• Shruti GOCHHWAL

IVF: In Vitro Fertilization Step by Step

IVF is an in vitro fertilization technology which facilitates in the production of eggs in a laboratory, where the sperms are fertilized outside the body. That is done where a pair cannot reproduce a baby because of problems of infertility.

IVF Process

This process of In vitro fertilization includes a series of steps like-

  1. Stimulating the ovaries to produce eggs

  2. Retrieving eggs

  3. Retrieving sperms

  4. Fertilizing it under lab conditions and

  5. Embryo transfer into the uterus

It may take between two to three weeks for one IVF treatment period, while the pair is required to take different procedures. More than one cycle will also be done in some circumstances due to failure of IVF treatment. Let’s learn about the In vitro fertilization procedure step by step.

1. Ovulation Induction

IVF

Woman taking hormone injection for IVF, Image Credits: pixabay


IVF procedure starts from day one of your period. You will receive synthetic hormones for activating your ovaries on the first day of your menstrual period if you plan to use your own eggs during the IVF phase. In general, every month, during menstruation, a woman produces one egg. Synthetic hormone treatment aims to develop more reproductive eggs. Multiple eggs are needed for treatment, as eggs are not fertilized in the majority of cases and this process may increase the probability of fertilization.

Several different medications may be prescribed during IVF which include:

●  Medications for stimulating ovaries

For stimulating the ovaries to produce more than one egg the following hormone therapy is given:

  1. Hormones like follicle-stimulating hormone (FSH),

  2. Luteinizing hormone

  3. Or a combination of both

● Medications to promote maturation of the oocyte

When the ovary follicles are prepared for the recovery of egg after 8-14 days. You may be treated with human chorionic gonadotropin (HCG) or various other drugs that facilitate egg maturation.

● Medications to halt premature ovulation process

These kinds of medications help prevent the release of developing eggs early.

● Medications that help prepare the lining of the uterus

Your doctor will consult with you to determine medication continuation and discontinuation. Your doctor will also do a vaginal scan or blood test to find out how ready the eggs are to be taken. These assessments also help to identify different other process performance or failure criteria.

During this time, if unfavorable conditions are detected, the doctor will even cancel the IVF treatment. If you cancel the IVF, your physician may prescribe a change of drugs which may improve your chances of the IVF procedure being successful.

2. Egg Retrieval

After 34-36 hours of final injection and before ovulation, Egg retrieval is carried out. The process of egg retrieval involves:

  1. The process is very quick and takes about 20 minutes to extract several eggs.

  2. The patient is sedated, and with the help of transvaginal ultrasound aspiration method, the eggs are retrieved.

  3. During the process, an ultrasound probe is directly inserted into the vagina which helps identify the follicles.

  4. Your doctor may then insert a thin needle into the ultrasound probe which passes through the vagina and the follicles to retrieve the eggs through a suction device.

  5. The mature eggs will then be placed in a nutritive culture medium and incubated.

3. Sperm Retrieval

If the partner’s sperm is used in the process, then he’ll need to give a semen sample. There are also other procedures such as testicular aspiration that can be used to extract sperm directly from the testicle by using the needle or a donor sperm. The extracted sperm is isolated from the fluid of semen in the laboratory.

4. Fertilization

Fertilization is commonly carried out under two methods

  1. Conventional insemination: This method is carried out in a petri dish where healthy sperm is allowed to fertilize a single egg out of multiple eggs and then incubated overnight.

  2. Intracytoplasmic sperm injection (ICSI): When the quality of semen or the number is not appropriate ICSI procedure is carried out where a single or healthy sperm is injected directly into each of the mature egg.

There are some cases in which your doctor may advise you to make your IVF fruitful. These include:

  1. Assisted hatching: In situations where your age is quite old, or you have had multiple failed attempts of IVF. your doctor may recommend “assisted hatching”.  In this technique, a hole is created in the membrane zona pellucida just before the embryo transfer. This can help the embryo hatch and implant into the lining of the uterus.

  2. Preimplantation genetic testing: Preimplantation genetic testing can help people with reduced likelihood of passing a genetic problem to their offspring. During this process, Embryos can grow at the incubators until a tiny sample can be retrieved and checked for the right number of chromosomes or particular genetic diseases. You can transfer embryos that do not include affected genes or chromosomes to your uterus.

5. Embryo Transfer

After 2-5 days of egg retrieval and incubation period. Your doctor will perform embryo transfer

  1. Your doctor will implant a catheter into your vagina, cervix and uterus during the process.

  2. The doctor inserts one or two embryos into the uterus using a syringe attached to the end of the catheter.

  3. If this process is successful, then your embryo will be implanted in the lining of the uterus usually after six to 10 days of egg retrieval.

After the procedure

You will carry out the daily tasks after the successful transfer of the embryo. You should however stop hard work because it will cause pain.

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