IVF Programme Step by Step Overview:
Initial Consultation
The couple should bring along their records of infertility workup that they possess, such as hysterosalpingogram films, semen analysis report, basal body temperature chart, previous laproscopy test results. The IVF team physician will counsel the couple about the program and some further investigations may be necessary to establish the chances of success. The woman may have to be scheduled for a screening laproscopy, hysteroscopy, and ultrasonography, if needed to assess the pelvic anatomy and accessibility of the ovaries for egg retrieval.
The woman is taken into the program from her previous cycle for down regulation. Medication is given to the patient during the early phase of her next cycle to increase the likelihood of developing more than one egg.
Blood tests are drawn frequently from the onset of stimulation to determine the progress of stimulated ovaries.
Serial Ultrasound examinations are conducted several times to visualize the developing follicles. The size of the follicles and result of the blood testes will determine the time of egg collection.
Eggs are retrieved transvaginally by needle aspiration guided by ultrasonic imaging. This requires local / general anaesthesia. The eggs thus obtained are immediately placed in a cultured dish that contains a special nourishing fluid. The patient can leave the IVF centre soon after egg retrieval.
Semen sample is collected preferably by masturbation in the morning of collection of the eggs. There is a facility of freeing the semen sample before the day of egg collection if required. The sperm cells are separated from the seminal fluid, mixed with the eggs and then are placed in incubator unit till such time, as the eggs are ready to be fertilized.
Fertilization is the process of sperm penetrating the egg. The egg being fertilized is now called an embryo. These are observed further to be certain that they are dividing (cleaving) normally.
Embryo transfer is done between day 2 to day 5 depending upon number and quality of embryos available The embryos are placed into uterus using thin tube (catheter) through the mouth of the womb (Cervix). The procedure is done on outpatient basis. The patient leaves IVF centre soon after transfer procedure. When indicated, blastocyst stage transfer is offered. Generally 2 to 3 embryos are transferred and spare embryos, if any, are cryo preserved for future use with patient’s consent.
In order to improve implantation of embryo in uterus, pure progesterone is given as luteal support in the form of. vaginal pessaries, or gel or injectables.
Blood test for beta HCG titre is performed to confirm pregnancy approximately 10 days following embryo transfer