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Overview

In Vitro Fertilization: Cost, Procedure, Recovery, Risk & Complication

What is IVF?

In-Vitro Fertilization (IVF) consists of a series of procedures that are used for the treatment of genetic or fertility problems, while assisting the conception of a child. One of the most effective forms of assisted reproductive technology, IVF procedures can be conducted using a woman’s own eggs and her partner’s sperm. It can also be done by taking the eggs, sperm or embryos from a known or unknown donor. There are some cases where a gestational carrier (a woman with an embryo implanted in the uterus) can be used.

During IVF, mature eggs are retrieved from a woman’s ovaries and fertilized with the sperms in the lab. Once it has been fertilised, the egg or eggs are implanted back in the uterus. A cycle of IVF can take about 2 weeks.

Indication

One may have to undergo an IVF treatment in the following conditions:

  • If a woman’s fallopian tubes are blocked or damaged
  • If ovulation is infrequent/absent, or there are few eggs available for fertilization
  • Loss of normal functions of the ovary before reaching the age of 40
  • A previous treatment of tubal ligation, where the fallopian pipes have been cut/blocked permanently. In this case, one can opt for IVF instead of tubal ligation reversal.
  • Poor mobility, abnormality in sperm size/shape, or below average concentration of sperm of the male partner
  • If you have the conditions of endometriosis (uterine tissue will implant and grow outside the uterus) or uterine fibroids
  • Unexplained fertility or a genetic disorder

What Procedure is followed :

Pre Procedure

Before beginning the process of IVF, both the partners may have to go through certain pre-procedure screenings such as:

  • Ovarian reserve testing, for determining the quality and the quantity of the eggs. The concentration of estrogen, follicle stimulating hormone as well as the antimullerian hormone in your blood is checked by your doctor in the initial days of the menstrual cycle. These test results may help in predicting the response of your ovaries to fertility medications.
  • Analysis of the semen of the male partner
  • Screening for any infectious disease like HIV
  • A mock transfer of the embryo for determining the depth of the uterine cavity and the technique that may work best for you
  • An examination of the uterine cavity that may involve sonohysterography (fluid is injected in the uterus through the cervix and an ultrasound creates images of the uterine cavity) or hysteroscopy
  • Some serious question like the numbers of embryos that will be transferred, what needs to be done with the extra embryos, how to handle a multiple pregnancy, and the complications that may occur with donor eggs and sperms or a gestational carrier have to be discussed.

During Procedure

IVF treatment involves the following steps:

  • Ovulation induction, where synthetic hormones stimulate the ovaries for producing multiple eggs. You have to be under several medications for a week or two before the eggs are ready for retrieval. Vaginal ultrasound or blood tests are examined by the doctor to determine it.
  • Egg retrieval, through a transvaginal ultrasound. In this process, an ultrasound probe is inserted in the vagina for the identification of follicles. A thin needle is guided through the ultrasound guide to reach the vagina for collecting the eggs. The laparoscopy method can also be used for the same.
  • Sperm retrieval through masturbation or testicular aspiration in case the partner’s sperm is being used
  • The next step is fertilization either by insemination (sperm and eggs are incubated overnight) or Intracytoplasmic sperm injection (ICSI), where a single sperm is injected directly in a mature egg.
  • Embryo transfer is next step performed at the doctor’s clinic. It takes place two to six days after the retrieval of the eggs.

Post Procedure

Once the embryo has been transferred, you can go back to your regular schedule. However, your ovaries may be enlarged for a few days, so it is advisable to avoid any vigorous activity that may cause discomfort.

The side effects of post treatment may involve:

  • Passing of a small amount of clear/bloody fluid after the procedure, which is caused because the cervix is swabbed before the transfer of the embryo
  • Mild bloating and cramping
  • Constipation
  • Breast tenderness because of the high levels of estrogen

In case you have a moderate or severe pain after the transferring of the embryo, consult your doctor who will evaluate your condition. Any indication of a complication like an infection pr ovarian torsion can be examined and treated.

Risk & Complication

An IVF procedure may bring along with it certain risks and complications like:

  • Multiple births if more than one embryo has been implanted in the uterus. Multiple foetuses can often lead to premature delivery or a low birth weight of the newborn.
  • The frequent injection of fertility drugs to induce ovulation may lead to ovarian hyperstimulation syndrome, a condition where the ovaries become painful and swollen.
  • Using an aspirating needle for collecting eggs may lead to bleeding, damage or infection in the bowel, bladder or a blood vessel.
  • In some cases, there may be chances of an ectopic pregnancy. This is a condition where the fertilised egg will implant outside your uterus, generally in the fallopian tube. The egg would not be able to survive outside the uterus and the pregnancy will not be possible to be continued.
  • Miscarriage or birth defects
  • There may be a possible connection between some medications used in IVF and a specific type of ovarian tumor, though there have not been enough cases to support it.
  • The procedure of IVF can be physically, emotionally as well as financially draining, leading to stress.

More Info

Make sure that you continue having the medications after the embryo transfer has been successfully completed. It is better to avoid travelling during this period. It is generally after 2 weeks after the embryo transfer that you have to go for a pregnancy test. It is important not to be stressed during this phase, but be optimistic and occupied. Also, the pregnancy test must be conducted by a doctor at the clinic and not by yourself at home.

The cost of an IVF treatment may vary from Rs. 10,000 – Rs. 70,000, depending on your condition.

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The Advantages And Disadvantages Of IVF!

MBBS Bachelor of Medicine and Bachelor of Surgery, DGO, MD - Physician, Certificate Course In Reproductive Medicine & Ivf, Basic Life Support (B.L.S), Advanced Infertility Management Training, ivf training in NUH singappre, masters in Reproductive Medicine
IVF Specialist, Gurgaon
The Advantages And Disadvantages Of IVF!

IVF, as we all know is an assisted reproductive technology. This is a process of fertilization by extracting eggs, retrieve a sperm sample and then manually get an egg and sperm to combine in a laboratory dish. The embryo then gets transferred to the uterus.

Now before going deep into the advantages and disadvantages of IVF, let’s take a look the kind of patients, on whom IVF can be used to treat the problem of infertility:

Women who have damaged or blocked fallopian tubes. Fallopian tubes refer to the pair of tubes through which eggs pass through to the uterus from the ovaries.

Males, who are suffering from infertility due to decreased sperm count.Any individual who has genetic disorder.

IVF helps many patients to conceive, who would otherwise be unable to have children following the conventional path. Achieving a successful pregnancy along with the delivery of a healthy baby is the ultimate objective of In Vitro Fertilization. Some other advantages are discussed below as follows:

  1. Have A Child Using Their Own Eggs: IVF allows Women, who have their fallopian tubes blocked or damaged, with the best alternative to conceive child artificially through the usage of their own eggs.
  2. Patients With A Low Ovarian Reserve: IVF helps to maximize the chance of conceiving among older patients. Generally some fertility clinics use Natural IVF as it’s main focus is more on the quality of eggs, rather than quantity.
  3. Help Males Get Rid Of Their Infertility: Males with infertility problems, as a result of low sperm count, will have much higher chance of conceiving through IVF.
  4. Assist Women Who Have Had Premature Ovarian Failure: Premature Ovarian Failure or Menopause among women can go through IVF treatment using donor eggs, which has been known to have high success rates.
  5. Safe Track Record: It was in the year 1978, when the first ‘IVF baby’, Lousie Brown was born using Natural IVF. It’s been 40 years since then and the technology has advanced with refined techniques, which has helped create safer, successful treatments.

There are certain disadvantages with this form of infertility treatment as well. Some of them are discussed below:

  1. Side Effects and Risks Associated With IVF: In Vitro Fertilization treatment is not without certain risks and side effects, the most severe one being ovarian hyper-stimulation syndrome.
  2. Women Can Have A Slightly Higher Chance Of Ectopic Pregnancy: For women having damaged fallopian tubes, IVF treatment can lead to the risk of ectopic pregnancy. In this type of pregnancy, the fertilized egg gets attached in a place other than inside the uterus.
  3. IVF Is Not Always A Success: One cycle of IVF may not bring success, hence patients well need to go through multiple cycles before being treated completely.

So, one can get a fair idea about the benefits and drawbacks of IVF treatment, which would ultimately help patients to take decisions accordingly.

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A Closer Look Into Embryo Transfer Procedure For IVF

MD - Obstetrtics & Gynaecology, DGO, Dip.Obst.(Ireland), FICOG
IVF Specialist, Delhi
A Closer Look Into Embryo Transfer Procedure For IVF

Among the assisted reproductive techniques, In Vitro Fertilization (IVF) is quite popular and offers hope when other infertility procedures fail to work. The procedure involves the female egg being combined with the male sperm outside the body (in vitro condition), and as a final step, the grown embryo is placed inside the uterus.

Chances of getting pregnant is dependent upon Embryo Quality and Endometrial receptivity.

Embryo transfer is a crucial step of the procedure, and following is an account of the process that would give you a detailed insight into what really happens before and after embryo transfer.

The entire process involved-
Before an embryo is transferred, a series of procedures happen.

Step 1: (Ovarian Stimulation)
In the very first step of embryo transfer, the patient undergoing the IVF treatment is given injections containing medicines that are meant to boost the development of the eggs in the follicles of the ovary.

Step 2: (Egg retrieval)
As the follicles start to mature or develop completely, the eggs are removed carefully.

Step 3: (Fertilization)
In the designated environment, the collected eggs are then fused with the collected sperm to form the embryo.

Step 4: (Incubation)
After the successful fertilization is successful, the embryos are cultured in an incubator.

Step 5: (Choose the best embryo for transfer)
If the process is successful and once embryos are formed, the good quality embryo is chosen from them and then transferred into the uterine cavity to complete the procedure.

Are there any risks?
Embryo transfer is a critical step of the infertility procedure and would need an expert to handle the process. There are a few risks associated with the embryo transfer procedure. However, those risks are very minimal. One such associated risk is the embryo getting implanted in the wrong place, for example in the fallopian tube. Another issue that could occur is the loss of embryos during the procedure of transferring them from the in vitro environment to inside of the uterus.

Is it a painful process?
The embryo transfer is similar to a pap smear and would need no anaesthesia for the woman, however, some women prefer to be on sedation during the process. The entire procedure of embryo transfer is a painless one, though some women may experience mild cramping which is quite normal.

Precautions to be taken after embryo transfer-
After the embryo has successfully been transferred to the uterus, the patient must lie on her back for a while before leaving the clinic. Also, the woman is advised rest and limit physical activity.

The chances of getting pregnant increases with the quality of embryo, and hence it is imperative that your doctor chooses the best quality embryo for transfer into the uterus. Also, the position of placing the embryo is extremely important. You can discuss with your doctor regarding these aspects while you are undergoing the treatment.

IVF - What Is The Success Rates?

MD - Obstetrtics & Gynaecology, DGO, Dip.Obst.(Ireland), FICOG
IVF Specialist, Delhi
IVF - What Is The Success Rates?

People say that marriage makes a man and woman complete, but it is a child that completes a family!

Sadly, World Health Organization (WHO) researchers claim that in 2010, 48.5 million couples worldwide were unable to have a child. Nevertheless, thanks to the Medical science elevations, that invented (IVF) In vitro fertilization, which is the panacea of all the infertility ailments.

However, there are several factors that play a crucial role in deciding the outcome of the IVF procedures. They are:

  1. Age: The age is considered the foremost IVF success factor, and younger women have higher chances of IVF success. Statistics of the live birth IVF success rate for women under 35 are 40 percent whereas women over age 42 have a 4 percent success rate. Women above 42 has 4% live birth rates with her own eggs.
  2. Previous Pregnancy: If a woman was conceived a child with the same partner that is currently undergoing IVF treatment, then there is a greater probability of IVF success. A history of recurrent miscarriage or a different partner tends to significantly reduce the chances of IVF success.
  3. Type of infertility problem: Problems like uterine abnormalities, exposure to DES or fibroid tumors decrease the likelihood of success with IVF along with some male infertility problems. The IVF success factors are also majorly dependent on ovulation, hence ovarian dysfunction, like high FSH levels that indicate a low ovarian reserve, may be a cause of worry.
  4. Use of donor eggs: If a woman is over 35-40, donor eggs become a significant consideration, as there may be a higher rate of IVF success. The probability of pregnancy for women over 40 also increases if donor eggs are from younger women.
  5. Lifestyle habits: Women who have poor lifestyle habits have a much lesser IVF success rate. Also, being obese or underweight can increase the risk of infertility as well as miscarriage. Most importantly, women who smoke can face multiple problems, such as:
    • They require higher dosages of fertility drugs to stimulate their ovaries.
    • They require almost twice as many IVF attempts.
    • They experience more failed fertilization cycles.
  6. Fertility clinic: A reliable, licensed clinic for IVF procedure is of great importance as they will have well trained and experienced staff to conduct the IVF procedure. Also, in a good clinic, the laboratory and technology used by the clinic will be of required standards that can add up to the success factor.

Every month, IVF clinics see a substantial amount of childless couple walking in with despair but later walking out with their bundle of joy. As it is always said, “Optimism is the faith that leads to achievement”, it is recommended to pay a visit to the clinic, go through the initial screening and hope for the best.

In case you have a concern or query you can always consult an expert & get answers to your questions!

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How To Increase Success Rate Of In-Vitro Fertilization?

MBBS Bachelor of Medicine and Bachelor of Surgery
IVF Specialist, Agra
How To Increase Success Rate Of In-Vitro Fertilization?

What is In- Vitro Fertilization?

In Vitro fertilization (IVF) is a process of fertilization where an egg is combined with sperm outside the body, in vitro ("in glass"). This process involves stimulating a woman's ovulatory process, removing an ovum or ova from the woman's ovaries and fertilizing them with sperms in a liquid in the laboratory. The fertilized egg (zygote) undergoes embryo culture for 2–6 days, and is then transferred to the same or another woman's uterus, to establish a successful pregnancy.The success rate depends on various factors such as maternal age.

Cause of infertility

  1. Embryo status
  2. Reproductive history
  3. Lifestyle factors

Ways to increase the success rate of In-Vitro Fertilization:

  1. Maternal age: Young age females undergoing IVF are more likely to get pregnant with a donor egg as compared to women older than 41yrs of age. If a woman undergoes IVF treatment by 23–39 years of age, the success rate is higher.
  2. Reproductive history: Women who have been previously pregnant have higher chances of being successful with IVF treatments than those who have never been pregnant.
  3. Avoid tobacco smoking: As it reduces the chances of IVF producing a live birth by 34% and increases the risk of an IVF pregnancy miscarrying by 30%.
  4. Maintain Body mass index (BMI) between 20-27: A body mass index over 27 causes a 33% decrease in likelihood to have a live birth after the first cycle of IVF.
  5. Avoid obesity: Pregnant women who are obese have higher rates of miscarriagegestational diabeteshypertension, thromboembolism and problems during delivery. Obesity in pregnancy may also lead to an increased risk of fetal congenital abnormality.
  6. Reduce alcohol and caffeine intake: As increased alcohol/caffeine intake decreases success rate of IVF.
  7. Number of embryos: Increasing the number of embryos transferred in the treatment cycle increases the success rate of conceiving.
  8. Getting treated for illnesses before IVF: Taking proper treatment for the underlying autoimmune disease before starting with IVF treatment is essential as it plays a role in decreasing IVF success rates by interfering with proper implantation of the embryo after transfer.
  9. Treating infectious disease: If the female undergoing IVF is suffering from any infectious disease like Rubella, Toxoplasmosis, etc needs to take treatment for the same as it may increase the failure rate of IVF by causing miscarriage/abortion or it may cause failure to hold the fetus.
  10. Mental state: The mental state of the female while undergoing IVF plays an important role. Females undergoing any kind of stress either physical or mental have higher chances of failure.
  11. Good clinic: Getting IVF treatment done from a good clinic and experienced doctor helps in achieving success.

In case you have a concern or query you can always consult an expert & get answers to your questions!

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In Vitro Fertilization - Quick Facts!

MBBS Bachelor of Medicine and Bachelor of Surgery
IVF Specialist, Delhi
In Vitro Fertilization - Quick Facts!

In vitro ova) from a woman's ovary are removed. They are combined with sperm outside the body in a laboratory procedure, and then the fertilized egg (zygote) is transferred to the same or another woman’s uterus for a successful Infertility

  1. Blocked fallopian tubes
  2. Endometriosis
  3. Women with ovulation disorder
  4. low sperm count or poor quality sperm
  5. Genetic disorder

Procedures
Two procedures are done to gain access to ovaries

  1. It involves inserting the needle through the vagina (transvaginally). With the help of an laparoscopy, a small thin tube with a viewing lens is inserted through an incision in the navel. This lets physician to see inside the patient, and locate the ovaries.

Method
Without additional techniques, the chances of pregnancy would be extremely small. The additional techniques used in IVF include-

 

  1. Ovarian hyperstimulation- Stimulation to induce development of multiple follicles of the ovaries.
  2. Final maturation induction- Induction of final oocyte maturation is performed, generally by an injection of human HCG), when the ovarian follicles have reached a certain degree of development. This is known as the "trigger shot”
  3. Egg and sperm preparation- Semen is prepared for fertilization by removing inactive cells and seminal fluid in a process called sperm washing. An oocyte selection may be performed prior to fertilization to select eggs with optimal chances of successful pregnancy.
  4. Co-incubation- Eggs are removed from the woman and placed in one of the fallopian tubes, along with the man's sperm. This allows fertilization to take place inside the woman's body. Therefore, this variation is actually an in vivo fertilization, not in vitro.
  5. Embryo culture- The main durations of embryo culture are until cleavage stage (day two to four after co-incubation) or the blastocyst stage (day five or six after co-incubation)
  6. Embryo Ectopic pregnancy
  7. Ovarian rupture, anesthesia
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Popular Questions & Answers

Hi, Can you tell me the necessary foods to be had and also to be avoided after the embryo transfer. As I have undergone ivf treatment. So want to have a positive result. Please let me know in detail about the food. Even rice, is it fine to have rice now?

MS - Gynaecology, MBBS Bachelor of Medicine and Bachelor of Surgery
Gynaecologist, Varanasi
You don't have to be so particular about your diet. Take regular meals at regular intervals. Almost every 2 hrs you need to take something. Breakfast should be high cals rich in carb, lunch should be well balanced diet dinnerlittle lighter. Apple # banana, fruit salad, soup, milk, egg and sprouts can be taken in between regular meals. You should avoid taking papaya .kathal. Excessive spicy food. Any thing that is hard to digest.
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How much % ivf/icsi babies are abnormal and defective? Many doctor says 70% babies are abnormal and defective.Is it right please suggest me?

MD - Obstetrtics & Gynaecology, DGO, Dip.Obst.(Ireland), FICOG
IVF Specialist, Delhi
No, this is not true. There have been incidents of increased genito urinary abnormalities with ICSI, but this is not proven as yet, research is underway.
1 person found this helpful

I am 6 weeks pregnant through ivf. Before starting ivf my tsh level was 5. 5 and sugar was 88. But after 6 week pregnancy tsh is 17.5 and blood sugar is 108. I have a lot of ivf medicines nowadays. I am taking eltroxin 125 already. Totally confused. Please advise.

MBBS, MD / MS - Obstetrics & Gynaecology
Gynaecologist, Kanpur
Do not worry. You have to keep on checking thyroid as its need increases during pregnancy take ivf medication. Better to take in person consultation.

Hello team, I am planning to go for IVF, I had FSH, LH and E2 done on day 2 of my period, results are FSH - 10.92, LH - 12.63 and E2 - 52, I had 75 IU injections for 7 days and left had one follicle which was around 13 mm and right had 10 mm (2 follicles) on 7th day of my ultrasound, so doctor suggested not to go for IVF this month as latest scan showed my left follicle was 18 mm and right were 13 mm on day 9. Also could you explain if one follicle is ready for rupture, what about the other follicles, are they going to rupture or only one time it will happen. Please suggest if we proceed to go for IVF next month with the 75 IU injections are do we need to have more medications and tests for IVF life how much IU injections required. Currently I am using M torr 800 MG and bifolate for quality of my eggs. As my left tube was disturbed due to ectopic pregnancy and lap done, also due to both tubes blocked, again hysterolap has been done and now right tube was patent. I am currently 32 years and Marriage life is 6 years. Please suggest a best option to have a child in our lives also what would be the success rate for my case if we opt for IVF. Male part is fine and no issues with motility and morphology. We are currently residing in Hyderabad and not sure whom to consult for the better results/success. Thanks,

MS - Gynaecology, MBBS Bachelor of Medicine and Bachelor of Surgery
Gynaecologist, Varanasi
Starting dose 75iu for ivf cycle? Actually all the follicles should grow uniformly. Because for ivf you need to extract many follicles. Not just one. So may be next cycles with higher dose of fish would help.

Table of Content

What is IVF?

Indication

What Procedure is followed :

Risk & Complication

More Info