IVF or In Vitro Fertilization is a process where fertilization occurs when an egg is fused with sperm, in vitro. Conception, in this case, takes place outside the human body, but once fertilization has taken place, the fertilized embryo is put back into the uterus.
Preparation for IVF can start as early as six months before the procedure. One can start with following a healthy diet and lifestyle, reducing alcohol intake and smoking, cutting out canned and processed food from your diet and following an exercise regimen to maintain an ideal BMI. Stress management techniques such as deep breathing and yoga are recommended. Improving your sleep cycle and getting sufficient sleep helps enhance fertility. Taking vitamin-rich food can also be a factor that improves the chances of conception.
A little before the treatment begins, the female patient is given oral medication, to optimize her chance of pregnancy. The IVF procedure is not painful for most people, though it can be a bit uncomfortable and cramps may occur in a few patients.
The IVF procedure begins 4 to 6 weeks prior to egg retrieval. Once fertilization takes place, the embryos are transferred approximately 3 to 5 days later.
A step by step process of the entire cycle is explained below:
Step One: Starting from Day 2 of the menstrual cycle the patient will need to undergo daily injections and ultrasound scans at regular intervals to monitor follicle growth. Ovarian stimulation may also be achieved with a combination of tablets and injections. In addition, blood tests are also done to monitor hormone levels. The uterine lining will be assessed at the time of the ultrasound scan.
Step Two: When the follicles reach the right size (18-20mm) as seen on the ultrasound scan by the IVF specialist, an injection called the trigger is given to mature the eggs
Step Three: The egg retrieval is scheduled 34 to 36 hours after administration of the trigger injection.
Step Four: On the day of oocyte retrieval the husband or partner will need to give a semen sample. There should be a period of abstinence of 2- 3 days before giving the sample. If the partner cannot be present or in case of difficulties in producing a sample on the day of egg retrieval, a semen sample is collected in advance and the semen analyzed and frozen for use during the IVF.
Step Five: The semen sample is processed and placed in a petri dish along with the retrieved eggs.
Step Six: Fertilization takes place and embryo development starts.
Step Seven: Embryos can be cultured in the lab for up to five days depending on their quality.
Step Eight: The embryo transfer may be done on any day between the second and fifth day after oocyte retrieval. By the fifth day the embryo is a blastocyst and having a blastocyst transfer can improve your chances of pregnancy. Generally, not more than two embryos are transferred but you can also opt for an elective single embryo transfer.
Step Nine: Two weeks after the date of embryo transfer a blood test is done to check for pregnancy
In case of a positive outcome, the expectant mother is referred to an obstetrician for prenatal care approximately six to eight weeks after embryo transfer.
If the outcome is not positive, one can consult the doctor and go for a repeat IVF cycle or choose another method that may improve their chances of pregnancy.
IVF is a very safe procedure when done by experienced doctors. However, there are some risks that one must be aware of.
Although the IVF process places the embryo in the uterus, sometimes it can get implanted outside the womb. This happens mostly due to damaged fallopian tubes and can cause abdominal pain, vaginal bleeding, and other complications. In case of severe abdominal pain please contact your IVF specialist immediately.
Injectable fertility drugs can sometimes cause hot flushes, insomnia, and nausea. It can also cause Ovarian Hyperstimulation Syndrome (OHSS) where ovaries become swollen, causing pain.
In certain cases where more than one embryo is planted in the uterus, it can lead to multiple pregnancies with twins, triplets, or quadruplets.