IVF means in vitro fertilization (fertilization that happens outside the body). It involves fertilization of eggs in the lab and transferring the resulting embryos into the uterus.IVF is advised for couples in whom other fertility therapies have been unsuccessful or are not possible.
2. Who needs IVF?
IVF was initially developed for women with damaged tubes. Today all forms of infertility are treated with IVF when simple treatment fails to achieve a pregnancy.
3. How are the ovaries stimulated?
The ovarian stimulation is done by injections (Gonadotrophins).These are naturally occurring hormones extracted from human urine or are genetically prepared.(HMG, FSH, Recombinant FSH).The final maturation of the egg is achieved by HCG injection.
4. Do the injections have any side effects?
Injections used are pure hormones which act only on the follicles, they cannot act anywhere else in the body.
5. What is Ovarian Hyperstimulation Syndrome (OHS)?
OHS is one of the few complications of IVF.In rare instances the enlarged ovaries are associated with the collection of fluid in the abdomen, this is called OHSS. IF not detected and treated effectively OHSS can be a serious condition.
6. How is egg growth monitored during Ovarian stimulation?
Ovarian stimulation is monitored by measuring the size of the follicle (structure that contains the egg) by sonography.
Monitoring may also include blood tests for estradiol (estrogen), Progesterone, and LH.
Monitoring allows doctor to change the dose of the injections if required and also decide the date of egg collection.
8. How are the eggs retrieved?
Egg retrieval or Ovum Pick up is a procedure done under short general anesthesia. A thin needle is inserted into the ovary under ultrasound guidance and the follicular fluid is aspirated, this fluid contains the egg which are then separated in the laboratory.This procedure is commonly also called egg pick up.
9. Will my husband be required on the day of IVF?
Your husband will be asked to produce a semen sample on the day of egg retrieval.
Abstinence for three to four days is recommended before the egg retrieval day.
The semen is processed to separate motile sperms in the laboratory. These are used to inseminate the eggs.
(Please read the Semen collection instructions before collecting the sample.In case of difficulties kindly revert to the hospital staff.)
10. What happens in the IVF lab?
Sperms are mixed with the eggs at an appropriate time. The next day the eggs are checked for signs of fertilization. On the 2nd and 3rd day the embryos are evaluated under a high power microscope.
11. How is embryo transfer done?
Embryo transfer is a painless procedure and no anesthesia is required. Embryos are loaded in a thin, soft plastic catheter (tube).This catheter is threaded gently into the uterus. This process is performed under sonography control.
12. How many embryos can be transferred?
In our clinic we limit the numbers of embryo transferred to a maximum of two.In exceptional situation three embryos will be replaced after discussion with both of you.
13. Will transferring more than two embryos increase my chance of success?
Transferring more embryos increases the risk of a multiple pregnancy,even though it may increase the chances of getting pregnant.
14. Do I need bed rest after the IVF procedure?
You can rest for an hour after the embryos are transferred, after which you can resume your normal activity.
15. What is ICSI?
ICSI means Intra cytoplasmic sperm Injection, in which a single sperm is injected into the egg under a high power microscope .A micromanipulator, is used to capture and inject a single sperm into the egg.
16 .When do we do ICSI?
ICSI is done when sperm count is very low or when the sperm motility is low. It is also done when the sperms are recovered surgically.
17. What is the difference between IVF and ICSI?
In IVF the sperms are concentrated and mixed with the egg, they are then kept in the incubator under controlled lab conditions.
In ICSI a single sperm is injected directly into a single egg under the microscope.
18. What is the success rate for IVF/ICSI procedures?
The success rate of IVF/ICSI depends on many factors, quality of sperm or ovum, other factors like uterine . On an average success rate for the procedures is 35%
19. Is the success percentage different for IVF and ICSI?
In our clinic we define a positive outcomeonly if the pregnancy is seen on Ultrasonography.This is called as a clinical pregnancy.On an average clinical pregnancy rate is 35% per embryo transfer.
Of all the factors affecting the success of IVF cycle the major factor affecting success rate is a women's age.Other factor such as Sperm qua;ity,Uterine factors,endometriosis etc. can affect the outcome.
20. How many times can one do IVF or ICSI?
Most couples who benefit from IVF and ICSI will achieve pregnancy by the third or the fourth attempt.
The decision to continue the treatment is based on the observations made on the first one or two cycles.
21. How many days are required for one IVF or ICSI cycle?
It takes about a month for preparation and process of IVF cycle
22. When and how can I know if I am pregnant?
After the embryos are transferred into the uterus, a blood test for estimation of bHCG level is done after 13days. If the test is positive for a pregnancy, the bHCG level is again estimated after 48 hours to judge the growth of the pregnancy.
A month after the embryo transfer, sonography can visualize the pregnancy as well as baby's heartbeats.
23. Can the embryos be stored?
Fertilized embryos may be frozen and stored for future use depending on their quality.
24. What is the chance of success using the frozen embryos?
In our centre the success of a frozen embryo transfer is 30% per attempt,which is very close to the fresh embryo transfer process.
25. What are the chances of twins or triplets after IVF/ICSI?
Chances of conceiving twins are 20% after a two embryo or multiple embryo transfer.
Electctive , single embryo transfer will eliminate the chances of twins(except identical twins)
26. Are babies born from IVF cycle more delicate than natural conception?
There is no difference in babies born out of IVF cycle.