The IVF procedure is the most reliable assisted reproductive technology. The procedure can be done using the couple’s eggs and sperm. Alternatively, the procedure may be done using eggs, sperm, or embryos from an anonymous or known donor*. A surrogate* or gestational carrier* may also be used. If this is the case, the fertilized egg is implanted in the uterus of another woman.
*Donor/Surrogacy procedures are currently applicable only in India.
*Donor/Surrogacy procedures are subjected to country laws.
IVF Process From Start to Finish
Before the IVF process begins, the couple needs to undergo various IVF tests, as well as medical and physical evaluations. For the female, tests may be needed to check hormonal levels. The number and quality of eggs may also be evaluated. Blood tests may be performed to check prolactin, AMH, TSH, and hemoglobin. The female will also be tested for diabetes. An ultrasound of the uterus will also be done. Males should perform a sperm analysis to evaluate sperm count, shape, and motility.
Step 1: Ovarian stimulation
After a thorough evaluation, the IVF process is carried out, usually starting on days 2-3 of the cycle (during the period). Injectable hormones are used for nine to twelve days, to help multiple eggs to grow, This provides a better chance of fertilization.
During the stimulation, your doctor will follow up on the follicle growth by performing a few ultrasounds, so the doses of the medication can be adjusted according to the response.
Step 2: Egg Retrieval
The next step of the process is egg retrieval. This is done at the hospital approximately 36 hours after the final injection and before ovulation. This process takes about 20-30 minutes and it is performed under anesthesia. Then, transvaginal ultrasound is used to identify follicles. A needle that is attached to a suction device is then injected, through the vagina, into the follicles to collect the eggs.
After the process, you may feel some light cramping. You may also notice a feeling of pressure. Once the mature eggs are in the lab, they are placed in a dish that contains a special culture solution that is made up of nutritive substances. The dish is then placed in an incubator, which creates a special environment for the eggs until the fertilization with the sperm is performed.
Step 3: Sperm Retrieval
If the process involves using your partner’s sperm, their semen is collected, treated, and get ready for fertilizing the eggs.
There are different ways to collect semen. The most common way is through masturbation. This is done on the same day that the eggs are collected. Another method involves testicular aspiration (TESA), in which a needle is used to retrieve sperm directly from the testicles. This procedure is done using local anesthesia on the day of the egg collection. Sperm from donors may also be used.
Step 4: Insemination
Fertilization (insemination) is the process of mixing the eggs with the sperm. It can be performed using two common methods:
● Conventional insemination. This process is like natural conception. Healthy sperm and eggs are incubated together. The goal is to have one healthy sperm fertilize the egg on its own.
● Intracytoplasmic sperm injection (ICSI). In ICSI, one sperm is injected into the center of each mature egg. This procedure is typically done when the sperm number quality is a problem or if conventional insemination was not previously successful.
Step 5: Embryo Transfer
Your doctor will discuss with you if the embryo transfer (the procedure where the embryos are placed inside the uterus) should be done a few days after the egg retrieval or in the next cycle.
Embryo transfer is a painless process. Using ultrasound as a guide, your doctor will insert a thin, long catheter into the uterus through the vagina. One or more embryos are transported from one end of the catheter with a small amount of fluid. The embryos are then placed into the uterus, where the embryo has to implant.
After the Procedure
After the IVF process, you can return to your normal daily activities. However, your ovaries may still be sensitive. Avoid vigorous activities that may cause you discomfort.
Risks and Side Effects of IVF:
● Bloody discharge
● Breast tenderness due to changes in hormones
Contact your healthcare team right away if you experience any unusual pain and discomfort after the treatment. Your IVF specialist may want to evaluate you.
About ten days after the embryo transfer, your doctor will conduct a blood test to determine if you are pregnant. If you are pregnant, you may be referred to an obstetrician for further process. In case you are not pregnant, you must stop taking progesterone. Then, you should get your period within a week.
Your chances of a successful IVF depend on a lot of factors, such as:
Maternal age: Pregnancy, in many cases, depends on your age. You are more likely to get pregnant with your own eggs during IVF if you are younger. For women over the age of 41, using donor eggs can increase the odds of conceiving.
Reproductive history: If you have had a successful pregnancy before, you are more likely to get pregnant using IVF. The success rate is low for women who had undergone IVF many times before but did not get pregnant.
Embryo status: A healthy and developed embryo is more likely to cause pregnancy than a less developed embryo.
Ovarian reserve: Having a healthy supply of eggs also increases your chances of getting pregnant with IVF.
Lifestyle factors: If you are an active smoker, you are less likely to get pregnant . The risk also increases with the use of alcohol, caffeine, certain medicines, etc.
Words from ART Fertility Clinics
Getting pregnant through IVF can be stressful for many couples. But if you work along with your partner and your healthcare team, you can increase your chances of successful conception.
For more information, get in touch with the doctors at ART Fertility Clinics.