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What is IVF treatment?

IVF treatment has 5 basic steps and embryo transfer process which include the following:

1. Monitor and stimulate the development of healthy egg(s) in the ovaries.
2. Collect the eggs.
3. Secure the sperm.
4. Combine the eggs and sperm together in the laboratory and provide the appropriate environment for fertilization and early embryo growth.
5. 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.

These steps are followed by rest and watching for early pregnancy symptoms. A blood test and potentially an ultrasound will be used to determine if successful implantation and pregnancy have occurred.

Do IVF treatments have any risk?

As with most medical procedures, there are potential risks. The risks of in vitro fertilization is related to each step of the procedure

Ovary stimulation carries the risk of hyperstimulation, where the ovaries become swollen and painful. This condition, "Ovarian Hyper stimulation Syndrome", is usually rare, mild, and involves the following potential side affects: nausea, vomiting, lack of appetite, or a feeling of being bloated. More severe symptoms that occur in 1% of cases include the following: Side effects of IVF treatment are

  • Severe abdominal pain
  • Severe nausea or vomiting
  • Decreased urinary frequency
  • Dark-colored urine
  • Shortness of breath
  • Ten pound weight gain within 3 to 5 days
  • Egg retrieval and the use of laparoscopy carry the typical risks associated with receiving anesthesia. Additionally, there is a slight risk of bleeding, infection, and damage to the bowel, bladder, or blood vessel.
  • Less than one patient in 1,000 will require surgery to repair damage caused during the egg retrieval process.

The chance of a multiples pregnancy is increased in all assisted reproductive procedures. There are additional risks and concerns related to multiples during pregnancy including the increased risk of premature delivery.

Assisted reproductive technology (ART) involves a significant physical, financial, and emotional commitment on the part of a couple. Psychological stress and emotional problems are common, especially if IVF treatment is unsuccessful.

Fortis Healthcare, D.Y Patil Group, NM Medical Healthcare
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