IVF (IN VITRO FERTILIZATION)
IVF or In Vitro Fertilization as the name suggests is fertilization of the female gamete that is the egg with the male gamete that is the sperm outside the body (In vitro). It is a form of assisted reproductive technology used when others have generally failed. Initially used only for tubal factor infertility, nowadays IVF is used in various other factors like endometriosis, diminished ovarian reserve, male factor infertility and unexplained infertility.
The process of IVF involves the following steps
1) Ovarian stimulation
This process involves stimulation of the ovaries with hormonal injections (gonadotropins) which go on for an average of 12-14 days depending on the patient’s response to the injection. The aim of the process is to harvest maximum number of follicles in a given cycle of a female. Once the follicles reach their maximum size, the trigger injection is given and the eggs are just retrieved before they rupture that is at around 34 hours post the trigger injection. Here the trigger injection serves the purpose of final maturation of the eggs.
2) Oocyte retrieval or the egg collection
As the name suggests this process involves retrieval of the eggs. In this process, the patient is admitted under day care that is the patient is discharged on the same day of the procedure. Here under a short general anesthesia, under the guidance of an ultrasound, a needle is introduced transvaginally and the follicles are punctured and the follicular fluid is sucked out and handed over to the embryologists to search for the eggs in this fluid. Both sides follicles of the ovaries are sucked out and the patient is shifted to the recovery room and discharged around 5-6 hours post procedure depending on the recovery of the patient and any other associated high-risk factors.
3) In Vitro Fertilization
In this process, the egg is placed in a culture medium where sperms are inseminated and by the natural process of selection, the fertilization occurs. The fertilization is then checked on day 3 for the embryo formation and is either frozen on day 3 or transferred in the uterine cavity.
4) Embryo transfer
The final and the crucial step of embryo transfer wherein the embryo so formed is transferred inside the uterine cavity under ultrasound guidance. The patient then rests for 20 minutes and can go home the same day. The patient is advised to rest it out for few days, however bed rest is not required per se.
