In Vitro Fertilization Treatment
What are the steps of IVF treatment?
The cycle before the treatment
- Step 1: The cycle before the actual IVF treatment begins you may be put on medications to control your menstrual cycle and depending on the protocol you may be required to take injections.
- Step 2: When you get your cycles, on the second day of your period, you will undergo an Ultrasound to check the ovaries and look for ovarian cysts and start the treatment.
- Step 3:Ovarian stimulation will be done with hormonal injections and frequent monitoring will be done with ultrasound to look in to the follicular growth and development. There may be need to do blood tests to evaluate the estrogen levels and progesterone to rule out premature leutanization. Once the follicles attain the dominant size, egg retrieval will be scheduled after 36 hours of HCG trigger.
- Step 4: Egg retrieval or ovum pick up is planned under general anesthesia, transvaginal USS guided oocyte retrieval is preferred, a needle is used to gently aspirate the follicle and then transferred to the Embryology lab for assessment of oocytes. After the procedure you will be monitored for few hours and then discharged, light spotting and abdominal cramps is common after ovum pick up.
- Step 5: Fertilization: On the day of egg retrieval husbands semen sample will be collected, sperms from washed and processed sample will be selected for doing ICSI of the mature oocytes. The fertilization will be checked 16-18 hours after doing ICSI and the embryos allowed growing in the lab for few more days.
- Step 6: Embryo transfer: The fertilized eggs now termed as the embryos are then transferred in to the uterus after 3 - 5 days using an embryo transfer catheter. The number of embryos transferred will depend on the quality of the embryos and also the age of the patient. Post the transfer you will be given rest for 3 hours and then discharged.
Advantages of blastocyst culture:
- Blastocyst is an embryo that has developed for five days after fertilization. Most of Embryo transfers are performed on day 2 or day 3. Recently, improvement in embryo culture condition has allowed sustained embryo development to the blastocyst stage. It is stage at which embryo naturally arrives to the uterine cavity and implantation occurs. Preliminary studies with new media and age in good responder woman have shown that ~50% of the fertilized eggs reach blastocyst stage.
Disadvantages of Blastocyst culture:
- Better selection of the embryos to be transf
- Better selection of the embryos to be transferred
- Limit the number of embryos to be transferred
- Eliminate the risk of multiple pregnancy
Candidate for blastocyst transfer:
- Longer time interval between retrieval and transfer
- No embryos or fewer embryos for freezingNo embryos or fewer embryos for freezing
- Risk of embryo arrest
- Woman with at least six number of good quality embryos on day II after oocyte pick up
- Woman under age 35
- Oocyte recipients who receives young oocytes from donor
- Step 7:Luteal support: This is started soon after your egg retrieval is done, progesterone injections are given daily and estrogen supplements started to prepare the uterus to receive the pregnancy. Post embryo transfer also this support is continued till the pregnancy test is done.
- Step 8:Pregnancy test and follow up: After 15 days of embryo transfer, pregnancy test is done, this will usually be a blood test, if the test is positive the progesterone support is continued for few more weeks.