IVF - In Vitro Fertilisation

IVF or In Vitro Fertilization is often known as “the test tube baby treatment”. IVF treatment involves placing sperm and eggs together in a culture dish so that fertilization occurs in the laboratory. Not all the eggs will fertilize when mixed with sperm, so to increase your chances of success we stimulate the ovaries to produce several eggs at the same time. The success rate with this procedure is anywhere between 20 – 35 %. Different centers have different results & this depends basically on patient parameters & proper functioning ART lab, which should be well equipped, & equipments calibrated regularly for proper functioning & better results.

Cases in which IVF may be recommended

  1. Women with blocked or damaged fallopian tubes, where the egg may not be able to meet the sperm or make its way into the uterus.
  2. Couples where there is a problem with the sperm, i.e. the number of sperm is low, the sperm do not move well, or where there are high numbers of sperm, which are not properly formed.
  3. Women with ovulatory problems.
  4. Women with endometriosis.
  5. Cervical problems.
  6. Couples who have unexplained infertility.
  7. Failure of IUI

Advantages of IVF

  • Fertilization is confirmed
  • Successful treatment in most infertility cases

Disadvantages of IVF

  • Technically demanding
  • Risk of multiple pregnancy
  • Price / costs

The IVF procedure at a glance

The IVF process can be summarized in the following five steps:

  1. The ovaries are stimulated with FSH, in order to cause ripening of several follicles. This is called controlled ovarian stimulation (COS). Successful COS requires very precise day-by-day adjustment of the hormonal dose. This can only be achieved with the use of FSH in combination with GnRH analogues – GnRh agonist or GnRh antagonist, allowing the continuous growth of a large number of follicles whilst preventing a spontaneous LH surge through the suppression the natural secretion of FSH and particularly LH. A premature LH surge can cause early ovulation and jeopardize the success of the treatment cycle;

  2. When ultrasound monitoring indicates that the follicles are large enough to contain an egg that has matured sufficiently, hCG is injected to induce final follicular maturation;

  3. The eggs are collected about 34 - 36 hours after the hCG injection. Egg collection is usually carried out via the vagina under ultrasound guidance utilizing a long hollow needle, although egg collection by laparoscopy (via the abdominal wall) may occasionally be used

  4. The eggs are then fertilized with the sperm and the first cell divisions are monitored.

  5. Embryos are transferred into the uterine cavity 2-6 days after in vitro fertilization. A full bladder is required for embryo transfer as it is carried out under ultrasound guidance, for correct placement of the embryos in the uterine cavity.

  6. A two-week wait for a pregnancy test

Usually, more than one embryo is transferred to increase the chance of a successful pregnancy. To avoid the risk of multiple births, it is generally recommended that a maximum of two to three embryos be transferred. In November 1999, the American Society for Reproductive Medicine (ASRM) released guidelines on the number of embryos to be transferred. Under British and German law, a maximum of three embryos can be placed in the uterus at one time, although there are no similar legal restrictions governing our country. The number of embryos transferred also depends on the age of the patient, cause & duration of infertility, previous failed treatments & quality of the embryo developed.

With the introduction of cryopreservation, excess embryos can be stored for future cycles thus avoiding the patient to go through ovarian stimulation and egg collection again. These stored embryos can be transferred in a natural or hormone replacement cycle. Post thaw survival of the embryos may not be 100 %.

IVF Procedure

Ultrasound guided oocyte aspiration with collection of eggs in a tube containing IVF medium

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What is done with the eggs & sperms in the Lab?

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How the eggs, sperms & embryos look in the Lab?

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Poor quality oocytes

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A fertilized egg is identified by presence of 2 pronucleus and 2 polar bodies

Development of Embryo

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All couples wishing to start an IVF/ICSI cycle must decide the fate of eggs, which fail to fertilize, sperm and spare embryos remaining after your treatment. If the eggs do not fertilize within 24 hours they will not become embryos and will be destroyed unless you choose to donate them for research. Having decided how many embryos to be replaced, you must decide whether you wish to consider freezing of the spare embryos for later use. In all cases the best embryos will be transferred and the remainder assessed for suitability for freezing, if desired. Any spare embryos will be destroyed in a manner, which is acceptable to you, unless you choose to donate them for research.

Although the research may not be of direct benefit to you, it is aimed at improving our understanding of human development and genetic disease and thereby improving the success of this type of treatment.

You are under no obligation to agree to your spare eggs or embryos being used for research in order to be accepted for treatment.

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» Blastocyst Transers
» Assisted hatching & PGD
» Oocyte donation
» In-vitro Oocyte
» Embryo Images
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Dr. Patil’s Fertility and Endoscopy Clinic

Center for Assisted Reproductive Technology, Endoscopic Surgery and Andrology

No 1, Uma Admirality, First Floor, Bannerghatta Road, Bangalore - 560029
Ph: 080 - 41201357, 41462419 Mobile: 9945221622
E-Mail: drpatilsclinic@gmail.com

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