In vitro fertilisation (IVF) is one of the Assisted Reproductive Technology (ART) techniques that can help infertile patients tohave a baby. IVF is a complex clinical procedure. The process involves the collection of mature eggs from the ovaries and combining them with the sperm in the laboratory. After fertilisation, the eggs are implanted into the woman’s uterus. It is a time-consuming and invasive procedure that takes around 2 weeks for the completion of a single fertilisation cycle.
The most common indications for IVF include:
The steps involved in IVF treatment are:
Ovulation induction: The doctor will administer fertility drugs to boost the production of your eggs. Blood tests and transvaginalultrasounds will be conducted to monitor the development of the eggs.
Egg retrieval: Your doctor will perform follicular aspiration, a minor surgical procedure to remove the eggs from your ovaries. This is usually done under light sedation.An ultrasound probe is inserted through the vagina and into the follicles under ultrasound guidance. Each follicle in the ovary is pierced in order to retrieve the egg.
Insemination and fertilisation: The eggs are mixed with the sperm in an environmentally controlled chamber to facilitate the process of insemination. The egg is fertilised a few hours after insemination. If the chance of fertilization is low, intracytoplasmic sperm injection (ICSI) may be used where the sperm is directly injected into the egg.
Embryo culture: Division of the fertilised egg forms an embryo. The development of the embryo is monitored and within 5-6 days, a normal embryo will have reached the blastocyst stage.
Embryo transfer: Embryo transfer is performed 3 to 5 days after egg retrieval and fertilisation. A thin tube containing one or more embryos is inserted into the vagina through the cervix and into the uterus. After transfer, if an embryo attaches or sticks to the womb lining, it results in pregnancy.
Occasionally, embryo transfer is carried out under the guidance of ultrasound, for which you will have to have a full bladder. You will be allowed to empty your bladder after the procedure. For the first two days after an embryo transfer you should refrain from heavy lifting, physical activity like running or aerobics, swimming, alcohol, smoking and intercourse. You can do a pregnancy test 10 days after embryo transfer to confirm pregnancy.
Embryo freezing: Embryo freezing or cryopreservation is offered to any good quality spare embryos that were created but not used. This allows these embryos to be stored for later use, therefor maximising the outcome of your IVF treatment cycle
As with any surgical procedure, IVF may involve certain risks and additional complications which include the risk of multiple births, prematurity and low birth weight baby, ovarian hyper stimulation syndrome (a condition of ovarian enlargement accompanied by fluid accumulation in the abdominal cavity), miscarriage, and possibility of ectopic or tubal pregnancy.
The risks of egg retrieval include bleeding, infection, damage to the bowel, bladder or blood vessels, but these are very uncommon.