IVF

Definition:

IVF is a medical procedure to help with fertility, prevent genetic problems, and assist in conceiving a child.

Steps Involved in IVF:

1. Egg Collection:

• Mature eggs are retrieved from a woman’s ovaries.

2. Fertilization:

• The eggs are fertilized with sperm in a laboratory.

3. Embryo Transfer:

• The fertilized egg (embryo) or multiple embryos are transferred to the uterus.

4. Cycle Duration:

• A full IVF cycle takes about three weeks, though it can take longer if steps are divided.

Purpose of IVF:

1. Treatment for Infertility:

• It helps couples struggling to conceive.

2. Genetic Problem Prevention:

• Ensures genetic issues are addressed before conception.

3. Fertility Preservation:

• Preserves fertility for individuals undergoing treatments that may harm reproductive ability.

Alternative Treatments Before IVF:

• Fertility Drugs:

• Stimulate the production of eggs.

• Intrauterine Insemination (IUI):

• Sperm is directly placed in the uterus during ovulation.

When IVF is Recommended as a Primary Treatment:

• Women aged 40 or above.

• Specific health conditions affecting fertility.

Health Conditions Where IVF is Beneficial:

1. Fallopian Tube Damage or Blockage:

• Makes egg fertilization or embryo travel to the uterus difficult.

2. Ovulation Disorders:

• Irregular or absent ovulation reduces egg availability for fertilization.

3. Endometriosis:

• Uterine tissue growing outside the uterus affects the ovaries, uterus, and fallopian tubes.

4. Uterine Fibroids:

• Benign tumors in the uterus wall can hinder embryo implantation.

5. Previous Tubal Sterilization or Removal:

• IVF can bypass sterilization (e.g., tubal ligation) for those wanting to conceive.

6. Impaired Sperm Production or Function:

• Issues like low sperm count, poor motility, or abnormal sperm shape can make fertilization difficult.

7. Unexplained Infertility:

• When no clear cause for infertility is found despite evaluations.

8. Genetic Disorders:

• For couples at risk of passing genetic disorders, Preimplantation Genetic Testing (PGT) is done.

• Eggs are fertilized, and embryos are screened for genetic problems.

• Only embryos without identified issues are transferred to the uterus.

9. Fertility Preservation:

• For individuals undergoing cancer treatments (e.g., radiation or chemotherapy) that may harm fertility:

• Eggs can be frozen: Unfertilized or fertilized (as embryos) for later use.

Gestational Carrier (Surrogacy):

• Women without a functional uterus or for whom pregnancy poses health risks can opt for a gestational carrier:

• Eggs are fertilized with sperm.

• The embryos are implanted in another person (the carrier), who carries the pregnancy.

Five Basic Steps of IVF

Stimulation (Super Ovulation)

• Purpose: To stimulate the ovaries to produce multiple eggs instead of the usual one egg per month.

• Procedure:

• Fertility drugs are given to the woman to boost egg production.

• Regular transvaginal ultrasounds monitor the ovaries.

• Blood tests check hormone levels.

Egg Retrieval

• Purpose: To collect mature eggs from the ovaries.

• Procedure:

• Follicular Aspiration: A minor outpatient surgery.

• A thin needle is guided into the ovaries using ultrasound.

• The needle suctions eggs and fluid from each follicle.

• Post-procedure:

• Cramping may occur but usually resolves within a day.

• If eggs cannot be retrieved naturally, donated eggs may be used.

Insemination and Fertilization

• Purpose: To combine the eggs and sperm for fertilization.

• Procedure:

• The man's sperm is mixed with the best-quality eggs in a controlled environment.

• Fertilization occurs within a few hours after insemination.

• If fertilization is unlikely, Intracytoplasmic Sperm Injection (ICSI) is used:

• A single sperm is injected directly into the egg.

• Many fertility clinics perform ICSI on some eggs as a precaution.

Embryo Culture

• Purpose: To monitor embryo development after fertilization.

• Procedure:

• Once the fertilized egg divides, it becomes an embryo.

• By day 5, a healthy embryo has several dividing cells.

• If there is a risk of genetic disorders, Preimplantation Genetic Diagnosis (PGD) may be done:

• A single cell from each embryo is screened for genetic issues.

• Helps select embryos without genetic disorders.

• Note: PGD is controversial and not available at all centres.

 Embryo Transfer

• Purpose: To place embryos into the uterus for potential implantation.

• Procedure:

• Done 3-5 days after fertilization.

• A thin tube (catheter) containing the embryos is inserted into the womb through the cervix.

• If an embryo implants in the uterine lining, pregnancy occurs.

• Multiple embryos may be transferred, increasing the chances of twins or triplets.

• Unused embryos:

• Can be frozen for future use or donated.

Key Considerations:

• Age Factor: The number of embryos transferred often depends on the woman's age.

• Risks: IVF increases the chances of multiple pregnancies.

• Flexibility: Frozen embryos offer opportunities for future attempts.

Conclusion:

IVF involves a systematic process to help couples facing fertility challenges. Each step is carefully managed to increase the likelihood of successful pregnancy, with options for genetic testing and embryo freezing enhancing the process.