Anything which occurs outside the body is called, in vitro and when fertilization of egg with sperm occurs out side the body it is called IN VITRO FERTILIZATION”. The first in vitro fertilization was done in the test tube and that is why it is popularly known as Test Tube Baby. Some problem in fertilization we need to asses the fertilization to help fertilization. We take out of the egg from the wife of egg from the woman’s ovary and in control lab and environment we fertilized egg with the help of sperm of her male partner. After fertilization the fertilized egg are cultured in to the control laboratory environment to form pre-enbryos and this pre-enbryos are then transferred back in to the uterus of the woman. If they implant and grow become the pregnancy.
Base line blood investigation
This includes Day 3 FSH, LH, PRL, TSH, Major pre-operative profile and other special blood investigations if necessary.
This will help us to choose best stimulation (medication) protocol to complete your IVF cycles.
Development of Oocytes (egg)
It is necessary. To stimulate the ovary to produce multiple follicle (the sac that contains the egg), in order to impro your chances of a successful out come from an IVF cycle. After the consult with the doctor, you will receive prescription for a specific type of medication stimulation protocol. There are many different medication protocols that the doctor may prescribe for you.
This decision is based on factors such as your age, infertility history, a past response to these medications, and a base line FSH level. The fertility medications that are necessary to stimulate the ovary are unfortunately all Injectable Medications. Doctor will explain you the dosage and method of administration. If we have more then one egg. We have better chance of pregnancy in IVF cycle. To get more eggs we stimulate the ovaries with stimulation drugs called gonadotrophins . Gonadotropins can be manufactured from urine or by recombinant DNA Technology. Appropriate type of gonadotrophins and dose of administration are selected for individual patients. Available gonadotrophins include HMG, FSH , and recombinant FSH manufactured by different pharmaceutical.
HCG (Human chronic gonadotrophin)
You will be given instruction for the exact time of this injection. It is generally taken 34-36 hours prior to the egg retrieval. This medication should be injected in to muscle. This medication completes the maturation of the egg. The egg collection process (retrieval) is usually accomplished using the ultrasound - guided trans vaginal method. A vaginal ultrasound allows for visualization of both ovaries. A needle is inserted through the vaginal wall in the ovary. Each follicle is punctured individually and the fluid containing the egg is examined by the Embryologist under the microscope until the egg is found. The duration of this procedure is usually less than 45 minutes. This procedure is done under general anesthesia.
Incubation and fertilization of oocytes (egg)
The eggs and sperm will be placed together in a special culture fluid and kept in incubators in our laboratory. This procedure is called insemination. The eggs will be examined 16-20 hours after insemination for signs of fertilization. If fertilization occurs , the fertilized eggs are now described as pre- embryos or zygotes.
When they divide to at least two cells they are called embryos. The laboratory environment is conducive for fertilization to occur, however, it cannot be guaranteed that fertilization will occur. Typically,60% of the eggs retrieved will be fertilized. This percentage may be higher or lower depending on each couple.
Embryo transfer (ET) usually occurs forty eight to seventy two hours post retrieval. The time of transfer will be designated by the IVF staff. The embryo(s) that is (are) assessed to be developing normally will be considered for transfer. Although a recommendation (1-3 embryos) will be made regarding the number to transfer, the final decision resides with the couple and the doctor.
Transferring multiple embryos may result in the growth of more than one fetus .if you have extra embryos after the transfer, they will be cryo preserved if they have demonstrated appropriate development. ET is performed by inserting a small catheter through the cervical opening into the uterine cavity. The embryo transfer is usually a painless procedure. There is a recommended rest period after the transfer. You will be given specific instruction prior to the transfer regarding your medications. Future testing dates and activity restrictions. With in 13 days post-transfer, hormonal levels and a pregnancy test will be done. If a pregnancy has occurred, further blood testing blood work and ultrasound will be required to assess normal progression.