IVF Process Explained
First successful birth of Louise Brown in 1978 was the culmination of scientific research in reproductive medicine. There has been a flood of breakthroughs since then, in both basic science and clinical medicine which has enabled millions of infertile couple to taste the joy of parenthood. Over 2 million successful births have been reported till date using assisted reproductive technologies (ART). IVF is the most common and popular form of ART.
Process of IVF
The Process of IVF begins when an infertile couple accepts their situation and decides to seek medical counsel. It takes courage to step into the infertility treatment center with a head full of questions.
Post the initial consultation which is basically a detailed account of your medical history to detect any discrepancies which hint at infertility, you are offered treatment options. A consultation with the clinical coordinator outlines the various treatment options offered by a facility. Here, the exact time line of the IVF treatment procedure is penned down. The final round of consultation is the financial aspect.
The real treatment of IVF begins here. There are two phases of preparing: first the pretreatment preparation followed by prescription of birth control pills.
During the pretreatment phase, comprehensive lab tests are conducted to understand the cause of infertility. These tests include ultrasounds, a blood panel, uterine evaluation, screening for infectious diseases and male fertility testing. On completion of the tests, birth control pills are prescribed to regulate the menstrual cycle and prepare ovaries for a possible fertilization. Pills are generally prescribed for a period of 2-4 weeks.
Monitoring and medication
On completion of the prescribed dosage of birth control pills, the period of Controlled Ovarian Hyperstimulation (COH) begins. COH is conducted in two stages:
- First stage is when the patient is prescribed fertility medication like Clomid or injectable solutions for a period of two weeks or more. These medications are used for the stimulation of follicles. Fertility medication aims at producing a minimum of four eggs through the process.
- Monitoring the process and efficacy of the fertility medication forms the second stage of COH. Timely ultrasound scans and blood tests are conducted to evaluate the development of eggs and follicles.
Egg retrieval, triggering and fertilization
When the fallopian tubes have grown to the appropriate size, final maturation of the eggs is triggered using hCG. An ultrasound is scheduled after 36 hours to retrieve the egg. Egg retrieval is performed under clinical sedation. Once the egg is retrieved, fertilization is attempted with the collected sample. Three options for external fertilization exist:
- Assisted hatching where the external layer of the egg is perforated to increase the chances of implantation
- Intracytoplasmic sperm injection (ICSI) is performed when the male sperm lacks the ability to penetrate the egg. Here, the sperm is directly injected into the egg.
- Preimplantation genetic diagnosis (PGD) or screening (PGS) is a selective process where healthy embryos are transferred. Chances of misconception owing to a genetic disorder are greatly reduced.
72 hours after fertilization, embryos are ready for transfer. Through the opening of the cervix, a thin flexible plastic tube delivers the embryo to the uterus. Supplementation of progesterone greatly helps in embryo implantation.