IN VITRO FERTILIZATION [IVF]
IVF in Sudha Sundar Clinic is a major treatment in infertility when other methods of assisted reproductive technology have failed. The process involves hormonally controlling the ovulatory process, removing ova (eggs) from the woman's ovaries and letting sperm fertilise them in a fluid medium. The fertilised egg (zygote) is then transferred to the patient's uterus with the intent to establish a successful pregnancy.
IVF may be used to overcome female infertility in the woman due to problems of the fallopian tube, making fertilisation difficult.
IVF also avails for egg donation or surrogacy where the woman providing the egg isn't the same who will carry the pregnancy to term. This means that IVF can be used for females who have already gone through menopause. The donated oocyte can be fertilised in a crucible. If the fertilisation is successful, the zygote will be transferred into the uterus, within which it will develop into an embryo.
There are five basic steps in the IVF and embryo transfer process which include the following:
- Monitor and stimulate the development of healthy egg(s) in the ovaries.
- Collect the eggs.
- Secure the sperm.
- Combine the eggs and sperm together in the laboratory and provide the appropriate environment for fertilization and early embryo growth.
- Transfer embryos into the uterus.
Step 1: Fertility medications are prescribed to control the timing of the egg ripening and to increase the chance of collecting multiple eggs during one of the woman's cycles. This is often referred to as ovulation induction. Multiple eggs are desired because some eggs will not develop or fertilize after retrieval. Egg development is monitored using ultrasound to examine the ovaries, and urine or blood test samples are taken to check hormone levels.
Step 2: Eggs are retrieved through a minor surgical procedure that uses ultrasound imaging to guide a hollow needle through the pelvic cavity. Sedation and local anesthesia are provided to reduce and remove potential discomfort. The eggs are removed from the ovaries using a hollow needle, a procedure called follicular aspiration. Some women may experience cramping on the day of retrieval, which usually subsides the following day; however, a feeling of fullness or pressure may continue for several weeks following the procedure.
Step 3: Sperm, usually obtained by ejaculation is prepared for combining with the eggs.
Step 4: In a process called insemination, the sperm and eggs are placed in incubators located in the laboratory. The incubators enable fertilization to occur. In some cases where there is a lower probability of fertilization, intracytoplasmic sperm injection (ICSI) may be used. Through this procedure, a single sperm is injected directly into the egg in an attempt to achieve fertilization. The eggs are monitored to confirm that fertilization and cell division are taking place. Once this occurs, the fertilized eggs are considered embryos.
Step 5: The embryos are usually transferred into the woman's uterus from one to six days later, but in most cases the transfer occurs between two to three days following egg retrieval. At this stage, the fertilized egg has developed into a two-to-four cell embryo. The transfer process involves a speculum which is inserted into the vagina to expose the cervix. A predetermined number of embryos are suspended in fluid and gently placed through a catheter into the womb. This process is often guided by ultrasound. The procedure is usually painless, but some women experience mild cramping.
IVF can also be combined with preimplantation genetic diagnosis (PGD) to rule out presence of genetic disorders. A similar but more general test has been developed called Preimplantation Genetic Haplotyping (PGH).
