:

IMSI is another advancement in the traditional IVF procedure. It is similar to ICSI except that in IMSI, the sperm is first analyzed under high magnification to select only the sperm which has the best morphology. This procedure is helpful in case the male partner’s sperm has quality issues.
Treatment of immunological causes of infertility before proceeding with the next cycle.
Preimplantation genetic testing of embryos for chromosomal abnormalities before embryo transfer.

With the latest medical advancements in the field of fertility treatment, it is now possible for a woman to conceive in spite of multiple IVF failures. However, it is important to let your fertility specialist run a battery of tests on you and your partner to ascertain the cause behind IVF failure. Your desire to become parents is no longer a dream!
NU Fertility at NU hospitals is the best place for IVF failure treatment in Bangalore, India. The fertility specialists here not only make it possible for you to conceive using IVF, but also rule out IVF failure reasons. Once the reason is known, they take you through the best possible treatment so that your wish of becoming a parent turns true. Visit NU Fertility in case you have any issues in conceiving through IVF as this is the best place for infertility treatment in Bangalore.

Diagnosis of vaginismus

Your healthcare provider will ask you questions about your symptoms, medical, and sexual history. A pelvic examination can help determine if there are any other issues or the presence of muscle spasms. A topical numbing cream may be applied on the outside of your vagina prior to the pelvic exam to reduce discomfort.

 

References:

1. Failed IVF Cycles: Reasons, What to Do Next, and Tips for Success. Grace Fertility. https://gracefertility.in/3-failed-ivf-cycles-what-next/. Accessed on 5 October 2023.
2. IVF Failure- Why Did My IVF Fail? The Fertility Foundation. https://fertilityfoundation.org/ivf-failure-why-did-my-ivf-cycle-fail/. Accessed on 5 October 2023.
3. Weathering the Storm: What to Do After Your First Failed IVF-When and How to Try Again? India IVF. https://www.indiaivf.in/blog/first-ivf-failed-what-next-when-to-try-again/. Accessed on 5 October 2023.
4. WHY DOES IVF FAIL? The Fertility & Gynaecology Academy. https://www.fertility-academy.co.uk/blog/why-does-ivf-fail/. Accessed on 5 October 2023.

Author: Dr. Sneha J

Patients seeking for IVF treatment

Work From Home – A Ray of Hope for Patients seeking IVF Treatment

The demand for IVF treatment is gathering pace. This is because it has helped all those patients who were otherwise unable to conceive. The ultimate objective of IVF is to have a successful pregnancy and a healthy baby. However, today’s digitally driven and stressful corporate world has created a challenge for women who are looking to welcome Motherhood with the help of IVF treatment.  However now there is a ray of hope as Work from Home is the new norm for most of the employees due to the current crisis caused by the pandemic.

How Work from Home Benefits?

The present pandemic has forced many employees working in the corporate world to compulsorily work from home. While this could slightly be a challenge to deal with those employees, especially working women, who have children to take care of, it can be a boon and much needed boost for those, who are eagerly looking to go the family way.

Success Rates of IVF Treatment

IVF has been a successful course of treatment adopted by many working women globally due to its success rated and flexible pre-requisites.  Having said that, IVF treatments needs to be well-planned, as the procedures involved take time. One of the major challenges women faced while working out of office was to request for time and leave. The high pressure, corporate work environment always made it difficult for women to plan the IVF treatment program.

The other reason is the sensitivity involved in discussing the nature of the treatment with superiors and managers. Many managers would think twice before sanctioning leave due to the stringent delivery schedules and productivity issues. Parallely, women too would find it difficult to discuss as they would want to keep the infertility issue confidential, which is understandable and rightfully so.

Working from Home comes as a big relief for all those working women who would want to plan to take IVF treatment and look forward to have a baby. They can plan their schedule in such a way that they can balance both personal and professional commitments. It is a challenge to decide to undergo the IVF treatment due to the complexities involved. The financial, physical and emotional stress on the patient due to the processes involved could be difficult to bear. This is where work from home can come in as a good solution.

Conclusion

The best part of a women’s life comes in when she is ready to go the family way and attain motherhood. It is one of the most joyous moments to expect her first child. However, finding herself in a position to meet her professional and personal expectations is a challenge in today’s world.

The IVF treatment is a proven way to help women enjoy motherhood in a safe and successful way. The need of the hour is to visit a fertility centre which gives a patient hearing to every patient and offers personalized care. It is of utmost importance to understand the work schedule of the couple and time the IVF procedures accordingly.

How to balance work from home and enjoy motherhood? NU Fertility at NU Hospitals has the answer to all your queries. 

IVF Fertility Care

Fertility Care – It’s all about being in Good Hands

Life presents us with many choices. It’s the choices we make that determine our future. This is all the more evident in the healthcare sector these days where patients would like to have multiple opinions before going ahead with the medical treatment advised by the physicians relevant to their specific health issues. In other words, patients would like to meet multiple doctors and take their individual opinions. This is also referred to as doctor shopping.

Doctor shopping is widely seen in patients addicted to drugs but there is another sector which is in great demand across the world and continues to see patients being impatient and choosing to doctor shop and that is choosing the IVF treatment to address fertility issues.

IVF continues to by far be the most used medically assisted reproductive technique. However, it has been observed that most of the patients resort to doctor shopping here. The reasons are multiple.

1. Patients want to take an opinion if they really need IVF or could do away with other simple treatments.

– Choose a fertility specialist who clearly justifies the treatment, discusses the other available options and their pros and cons. Discuss the success rates of each of the options available and then decide

2. Next thing to be discussed is the success rate of IVF.

– Always remember IVF success rate is anywhere between 50-65 % across the globe and never 100%. Success depends on multiple factors. Patient factors cannot be changed but appropriate clinical judgement and individualization of protocols can make a difference. Choose a clinician with a good experience. Read their online reviews and consider taking reference from other patients who have undergone IVF there.

The IVF lab and the embryologist make a huge difference in the success rate. Choose a centre which has a well maintained and well equipped IVF lab. Make sure they have a in house senior embryologist. Insist on talking to them so that you can get to know who is handling your embryos and also clear all your doubts and uncertainties. Make sure to enquire about the success rate of the centre which you are considering.

3. Next important consideration is the finance.

– Most of the IVF clinics are not transparent about the charges. They do not divulge the exact price during the discussions with the patients. Most centres offer IVF packages. However, having had to make a choice, you may not be right all the time as you might just be lured into attractive packages and actually end up shelling much more than what you anticipated.

When comparing the IVF packages enquire about the hormonal injections used. Substandard drugs can decrease the cost of the IVF package but may compromise with the outcome. Also find out if the package includes the procedures like semen freezing, embryo freezing, blastocyst transfer, laser hatching, frozen embryo transfer or any other add on s which may be suggested by your fertility expert.

4. Publicity: With many IVF centres cropping up, all of them resort to publicity to be visible. Don’t blindly follow the publicity material. Decide based on the above parameters.

Conclusion

It’s time to choose wise and choose well. Hence make your choices reflect your hope, not your fears. It’s up to you to make a healthy choice. Are you still stuck with making the best choice now?!

Your search ends here at NU Hospitals. You will surely not have to make another choice.

 

 

Brief History of In Vitro Fertilization

Brief History of IVF

Let’s start at the beginning. In-Vitro Fertilisation, or now more commonly known as IVF treatment saw a flicker of hope as early as the mid-1800s. In the mid-1800s, scientists finally discovered the process of artificial fertilization using a combination of sperm and egg.

History of IVF In the 19th Century

In the 1900s, fresh pieces of research on hormones and how they related to fertility began more fervently. Though around then, IVF-like researches were performed on rabbits..

In 1965, Dr. Jones worked with Dr. Edwards of England and fertilized the first human egg in vitro, all for the world’s first IVF baby.

After three years, in 1968, Dr. Edwards joined Dr. Patrick Steptoe in England, and performed a laparoscopy surgery to retrieve an egg and fertilize it in-vitro (in the lab). The results were published in 1969.

In 1973, the first pregnancy through IVF was reported from Monash university by CarlWood and it was a biochemical pregnancy.

In 1976 an ectopic pregnancy was reported by Patrick Steptoe and Robert Edwards.

First Pregnancy through IVF

Then in 25th July 1978, IVF saw its first birth by Patrick Steptoe and Robert Edwards. It took 102 IVF cycles to achieve this first successful IVF birth. The couple, Lesley and Peter Brown, became the parents to a healthy daughter, Louise Joy Brown, the world’s first test-tube baby.

In this sentinel IVF birth, the mother had a natural menstrual cycle, physicians laparoscopically retrieved a single pre-ovulatory oocyte from her ovary, fertilized it in vitro, and then transferred the resulting eight-cell embryo into her uterus. Even as the birth made headlines around the world, several legal and ethical questions were raised about the future of mankind. However, this one successful birth presented a happy chance for many couples who were battling fertility issues.

When Second IVF baby was born ?

Second IVF baby was born in India – Durga alias Khanupriya Agarwal on October 3rd 1978 . The Pioneer was Dr Subhash Mukopadyay.

Now with reproductive technology booming, the race for test-tube babies was on. After England’s test-tube baby, Australia announced its achievement in 1980. A year later, USA announced the birth of its very own IVF baby, Elizabeth Carr. But many harboured a big concern: the worry that an IVF baby cannot conceive naturally. The concern was put to rest when Louise Joy Brown gave birth to her own baby in 2006, conceived and birthed naturally.

After the 80s, fertility treatments took off like wildfire. Fertility drugs were improved and further researched on; instead of laparoscopic surgeries to retrieve eggs, doctors began taking it out through the vagina; sperm boosting hormones for men facing fertility issues was being prescribed. Embryo freezing and thawing as well as ICSI have revolutionised the IVF treatment and its outcome.Comprehensive Chromosome Screening is now a very important health check for the unborn baby.

How IVF Treatment has been developed in India?

Growth of IVF treatment has been the fastest compared to any other medical field. And keeping up with the achievements in India, one can now secure the best IVF treatment in Bangalore with us. The positive impact of IVF was so great that now World IVF Day is celebrated on the 24th of July, to commemorate the birth of the first IVF baby – Louise Joy Brown.

ivf or tube reversal _nu fertility

Tube Reversal vs IVF Treatment : Which is the better Choice?

Attaining Motherhood and having children is one of the very important stages in life which a woman comes across. Though Pregnancy and Childbirth can get challenging at times, it is looked forward to as stage of immense significance, by every woman. While on one hand, birth control has become a topic for global discussion, on the other hand, there are many enthusiastic women, in their middle ages, who are looking at exploring options to extend their family, even after undergoing procedures towards achieving permanent birth control.

With life throwing up so many surprises at us at all times, circumstances change, relationships change and this might bring in a change in family building goals too. Recent studies indicate that in spite of having chosen the path to permanent sterilization, up to 14.3% of sterilized women request information about possible fertility options within a few years of having undergone the tubal sterilization procedure.

What are the possible options women can explore to achieve their dream of having children, following tubular sterilization?

Available Options

More widely suggested options for patients, in this case, is a surgical reversal of sterilization which is also referred as Tube Reversal or the process of In Vitro Fertilization or IVF, which is gaining global identity at a very rapid pace.

However, out of these two,

  1. which is the most preferred?
  2. Which process is cost-effective?
  3. Which is safer, easy and less risky based on female age? And most importantly,
  4. which process is more likely to yield the desired results?

To answer all these questions, which are on expected lines, let’s get straight into the options involved and study them independently.

Tube (block) Reversal

For simple understanding, Tube (block) Reversal is a short stay procedure, performed as an outpatient, to restore contact between tubal segments. This is a small procedure, performed using microsurgical techniques. Basically, this procedure is aimed at supporting women, who wish to become pregnant without more complex medical attention.

Process Involved during Tube Reversal,

  1. The blocked sections of the fallopian tubes are reconnected with the remainder of the Fallopian tubes, which subsequently facilitate the eggs to move up the tubes smoothly and interact with the sperm.
  2. Your doctor will take a closer look at your medical parameters before suggesting a Tube Reversal procedure. Age, body weight and fertility factors such as the (egg count, sperm quality) are taken into consideration.
  3. Furthermore, one must consider the post-operative recovery period and time off from work, usually relatively minimal but, could be possibly prolonged. Your doctors will also look into possible complexities for ectopic pregnancy as well.
  4. However, it is interesting to note that not every type of tubal sterilizations is reversible. If the earlier fallopian tube segments are either short or subjected to damage due to surgery or infection earlier, the Tube Reversal might not be the best option. Therefore, your doctor would clearly ascertain these factors to come to a conclusion.
  5. An in-depth study of the male partner’s semen sample is also conducted as a part of the pre-surgical tests required.
  6. The time taken to confirm that the Tube Reversal surgery was a success or not is usually 3 months after the surgery was performed.

In addition, it might take close to 2 years for the patient to become pregnant, after the success of the surgery.

Many patients tend to term this waiting period as pretty long as they continue to remain anxious about the results.

Misconceptions about IVF 

In Vitro Fertilization (IVF)

IVF or In-vitro fertilization continues to gain prominence as a very effective alternative to Tube Reversal. Since its inception in 1970, this technique has been refined and continues to make immense progress with very high success rates.

To put in in easy words, IVF is a procedure by which an egg is fertilized in the lab and then transferred to a woman’s uterus. This facilitates the process of pregnancy to occur by completely bypassing the Fallopian tubes. So, the events which ordinarily occur in the fallopian tubes thus occur in the laboratory, providing a sort of tubal bypass.

The process of IVF allows the choice of the strongest and healthiest embryos.

Compared to a Tube Reversal process, IVF can be thought about as an effective solution, even for problems like advanced age, tube damages beyond repair and male factor infertility. The post-procedure downtime in IVF is rather minimal. However, with the sensitivity involved with the procedure, it is always important to choose a best IVF clinic with care.

This question has been very effectively answered by best Fertility Hospital in Bengaluru, which has proven experience in offering high standard IVF services, to the fullest satisfaction of its patients. The experience and techniques employed by the IVF physicians at NU fertility is a combination of the very latest in technology and subject expertise.

Which then is the best choice: IVF or Tubal Reversal?

One of the best things about IVF is that the time taken for pregnancy is much shorter as it takes only two months for the process to be completed. The age of the woman in question is also important as the choice of whether to go for Tube Reversal of IVF depends largely on this factor. The number of children, a couple would desire also influences the decision. It is well understood that with advance in age, the chances of a woman to conceive is lesser and hence for those women who are above 35 years of age, IVF perhaps be a better choice.

Though women below the age of 35, who would want to attain parenthood again after having undergone Tube Ligation, might look into Tube Reversal, published reports for all age groups truly indicate that the success-per-cycle rates in IVF are better than those for tubal reversal.

Conclusion

Doctors connected with leading medical institutions suggest IVF over Tube Reversal, but that is surely not without a reason. Though there is not much of a difference with respect to cost in both the procedures, IVF enjoys less risk factors and more success rates, than Tube Reversal. Findings have suggested that the chances of ectopic pregnancy with Tube Reversals are as high as 20% while that with IVF is almost legible, as low as (3) %. (The pregnancy rates with IVF in tubal factor infertility are 65%; the highest among all causes of infertility while the pregnancy rates with tubal surgery vary between 20-60% depending on multiple factors.) Compared to a Tube Reversal procedure, IVF does not require a prolonged hospital stay.

Above all, it’s the quality of your medical service provider and the comfort level they offer from the basic stages of discussions that matters and NU Hospitals sees that you are comfortable, both before and after your treatment is completed to your fullest satisfaction.

ivf misconceptions

Misconceptions about IVF

IVF is one of the most fascinating discoveries of the 20th century. Nobel prize in medicine was awarded to Sir Robert G Edwards in 2010 for this amazing discovery. It has been about 40 years since the birth of the first child through IVF. Over 4 million people owe their existence to IVF. Despite this, many people are not convinced by this concept.

 Popular Misconceptions about IVF

  • IVF injections cause cancer.

All the injections which are given are eliminated from the body within one month. There have been numerous studies till date which have proven that the gonadotropin injections do not cause cancer. However, a small risk of borderline ovarian tumours is noted, which have an excellent prognosis with preservation of fertility. An oocyte donor can donate eggs for up to 6 cycles safely!

  • The medications take away all eggs and result in early menopause.

Normally a group of follicles containing eggs begins to grow at the beginning of a menstrual cycle. Only 1 egg matures enough and is released from the ovary. Remaining degenerate. In IVF, these injections rescue the degenerating eggs and stimulate them to reach maturity. As a result, the age of menopause is not affected.

  • Babies born through IVF are not normal physically and mentally.

2% of the babies conceived naturally are born with some malformation. Similarly, about 2-3% of babies born through IVF are with malformations. Most of the abnormal embryos do not implant in the uterus and grow.

  • IVF results in twins and higher-order pregnancies

We can limit the number of embryos transferred into the uterus and hence prevent multiple pregnancies. In other treatment options such as ovarian stimulation and Intrauterine insemination IUI, all the eggs that are released are capable of being fertilized. Hence, we have no control over the rate of multiple pregnancies.

  • After IVF treatment, complete bed rest is required.

Both the egg retrieval and embryo transfer are daycare procedures, requiring an admission of 3-4 hours. It is advisable to avoid the strenuous physical activity of any sort; however, there is no evidence that complete bed rest favours embryo implantation. Routine activities can very well be carried out without affecting pregnancy rates.

NU Fertility - IVF Treatment

Things To Know Before Opting For IVF

Once a couple decides to go ahead with IVF(In vitro fertilization), the next concern is the IVF success rate and to decide when to go for IVF treatment. As we all know IVF has its limitations and a variety of factors influence the outcome. Some of them are under our control and some of them are not.

What is the Sucess Rate of IVF?

The outcome of an IVF cycle depends on the quality of the embryo which in turn depends on the egg quality and the sperm quality. Egg quality is mainly dependent on the age of the woman. As age increases, particularly in the late thirties, the chances of having aneuploid/ abnormal eggs increases.

ICSI( intracytoplasmic sperm injection) can overcome most of the sperm-related problems but severely abnormal semen samples can give rise to poor quality embryos, thereby compromising the IVF success rates. Egg numbers are equally important. Studies show that IVF success increases as the number of eggs retrieved increases up to about 15 eggs. Thereafter there is no further increase in the success.

Keep Reading

In vitro fertilization (IVF)

In-Vitro Fertilization (IVF)

  •  What is In-Vitro Fertilization (IVF)?

IVF (In-vitro fertilization) or test tube baby as it is commonly called is a procedure in which the eggs and the sperms are fertilized outside the body and then transferred back to the womb after 2-5 days.

  • Who needs an In-Vitro Fertilization (IVF)?

IVF may be considered if,

  1. You have been diagnosed with unexplained infertility.
  2. Your fallopian tubes are blocked other techniques such as fertility drugs or intrauterine insemination (IUI) have not been successful.
  3. Other techniques such as fertility drugs or intrauterine insemination (IUI) have not been successful the male partner has fertility problems and an abnormal semen analysis.
  4. The male partner has fertility problems and an abnormal semen analysis.
  5. You are using your partner’s frozen sperm in your treatment and IUI is not suitable for you.
  6. You are using donated eggs or your own frozen eggs in your treatment.
  7. You are using embryo testing to avoid passing on a genetic condition to your child.
  8. If you have severe endometriosis.
  • What do I expect during my test tube baby treatment cycle?

Your IVF/ Test tube baby treatment cycle would be as follows, 

Step 1: Once you have decided to go ahead with IVF, you will undergo a daycare procedure called hysteroscopy to assess the suitability of the uterus to hold the baby. It is generally done one month before your IVF cycle and involves the introduction of a small camera into the womb through the vagina to visualize the inside of the uterus. You will be given anesthesia during the procedure and hence there will be no pain.

Step 2: Your husband has to freeze one semen sample as a backup.

Step 3: Typically your treatment would begin on the second or third day of periods. It involves a scan and hormone tests followed by daily injections for about 8-10 days, along with monitoring by scan and hormone tests in between. Once the eggs are sufficiently grown as per the scan and hormone tests, you will receive injection Hcg as an ovulation trigger.

Step 4: Egg retrieval is performed transvaginally 35 – 36 hours later, with light anesthesia, using transvaginal ultrasound guidance. You will be discharged the same evening unless there are problems associated with bleeding, undue pain or ovarian hyperstimulation.

Step 5: After retrieval, eggs are assessed for their maturity. Meanwhile, the husband has to give a fresh semen sample. Mature eggs are injected with the sperms on the same day and grown in the incubator for 3-5 days.

Step 6: The final step is the embryo transfer. 3-5 days after your egg retrieval, two or three embryos are selected and gently transferred into the womb using abdominal ultrasound guidance. The procedure is usually painless, no anesthesia is required and you will be discharged in about two to three hours.

Step 7: You will be given certain supportive medications starting from the day of egg retrieval until your pregnancy check. You will be called for a pregnancy check 16-17 days after your embryo transfer.

  • What precautions do I take during the In-Vitro Fertilization (IVF)/ Test tube baby treatment?
  1. Eat a healthy diet rich in fruits and vegetables
  2. Be stress-free and relax your mind
  3. Avoid intercourse during the treatment.
  4. Don’t do a strenuous job during the treatment as your ovaries are enlarged and they may twist sometimes causing acute pain.
  • How do I prepare myself for an egg retrieval procedure?
  1. You will get admitted to the hospital early in the morning, between 6 am – 7 am and you have to be empty stomach at least 6-8 hours before the procedure.
  2. You will be administered light anesthesia as intravenous medication.
  3. The procedure is done vaginally using the scan guidance and a small needle.
  4. The entire procedure takes about 20-30 minutes.
  5. Post-procedure you may have slight pain or bleeding which usually subsides with medication.
  6. You will be discharged about 6 hours later.
  • What do I expect during embryo transfer?

It is done 3-5 days following the egg retrieval, which will be decided by your clinician. No anesthesia is required as it is a painless procedure. Rarely during your initial assessment, if it is found that getting into the uterus is difficult or if you are very uncooperative, you may be given light anesthesia. Your bladder has to be full before the procedure as it is done under abdominal scan guidance. Do not wear perfume/ deodorant or powder on that day as they are harmful to the embryos. Two or Three embryos are gently transferred to the uterus using a small catheter. You will lie down for about 15 – 30 minutes after the procedure and later you can pass urine. No need to take bed rest until your pregnancy check. This does not increase your chances of becoming pregnant.

  • What is ICSI? How does it differ from In vitro fertilization (IVF)?

ICSI Clinic in BangaloreICSI – Intracytoplasmic Sperm Injection, is an IVF procedure in which a single sperm is injected directly into an egg whereas in IVF, about 50,000 to 1,00,000 sperms are inseminated around the eggs and one of them penetrates the egg on its own. ICSI increases the fertilization rates especially in male factor infertility and cases of previous fertilization failure.

  • What is the success rate of test-tube baby?

The success rate varies with multiple factors especially the age of the women, egg and the sperm quality and the underlying cause of infertility. Overall the success varies between 40-50 %. Success decreases as the age of the woman increases.

  • What is the frozen embryo transfer?

Surplus embryos after your transfer can be frozen and kept in liquid nitrogen at -180 degree Celsius, for later use.

  • What are the complications?

Two most important complications of In-Vitro Fertilization (IVF) are

  1. Multiple pregnancies (20-25%).
  2. Ovarian hyperstimulation syndrome which occurs due to excessive response and can be prevented b appropriate modifications in the medications.
  3. Rarely ovaries may twist causing acute pain and may require a laparoscopy.
  • When can I know if I have become pregnant?

You will be tested for beta HCG – a blood test to confirm pregnancy 14 to 16 days after your embryo transfer.

  • Is my pregnancy going to be riskier after IVF? IVF Centre in Bangalore

There is no evidence to show that IVF babies have an increased rate of abnormalities. The pregnancy outcome will be like a normal conception but your doctor may have a low threshold for intervention when the problem arises.

References

  • Fertility: assessment and treatment for people with fertility problems.NICE clinical guideline;– Issued: February 2013.
  • van Loendersloot LL, van Wely M, Limpens J, Bossuyt PM, Repping S, van der Veen F (2010). “Predictive factors In-Vitro Fertilization (IVF): a systematic review and meta-analysis”. Human Reproduction Update 16 (6): 577–589.
Does the collection of eggs increase the chance of pregnancy?

Does the collection of eggs increase the chance of pregnancy from IVF?

The process of IVF(In-Vitro-Fertilization) involves the ovarian stimulation with hormones with the intention of retrieving more eggs. The whole idea is to have enough eggs to produce an optimum number of good embryos to transfer and to freeze a few in case the fresh transfer fails. The question here is how many do we actually need? What is the optimum number of eggs needed to achieve a live birth, which in turn is the ultimate aim of IVF?

Does the collection of eggs increase the chance of pregnancy?

The higher number of eggs retrieved is associated with a probability of more chromosomally normal (euploid) embryos which can implant and give rise to a living birth. Chromosomally abnormal embryos (“aneuploid”) are unlikely to develop as pregnancies, and, if they do, frequently result in miscarriage. The frequency of chromosomally abnormal embryos increases with age and thus the pregnancy rates decrease with age. To produce one and two euploid embryos respectively, five and 14 oocytes would be required at age 34, while 10 and 24 oocytes would be required at age 38. Thus it makes sense to retrieve more eggs.

But this comes at a cost .. To retrieve more eggs often we have to use a higher dose of hormones increasing the cost as well as the side effects. It also leads to a potentially serious complication of ovarian hyperstimulation where they collect fluid in the abdomen, lungs and also susceptible to hypotension, increased clotting tendency and at times renal shutdown. The excessive ovarian response can also cause the enlarged ovaries to twist on its pedicle, cutting off its blood supply – what we call as ovarian torsion. This is an acutely painful condition which requires immediate medical and surgical attention. Another reason for concern is the compromised egg quality for unknown reasons when there is an excessive ovarian response. The raised estradiol hormone in case of excessive ovarian response advances the implantation window, thereby causing an asynchrony between the embryo and the endometrium (uterine lining), ultimately decreasing the implantation rates.

Frozen Embryo Transfer

So our aim in IVF cycle is to retrieve anywhere between 8 to 15 oocytes, so as to consider a fresh embryo transfer and also to expect a reasonably good pregnancy rate. Studies have proven that pregnancy rates steadily increase till 15 oocytes and thereby it decreases. When there is hyperresponse we may have to defer embryo transfer and freeze all embryos to avoid potential complications of ovarian hyperstimulation. They can be transferred at a later date after preparing the endometrium – Frozen Embryo transfer.