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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.

Popular Health Tips

Can IVF Help Menopausal Women Get Pregnant?

MD / MS - Obstetrtics & Gynaecology, MBBS
IVF Specialist, Delhi
Can IVF Help Menopausal Women Get Pregnant?

Women undergo menopause in their 40s and this is primarily known as the age after which they can't bear children in their wombs any more. The ability to develop and maintain a healthy pregnancy wanes as a woman crosses the age of 30, which according to research is the optimal time for a woman to become a mother.

The body undergoes changes as it gets older and women slowly start losing the perfect conditions for pregnancy. However, with the rise of the IVF treatment for infertility, a great number of people are choosing to embrace parenthood at a relatively advanced age. However, the question is, can the same IVF treatment prove effective for a woman after her menopause?

The answer is yes. There have been several instances where a woman past menopause has been implanted with a fertilized egg and has been able to conceive a healthy offspring from the same. However, such an IVF treatment is much more complex and can require a lot of external hormonal treatments on the side as well.

How can IVF help menopausal women?
Women, who have gone into menopause more than 6 months ago, require additional care to achieve pregnancy through IVF. The uterus is usually shrunken in such people and the endometrial lining also develops a resistance to estrogen. Several cycles of estrogen treatment are needed for such women to achieve a healthy pregnancy.

Most doctors suggest at least a couple of months of estrogen and progesterone treatment prior to taking the actual IVF treatment. However, there is no guarantee that the same will be effective in every case.

By any chance, if the menopausal woman chose to store her eggs prior to her menopause, she can get those eggs fertilized and implanted after menopause, using the IVF method, in order to achieve a healthy pregnancy. Through, this procedure, the woman can not only become pregnant after menopause but can also ensure that she is the biological mother of the child who would be born.

At any rate, it is best to undergo the IVF treatment before menopause, as this improves the chances of conceiving. The hormonal treatments are often easier and most women can completely forego the progesterone and estrogen supplementation in such a case. This will not only reduce the time required to complete the treatment but will also significantly reduce the cost that the parents have to bear. In case you have a concern or query you can always consult an expert & get answers to your questions!

How Successful Is Frozen Embryo Transfer?

MBBS Bachelor of Medicine and Bachelor of Surgery
IVF Specialist, Agra
How Successful Is Frozen Embryo Transfer?

Women are not really sure about frozen embryos’ ability to result in pregnancy. Ironically, the success of Frozen Embryo Transfer has dramatically improved over the last few years. In the days gone by, the chance of women getting pregnant through the use of frozen embryos seemed to be on the lower side compared to that from the transfer of fresh embryos. Recent data related to this suggests that this is no longer the case.

Reasons behind the low success rate of frozen embryo transfer in the past
Previously during the frozen embryo transfer process, the embryos which had to get frozen were the ones that did not get chosen for the fresh embryo transfer initially. The reason being that the embryologist had gone ahead to choose the best possible embryos for getting them transferred initially. As far as the fresh embryo transfer is concerned, quality of embryo has got a major effect on the chance of a woman getting pregnant. On the other hand, if quality of embryos frozen is not good, the rate of survival after it gets thawed along with the rate of pregnancy would be on the lower side.

The second important reason is the amount of embryos that got transferred. Let us consider a couple who produce four very good quality embryos. Two of them are transferred during fresh In Vitro Fertilization Process and the remaining two are frozen. This leads to pregnancy and the woman gives birth to a baby. Later on, the couple once again decides to go for pregnancy by using the frozen embryos. Though only one embryo survives after getting thawed. The frozen embryo transfer is that of a single embryo. The success rate of a frozen embryo transfer through a single embryo is always going to be on the lower side than what it will be when multiple embryo transfer is involved.

Finally the method of freezing embryos has seen a sea change quite a number of years ago. Nowadays the freezing of embryos takes place by a fast method, known as vitrification. This process has got a much better survival rate when embryos get thawed along with good rates of pregnancy when those particular embryos are transferred in a much better manner.

Studies about high success rate of frozen embryo transfer
There have been studies performed in women, who have had quite a vigorous stimulation of their ovaries and were considered to be at high risk for Ovarian Hyperstimulation Syndrome. The physicians took the decision of skipping the process of embryo transfer and instead go ahead to freeze all the embryos for use at a later stage.

This tends to significantly decrease the risk of having serious Ovarian Hyperstimulation Syndrome along with decrease in complications. Other cases involved, physicians deciding to move on with a fresh embryo transfer depite the risk of Ovarian Hyperstimulation Syndrome. In both the scenarios the couples have quite a large number of embryos and the embryos selected for transfer were the best embryos.

The studies have shown no difference in the rates of pregnancy between fresh or frozen embryos or for that matter higher rate of pregnancy with frozen embryos. In case you have a concern or query you can always consult an expert & get answers to your questions!

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IVF - How Different It Is From Tubal Ligation Reversal

MBBS Bachelor of Medicine and Bachelor of Surgery, DGO
IVF Specialist, Gurgaon
IVF - How Different It Is From Tubal Ligation Reversal

Life is always filled with unexpected turn of events. Who would love life if the next day can be predicted? But one loves to control certain things in life. One such is having a control over the number of kids in the family. Unwanted pregnancies can be stopped by sterilization. Every couple has the plan for the number of kids in the family. You may think you have achieved the target and would love to stay safe. But the family goals can change, and there can be some pressing need for another baby. Do not worry, if you are in the same boat. Your sterilization is not an evergreen end card for pregnancy. It can be reversed. When you want to have a child after tubal sterilization, you can either reverse it or go for IVF. You need to weigh the options, and to do this, you need to know more about them.

Tubal reversal: This is a short stay procedure, mostly an outpatient procedure. The connection between the tubal segments is restored with micro-surgery technique. Any surgery can create complications and here too, the chances of infection and poor tissue healing are there. Damage to the Fallopian tubes, uterus, side walls of the uterus, and ovaries can occur. The recovery time is short, but can extend in case any of these complications arise. There is also a risk of a tubal pregnancy. It has to be understood that not all tubal sterilizations can be reversed. When tubal reversal is carried out, your doctor asks to bring the pathology reports of the sterilization process, and also the semen test results of your partner. This is because when sperm count is abnormally low, your chance of getting pregnant is very low. When you rule out the most significant male factor, there are risks of wasting money in reversal and there are health risks involved as well.

IVF: In vitro fertilization (IVF) has brought a ray of hope since the 1970s for women who have problems with the Fallopian tubes. The procedure has gone through modification over years, only to show the success rate accelerating. When there are fertility problems in both the partners, IVF can help in achieving successful childbirth. This is also a sure shot way to get pregnant when the causes of infertility are not known. The sperm and eggs are selected and fused in the laboratory. The fused embryo that results is transferred to the uterus. Tubal bypass occurs here. This means the process that should take place in the tubes is taken care of in the laboratory. The healthiest embryos are chosen for transfer to the uterus, and the success rates are hence higher.

As the tubal bypass happens, you can see this a good option if you have gone for tubal sterilization earlier and want to conceive again. What makes IVF a good choice is the success rate. The tubal reversal simply means that the block is removed. In case of IVF, an embryo is attached to your uterus. This means there is no beating around the bush. Your chances of getting pregnant are higher multiple times in case of IVF as compared to tubal reversal. In case you have a concern or query you can always consult an expert & get answers to your questions!

IVF- The Last Resort!

MS - Obstetrics and Gynaecology, MBBS Bachelor of Medicine and Bachelor of Surgery, FELLOWSHIP IN REPRODUCTIVE MEDICINE
IVF Specialist, Bhopal
IVF- The Last Resort!

Life is beautiful! Right from the birth you grow through life stage by stage. One such amazing stage is parenthood. For those of you who desire to become a parent, there is nothing more painful than trying and failing at each and every known procedure to conceive naturally. The heartbreak of infertility can turn out to be devastating. Fortunately, there are several techniques to address this situation, the last resort being In- Vitro Fertilization (IVF).

What is IVF?
In- Vitro Fertilization (IVF) is a procedure by which an egg is fertilized by sperm outside the body: in vitro meaning in glass. A colloquial term for babies conceived as the result of IVF is “test tube babies” but the fact being they are cultured in petri plates. The zygote produced from the fertilization develops under carefully controlled conditions until it becomes an embryo, which is then transferred into the uterus either by inserting it into the fallopian tubes, or intra- vaginal placement into the uterus. Once the embryo implants on the uterine wall, a pregnancy has just begun its course. Furthermore, the birth of a live infant capable of surviving outside the mother’s body marks a successful IVF cycle.

Indications of IVF:
IVF is most clearly recommended only when infertility results from one or more causes having no other effective treatment. The below list clarifies when an IVF can become your only option.

  1. Tubal disease: A case where the fallopian tubes in women reproductive system is blocked.
  2. Endometriosis: The uterine lining grows outside the uterus which often has tubal and ovarian cysts.
  3. Ovulatory dysfunction: This is applicable to patients with polycystic ovarian disease(PCOD) and other ovulatory problems.
  4. Age of the woman: The woman’s ovarian capacity and function diminishes with age which can be overcome by IVF.
  5. Male factor infertility: This is contributed by azoospermia, oligozoospermia, asthenozoospermia, anti-sperm antibody, etc.
  6. Pre implantation genetic testing(PGT): Patients with potential risk for genetic disorders such as cystic fibrosis and thalassemia are recommended to test their embryos to rule out the possibilities of the risk genes being inherited.

Recommendations:
IVF may demand a fortune to get a positive result. It is indeed an expensive treatment. Sometimes, it is recommended that the couple start from the preliminary treatments based on thorough follicular study and semen analysis. IVF success rate is variable and depends upon many factors. Look out for the associated risks of IVF. If you have made up your mind for IVF then follow the doctor’s instructions during the treatment with at utmost care and hope for the best result to come your way. As it is rightly said: “All is well that ends well!” In case you have a concern or query you can always consult an expert & get answers to your questions!

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Why Anti Mullerian Hormone (AMH) Test Is Important Before IVF?

MD - Obstetrtics & Gynaecology
IVF Specialist, Sonipat
Why Anti Mullerian Hormone (AMH) Test Is Important Before IVF?

Many couples are reaching IVF clinics due to infertility problems. IVF is a very useful process for those couples who are unable to conceive. A few tests will be done on both male and female, and then the treatment for infertility will start. Many people reach out to the doctor with a low AMH count. What actually is AMH count and how does it affect IVF treatment? Continue reading to know more about AMH:

What is an AMH test?
In the ovarian follicles, cells produce a protein called AMH or Anti Mullerian Hormone. AMH levels can be classified as below:

  • Very Low AMH levels means 0.5 ng/ml or below. This condition indicates severe fertility concerns and very low ovarian reserve.
  • Low AMH levels means 1.0 ng/ml to 1.5 ng/ml. This condition indicates that the ovarian reserve is low, but that chances of getting pregnant are still good.
  • Normal AMH levels mean 1.5 ng/ml to 4.0 ng/ml. This condition indicates a good ovarian reserve and very good chance of responding to IVF or other fertility treatments.

Many people have a misconception that low or very low levels of AMH do not indicate that the IVF treatment is suitable for the woman. Some women may have a low quantity of eggs due to low AMH levels, but the quality of the egg can be good and hence the chances of pregnancy are good.

Why is an AMH test important for IVF treatment?

  • One of the most reliable tests done for confirming if the woman will have a successful pregnancy is the AMH test. This test can be done at any time of the month irrespective of the monthly cycle and the lifestyle of the woman. The exact fertility health can be analyzed with the help of this test.
  • Blood samples are taken and tested for AMH levels. This is not included in your normal blood test reports and hence you need to ask the doctor if you want to know the AMH levels. A combination of Antral follicle count test with AMH tests will give you the best results.

Why do AMH levels drop?
There are many factors that are responsible for the AMH levels to drop and one of them is aging. Other factors include hormonal imbalance, low blood circulation to the ovaries, unhealthy food choices, stress, autoimmune diseases, genetic factors and your lifestyle.
One single test of AMH levels will not give you the exact results. You need to get the test done a few times to know the exact values. Though your birth control pills may not affect the AMH levels, you can stop them for a few months and then get the test done. Talk to the doctor regarding the other medications you take and other fertility drugs you have used in the past or presently. This helps the doctor to give you the right advice. In case you have a concern or query you can always consult an expert & get answers to your questions!

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Popular Questions & Answers

I had an IVF on 23rd July. But got a negative hcg and still not had my periods yet. I have heard about cryptic pregnancy. How common is it and is it possible to have negative hcg throughout pregnancy?

MBBS Bachelor of Medicine and Bachelor of Surgery, DNB - Obstetrics & Gynecology, DGO
IVF Specialist, Delhi
Hi there Even in ectopic pregnancy hcg test is suppose to be positive. So you are not pregnant and you can see your doctor to evaluate further.

Hi ,my age is 30 years and I have already gone through one cycle of Egg retraction for IVF cycle ,we have 6 embryos out of which 3 are best ,now I am going to another egg retrieval ,I have AMH value as 0.83 ,so can you please let me know what are chances of Pregnancy ?

MBBS Bachelor of Medicine and Bachelor of Surgery, DNB - Obstetrics & Gynecology, DGO
IVF Specialist, Delhi
Hi, you have good quality of embryos as per you say so there are good chances of pregnancy.
1 person found this helpful

I haave 4 dominant follicles (2 on right, 2 on left) All more than 20 mm. Had HCG Shot yesterday and had IUI today after one follicle ruptured on the right. 3 follicles are yet to rupture (due anytime today). Will one IUI be enough for fertilization?

MBBS Bachelor of Medicine and Bachelor of Surgery, DNB - Obstetrics & Gynecology, DGO
IVF Specialist, Delhi
Hi, Yes Life of good sperm is about 72 hours so one iui should be enough but for better result you can take 2nd shot of iui.
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Hi, My age is 30 years and my AMH value come as 0.83,I am going through IVF procedures and my eggs are collected and 6 embryos are created. Out of 6 ,3 are best and 3 are ok ,they are also performing second cycle for egg retrieval and subsequent embryos collection in week time. My question is what are the chances of success of IVF considering the low AMH.

MBBS Bachelor of Medicine and Bachelor of Surgery, DNB - Obstetrics & Gynecology, DGO
IVF Specialist, Delhi
Hi there Chances of conceiving are usually low with low AMH if you are using your own eggs but if you already have good quality and quantity of embryos then you have good chances of pregnancy.
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What is Blighted ovum? Recently I had aspiration abortion because of this. I am confused, why this happened to me? I had twin sac at that time. Should I opt for Ivf for next time or is there any problem in me or in my hubby?

MBBS Bachelor of Medicine and Bachelor of Surgery, DNB - Obstetrics & Gynecology, DGO
IVF Specialist, Delhi
Blighted ovum means the embryo has stopped growing. It may be be to unhealthy gametes. It is generally not a repetitive process unless you have associated hormonal issue. Plan for next baby and start medicine as soon as possible.
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Table of Content

What is IVF?

Indication

What Procedure is followed :

Risk & Complication

More Info