In Vitro Fertilization (IVF)
In Vitro Fertilization (IVF) helps with fertilization, embryo development, and implantation which help with pregnancy.
How does IVF work?
IVF stands for in vitro fertilization. It’s one of the more widely known types of assisted reproductive technology (ART). IVF works by using a combination of medicines and surgical procedures to help sperm fertilize an egg, and help the fertilized egg implant in your uterus. First, you take medication that makes several of your eggs mature and ready for fertilization. Then the doctor takes the eggs out of your body and mixes them with sperm in a lab, to help the sperm fertilize the eggs. Then they put 1 or more fertilized eggs (embryos) directly into your uterus.
Pregnancy happens if any of the embryos implant in the lining of your uterus. IVF has many steps, and it takes several months to complete the whole process. It sometimes works on the first try, but many people need more than 1 round of IVF to get pregnant. IVF definitely increases your chances of pregnancy if you’re having fertility problems, but there’s no guarantee — everyone’s body is different and IVF won’t work for everyone.
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Who Needs IVF?
- Tubal Damage or Block
- Absent or Low Sperm Count (< 5million /ml)
- Damaged uterine lining (Endometrium)
- Poor Ovarian (Egg) capacity/Advanced female age
- Failure of Fertility treatment for more than 2 to 5 years.
In vitro fertilization (IVF) is a treatment for infertility or genetic problems. If IVF is performed to treat infertility, you and your partner might be able to try less-invasive treatment options before attempting IVF, including fertility drugs to increase production of eggs or intrauterine insemination — a procedure in which sperm are placed directly in your uterus near the time of ovulation.
Sometimes, IVF is offered as a primary treatment for infertility in women over age 40. IVF can also be done if you have certain health conditions. For example, IVF may be an option if you or your partner has:
- Fallopian tube damage or blockage. Fallopian tube damage or blockage makes it difficult for an egg to be fertilized or for an embryo to travel to the uterus.
- Ovulation disorders. If ovulation is infrequent or absent, fewer eggs are available for fertilization.
- Endometriosis. Endometriosis occurs when the uterine tissue implants and grows outside of the uterus — often affecting the function of the ovaries, uterus and fallopian tubes.
- Uterine fibroids. Fibroids are benign tumors in the wall of the uterus and are common in women in their 30s and 40s. Fibroids can interfere with implantation of the fertilized egg.
- Previous tubal sterilization or removal. If you've had tubal ligation — a type of sterilization in which your fallopian tubes are cut or blocked to permanently prevent pregnancy — and want to conceive, IVF may be an alternative to tubal ligation reversal.
- Impaired sperm production or function. Below-average sperm concentration, weak movement of sperm (poor mobility), or abnormalities in sperm size and shape can make it difficult for sperm to fertilize an egg. If semen abnormalities are found, your partner might need to see a specialist to determine if there are correctable problems or underlying health concerns.
- Unexplained infertility. Unexplained infertility means no cause of infertility has been found despite evaluation for common causes.
- A genetic disorder. If you or your partner is at risk of passing on a genetic disorder to your child, you may be candidates for preimplantation genetic testing — a procedure that involves IVF. After the eggs are harvested and fertilized, they're screened for certain genetic problems, although not all genetic problems can be found. Embryos that don't contain identified problems can be transferred to the uterus.
- Fertility preservation for cancer or other health conditions. If you're about to start cancer treatment — such as radiation or chemotherapy — that could harm your fertility, IVF for fertility preservation may be an option. Women can have eggs harvested from their ovaries and frozen in an unfertilized state for later use. Or the eggs can be fertilized and frozen as embryos for future use.
- Women who don't have a functional uterus or for whom pregnancy poses a serious health risk might choose IVF using another person to carry the pregnancy (gestational carrier). In this case, the woman's eggs are fertilized with sperm, but the resulting embryos are placed in the gestational carrier's uterus.
About 12 days to two weeks after egg retrieval, your doctor will test a sample of your blood to detect whether you're pregnant.
- If you're pregnant, your doctor will refer you to an obstetrician or other pregnancy specialist for prenatal care. If you're not pregnant, you'll stop taking progesterone and likely get your period within a week. If you don't get your period or you have unusual bleeding, contact your doctor. If you're interested in attempting another cycle of in vitro fertilization (IVF), your doctor might suggest steps you can take to improve your chances of getting pregnant through IVF.
The chances of giving birth to a healthy baby after using IVF depend on various factors, including:
- Maternal age. The younger you are, the more likely you are to get pregnant and give birth to a healthy baby using your own eggs during IVF. Women age 41 and older are often counseled to consider using donor eggs during IVF to increase the chances of success.
- Embryo status. Transfer of embryos that are more developed is associated with higher pregnancy rates compared with less-developed embryos (day two or three). However, not all embryos survive the development process. Talk with your doctor or other care provider about your specific situation.
- Reproductive history. Women who've previously given birth are more likely to be able to get pregnant using IVF than are women who've never given birth. Success rates are lower for women who've previously used IVF multiple times but didn't get pregnant.
- Cause of infertility.Having a normal supply of eggs increases your chances of being able to get pregnant using IVF. Women who have severe endometriosis are less likely to be able to get pregnant using IVF than are women who have unexplained infertility.
- Lifestyle factors.Women who smoke typically have fewer eggs retrieved during IVF and may miscarry more often. Smoking can lower a woman's chance of success using IVF by 50%. Obesity can decrease your chances of getting pregnant and having a baby. Use of alcohol, recreational drugs, excessive caffeine and certain medications also can be harmful.
Talk with us or your doctor about any factors that apply to you and how they may affect your chances of a successful pregnancy.
Failed IVF Cycle
Our Center specializes in treating couples who have had failed IVF cycles. A failed IVF cycle can be because of poor egg quality, sperm quality or uterine lining. It is assumed that all the stimulation egg pick up, laboratory procedures and embryo transfers have been done meticulously in previous attempts. We offer certain modifications in an IVF cycles for optimizing outcome in couples suffering from failed IVF attempts.
- Optimized stimulation protocol:The short antagonist protocol offers the best results in terms of selection of the best oocytes (eggs) in most cases.
- Selection of Sperm :In many cases, IntraCytoplasmic Sperm Injection (ICSI) is offered as it has been suggested that it may improve fertilization rates and hence, overall pregnancy outcome. Our embryologist takes special care to select the best sperms for doing ICSI.
- Hysteroscopy :The hysteroscope aids us in picking up uterine abnormalities which are sometimes missed at routine ultrasound e.g., small polyps. It is also useful in washing and cleaning the uterus which sometimes may help in improving the outcomes. Endometrial scratching is also done at the same setting to improve the uterine receptivity.
- Intravenous Immunoglobulin (IYIG) : DHEA, L Arginine, Zinc, selenium etc. are given to women and men as indicated to improve the egg and sperm quality.
- Vitamins and Antioxidants : DHEA, L Arginine, Zinc, selenium etc. are given to women and men as indicated to improve the egg and sperm quality.
- Atosiban : This is a uterine relaxant which is given during the embryo transfer. It helps in relaxing the uterus and therefore, improving the endometrial receptivity.
- Laser Hatching : Laser hatching of the embryos is performed on the day of embryo transfer to ensure that the shell of the embryo hatches easily. This allows the embryo to implant better. This is mainly suitable for embryos with thick shells, advanced age groups and frozen embryos.
- ERA : ERA presumably detects the phase of the endometrium in which the embryo best implants. However, there is controversy regarding the actual benefit of this in improving the live birth rate.
- PGS : PGS is a way of detecting abnormal embryos thus may help in improving the pregnancy rates. However, each case must be individualized.
- Day of Transfer :Not all women will be benefitted by Blastocyst (Day 5 ) transfer as many seem to believe by studying the internet. The day of transfer should be individualized for each patient.
- Meticulous Transfer Technique : Embryo transfer is the final and one of the most crucial steps of IVF. All embryo transfers at AFGC are performed by Srijan Fertility Centre specialists.
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