In vitro fertilization is one of the most effective and widely known forms of Assisted reproductive technologies (ART) used for assisting in the conception of a child. In this fertility treatment, the healthy eggs are combined with healthy sperms outside the female’s body and then implanted inside the female uterus, resulting in pregnancy.
This may sound simple, but IVF (also called as Test Tube baby process) is a complex series of procedures that include collecting (or retrieving) mature eggs from the woman’s uterus and healthy sperms from a male donor, manually combining them in a lab for fertilization, and transferring the fertilized eggs (or embryos) into the female uterus. The procedure can be done by using the couple’s own eggs and sperm or It may involve eggs, sperm, or embryos from an anonymous donor.
IVF is a time-consuming procedure with one full cycle of IVF process taking up to 3 weeks and sometimes several months if the woman needs more than a round of IVF to get pregnant. The chances of getting pregnant with the help of IVF depend on a lot of factors, which include the age of the woman and the reason for infertility. You can also have a surrogate or gestational carrier, it refers to a woman who carries your baby for you.
Let’s understand the whole procedure of an IVF treatment. Knowing what to expect will help you to better prepare yourself to endure this tedious procedure and hopefully get to start a healthy family. The IVF treatment contains many steps, which can be broken down as –
In the first step of IVF, the woman is given various fertility medications or synthetic hormones to stimulate the ovaries to produce multiple eggs. Under normal circumstances, a woman produces a single egg during each menstrual cycle. But this treatment needs more eggs to maximize the IVF success rate as some eggs might fail to fertilize and develop properly. Hence, different medications are used to increase egg production.
Your doctors will discuss with you to decide which type of medication you will be given and the timings. It typically takes a week or two, when it is time for eggs to be retrieved. Doctors will perform regular blood tests and multiple ultrasounds to check the growth of the eggs and to find the best time to retrieve them.
Egg retrieval, also known as follicular aspiration, is a surgical procedure used for the collection of eggs from the woman’s ovaries and is performed with anesthesia. Your doctors will sedate you and will give you pain medications.
Typically, “Transvaginal Ultrasound is used for the retrieval of eggs. In this method, the doctor will insert the ultrasound wand into the vagina to guide a thin medical needle from vagina to reach the ovary, and into the egg-containing follicles. The needle used is linked to a device which will extract the eggs and fluid out of the follicles.
The retrieved eggs are placed inside a special medium (nutritive liquid or a culture medium) & then are incubated until the insemination. Doctors will identify the mature & healthy eggs, which will be used for fertilization.
After the egg retrieval process, you may have to experience abnormal cramping.
If the male partner’s sperm is healthy, then it will be used for the procedure. The male partner has to provide a semen sample at your doctor’s clinic before the egg retrieval procedure begins. A semen sample is typically collected via the act of masturbation, but sometimes other methods like testicular aspiration may be required. In the clinic, sperm are separated from the semen fluid and examined for their health.
If the partner sperm can not be used for any reason, then a donor sperm can be used.
Conventional Insemination and IntraCytoplasmic Sperm Injection (or ICSI) are the two most commonly used methods for the fertilization of eggs and sperm in a lab.
Conventional or standard insemination – If the sperms are healthy, then 50,000 to 100,000 motile sperm are placed inside a petri dish that contains the healthy eggs. Both eggs and sperm are left for incubation for the night after mixing or fusing.
ICSI (IntraCytoplasmic Sperm Injection) – If the sperms are available in low quantity or if they are not mobile enough (don’t swim as well), then they need a little assistance in the fertilization process. The required assistance is provided in the ICSI method. In this method, the healthy sperm are identified and directly injected into the egg. The whole procedure is done under a microscope by an embryologist.
After the successful fertilization, the eggs will start converting into an embryo. The development of the embryo is carefully monitored by the doctors. There will be multiple embryos created in a single petri dish. The doctors have to monitor and assess all of them to choose the ones that will be transferred to the woman’s uterus.
Embryos transfers usually take place after 3 (at the cleavage stage) to 5 days (at the blastocyst stage) after the egg retrieval. Embryos transfer is a simple process and does not cause any pain, although some may feel mild cramps. You might be mildly sedated during the process.
In order to transfer the embryo or embryos, a flexible, supple, thin, & long tube known as a catheter is inserted into the vagina through the cervix, into the uterus. Embryos are loaded in this catheter and placed inside the uterus, where the embryo will then get implanted itself on your uterus lining, thus completing the pregnancy.
The doctors, after 12 to 15 days after the egg retrieval will test your blood sample to check whether you are pregnant or not. If you are pregnant, you can go consult with a pregnancy specialist for prenatal care. But many have to go through multiple cycles of the IVF process before they can get pregnant.
IVF is quite an expensive and highly invasive treatment, it will take a physical, financial, and emotional toll. It also has some risks involved in it like the risk of multiple pregnancies, premature delivery, and Ovarian hyperstimulation syndrome. Hence, it is highly recommended to first try out every other infertility treatment method available before opting for an IVF treatment.
Speak with your doctor and partner extensively to determine if IVF is the right treatment for you and your family.