In Vitro Fertilization (IVF) is a procedure wherein an egg is fertilized outside a woman’s body. It is a form of Assisted Reproductive Technology (ART), in which the child born is known as “test-tube baby”.
During this procedure, a woman’s ovum is removed from her ovary and fused with a man’s sperm manually in a lab and fertilized outside her body and then inserted back in her uterus to get her pregnant.
The process includes complex medical procedures and specially directed medications. The medications aid in boosting the development of eggs.
The fertility expert subsequently extracts developed eggs and fertilize them with sperms in a lab. One or more fertilized embryos are consequently placed in the uterus.
How IVF Process Works?
A man, ideally the woman’s partner donates a sample of semen so that the strongest sperm can be picked for fertilization. If the man is infertile or if a woman doesn’t have a partner/spouse, the sample is taken from a donor.
The IVF process includes the following phases:
1. Fertility Medication
Before commencing, the woman will have to take fertility medication and will be administered injections to stimulate the ovaries that will aid in producing eggs. The medication will continue for a period of 10 days.
2. Follicle Aspiration
Follicle Aspiration is the procedure in which the eggs are harvested from the ovaries. Each follicle is a sack filled with fluid that comprises an egg.
A long needle is inserted through the vagina to pull the eggs from the follicles using a suction device.
3. Fertilization
These eggs collected are taken to the lab immediately for fertilization. Fertilization is done through a process known as artificial insemination. In this process, multiple sperms are fused with the fittest egg.
The fertilized eggs are monitored for a few days as they begin to develop. Some of these eggs are transferred, and the rest are stored below the freezing point for future use.
4. Embryo Transfer
The embryos are transferred three to five days after fertilization. A loaded syringe containing multiple hatched embryos are inserted into the uterus through the vagina. Most couples will have to wait for at least two weeks before a pregnancy test.
Tests Performed Before Undergoing IVF
Before the IVF treatment begins the man and the woman will have to undergo several tests to ensure that they are both fit physically and mentally for this type of treatment.
Here is a list of some of these tests:
Prolactin and AMH (only for women):
Prolactin and AMH are hormones measured from a blood test. This test must have been carried out recently to help in judging the most appropriate drug regimens.
Cervical smear:
It is important for women to have a cervical smear in the past three years before going for IVF treatment.
If you have not had a cervical smear, then you will have to visit your GP to arrange for one before beginning IVF. All fertility clinics will ask for a copy of the most recent smear test at the time of your treatment.
Rubella:
A blood test will be carried out to corroborate your immunity to rubella. It is essential to have the result of this test before the treatment begins.
If the results show that you are not immune, you must talk to your fertility specialist about the need for immunization.
Chlamydia screening:
Chlamydia is a microbe that can damage your fallopian tubes. To see if you are carrying this microbe, a vaginal swab for the female partner and the male partner’s urine test will be done.
Ultrasound scan:
All patients who are scheduled to undergo IVF will have to go through an ultrasound scan to eliminate fluid in the fallopian tubes, cysts in the ovaries, polyps within the cavity of the uterus, and fibroids in the uterus wall.
Tubal patency test:
This test is an ultrasound examination of the fallopian tubes. There are two ways of carrying out this test, the HyCoSy method, and the Laparoscopy and Dye test. These tests help determine if you are suffering from endometriosis.
Semen evaluation:
Even if you had a semen analysis done recently, your doctor may still ask you to have this done again.
Your doctor will ask you to produce a sample on-site, which is then subjected to a detailed analysis that lets them determine the treatment options available for you.
Ovarian reserve testing:
This includes a few hormone blood tests that will give your doctor an idea of the number of eggs in a woman’s body. Certain hormones are tested specifically, Estradiol, AMH, and FSH.
Digital high magnification:
In this process, the best and healthiest sperm is picked for insertion.
Embryo Biopsy
Comprehensive Chromosomal Screening (CCS)
In the instance of a miscalculation in the construct of a chromosome that leads to a sperm or egg having an extra or missing chromosome, the embryo produced will have an extra or missing chromosome.
This condition is known as aneuploidy. Aneuploidies often will not lead to implantation of the embryo.
Preimplantation Genetic Diagnosis (PGD)
This procedure is done in conjunction with IVF. This procedure is meant to help identify inherited genetic diseases or genetic abnormalities in embryos before implantation, thus preventing the transfer of imperfect embryos.
If you have tried in vain to get pregnant and choose to go through infertility treatment, there are several factors to contemplate. The same is accurate for pre-implantation genetic testing.
