In Vitro Fertilization (IVF) & ICSI
IVF/ICSI or Test Tube Baby is the process of fertilizing an egg outside the body. Life begins with fertilization; the sperm entering the egg and subsequent formation of the embryo and then its implantation in the uterus.
The steps of IVF procedure
Stimulation of Follicles: We know that while millions of sperms are expelled in each ejaculation, the eggs are present inside the female's body and they are in immature form. These eggs are within 'follicles' in each ovary. In order to fertilize eggs through in-vitro, they have to be developed and then retrieved from the body. This is called 'ovarian stimulation'. From second or third day of menses, injections of follicle stimulating hormone are started daily. These injections are in pen form and are virtually painless. Injections are continued for ten to twelve days till follicles reach a size of 18 mm.
We check levels of hormone estrogen and progesterone on the day that follicle reaches size of 18 mm and an injection called 'trigger' is administered.
35 hours after trigger, process of egg retrieval is performed.Transvaginal Oocyte Retrieval (egg pickup): The follicles are aspirated under ultrasound guidance. This procedure does not involve any cut or stitch and is done under sedation, so its practically painless. Each follicle is aspirated and the embryologist screens the fluid from follicles and picks up the eggs under microscope.
Fertilization: The eggs retrieved are incubated in culture media for two hours. The partners semen sample is taken in morning of egg retrieval and is prepared in the andrology lab.. There are three methods of fertilizing the eggs: Conventional IVF, Intracytoplasmic Sperm Injection and Test Tube Baby. In Conventional IVF, eggs are incubated with sperms and one sperm fertilizes the egg. In Intracytoplasmic Sperm Injection, one good quality sperm is injected inside the egg using a special inverted microscope and micromanipulator. After 18 to 20 hours of ICSI, the fertilization check is performed. Usually 70 to 100% of mature eggs are expected to fertilize. The fertilized eggs are called embryos and they are further cultured for 2 to 5 days when the process of embryo transfer is carried out. And Test Tube Baby is a process of fertilizing an egg with sperm inside a test tube. This process undergoes for 2-6 days and is then transfers to the same or another woman’s uterus. Test Tube Baby Center in Bhopal operated by Dr. Priya Bhave Chittawar, who is a specialist in In Vitro Fertilization (IVF).
Embryo Transfer: The best quality embryos are transferred back in the uterus under ultrasound guidance. Usually two to three embryos are transferred. This procedure is done without anesthesia and this is painless. Patients can go home 30 minutes after embryo transfer and no restriction as activities or bed rest is required. After embryo transfer, medicines to support the pregnancy are given and blood test to check the result is carried out 14 days after embryo transfer.
The success rate of IVF is variable and depends on cause of infertility, quality of sperms and eggs, ovarian reserve, age of female, the quality of the IVF lab and of course the skill of the treating doctor. Roughly the pregnancy rates are 40 to 45% in women less than 35 years and 30 to 35% in women over 35 years.
IVF Center and Test Tube Baby Center in Bhopal have higher success rates in women where donor eggs are used and may be close to 60% per cycle.