What couples taking IVF treatment need to know:

IVF is the most effective solution for some infertility issues, and it is the most popular type of assisted reproductive technique. Most couples opt for IVF when they have lost hope after years of trying through traditional methods, or when other treatments fail. In Vitro Fertilization (IVF) is a process of fertilization with a complex series of medical and surgical procedures. In this process, the sperm is mixed with the egg in vitro, which means in a lab or outside the body. Another advantage of IVF is that in addition to assisting with conception, it also prevents genetic problems. 

When should a couple opt for IVF?

IVF may be the only treatment for couples, who have been diagnosed with one of the following reasons:

• Low sperm counts
• Problems with ovulation due to conditions like polycystic ovary syndrome
• Endometriosis
• The uterus or fallopian tubes blocks
• woman’s advanced age and years of infertility
• if either one in a couple has been sterilized
• Inferior quality of egg
• Sperm or eggs affected by antibody problems
• The genetic disease in either partner in a couple

Expect some case like complete tubal blockage, IVF may never the first infertility treatment. It is important to consult with the fertility clinic before opting for IVF treatment.

How to prepare for the process of IVF?

There are some preliminary blood tests that are performed to assess the general health of the couple. While choosing the fertility clinic, it is essential to consider their success rate and also keep in mind that the success rate may also depend on the age of the patients, medical issues and treatment approaches. It is always recommended asking for detailed information about the process and costs associated with each procedure. The average IVF cost in India ranges from 2 to 4 lakhs.

A couple is likely to undergo various screenings before the start of the IVF cycle using their own sperm and eggs. These include:

Ovarian reserve testing: The doctor might test the concentration of FSH or Follicle Stimulating Hormone, Estrogen, and anti-mullerian hormone in a female partner’s blood to determine the quantity and quality of the eggs. These tests take place during the first few days of the menstrual cycle. The ultrasound of the ovaries is done and often used with the test results to predict how the ovaries will respond to fertility medication.

Semen analysis: The semen analysis may be done at the later part of the fertility evaluation. Just before the start of an IVF treatment cycle, the treating doctor may conduct this analysis.

Infectious disease screening: The couples will be screened for infectious diseases. This screening is done to find any potential health disorders without any signs or symptoms. It may include hepatitis, HIV, RPR (syphilis), Blood type and Rh Factor.

Practice embryo transfer: Mock embryo transfer is a common procedure done by the fertility doctor that occurs during or before the IVF cycle. It helps to determine the depth of the uterine cavity, measures the length between the female partner’s cervix and finds the perfect location to place the embryo in the uterus. 

Uterine exam: Before the start of IVF, the doctor will examine the inside lining of the uterus. The ultrasound is done to obtain images of the uterine cavity by injecting the fluid into the uterus through cervix. It is called sonohysterography. A thin, flexible, lighted telescope, called hysteroscope can also be used by inserting it through the vagina and cervix into the uterus. This is called hysteroscopy.

What to expect during the process of IVF?

Taking fertility medications for several months is the first step in the IVF process that helps the ovaries to produce mature eggs from the female partner and ready for fertilization is called Ovulation Induction. The hormone levels are measured regularly with blood tests and ultrasounds that also help to keep track of the egg production. Once the mature eggs are produced, the eggs are removed from the body. This procedure is called Egg Retrieval. It is a minor surgical procedure. During this procedure, the patient is sedated or under short anesthesia and ultrasound is used to locate follicles in the ovary. The eggs are pulled gently out of each follicle using a needle connected to a suction device.

After this, the retrieved eggs are mixed with sperm of the male partner or a donor in the laboratory. It is called Insemination. The sperm must be donated on the same day. The eggs and sperm are stored together in a container and are kept under adequate conditions to ensure optimal growth where fertilization happens. The sperm may be injected directly into the eggs if it has lower motility and not be able to swim as well to promote fertilization. The fertilized eggs then divide and become embryos and reach an advanced blastocyst stage.

After a few days (approximately 3 to 5 days), one or more embryos are transferred into the uterus is called Embryo transfer. A thin tube slides through the cervix into the uterus, and the embryo is placed through the tube directly into the uterus. If any of the embryos can attach to the lining of the uterus, it may result in pregnancy.