IVF (In Vitro Fertilization) popularly known as test tube baby technique. This technique is mainly for females who cannot conceive due to various reasons like a construction of fallopian tubes or some other reasons. The chances of success of treatment decrease if age is beyond 35 yrs.
In IVF, Process of Fertilization occurs outside the women’s body by surgically extracting women’s egg & fertilizing it in a laboratory using a sperm that is given as a sample. Then the fertilized egg is surgically implanted into the woman’s womb.
Step 1: Ovulation induction
Before and during the in vitro fertilization process, your fertility specialist will monitor your ovaries and the timing of the egg release. The doctor will make sure that your ovaries are producing eggs, and that your hormone levels are normal, among other procedures.
Step 2: Egg retrieval
During this step in the IVF process, pain medication is given to reduce any discomfort. Then a very thin needle is passed through the upper vaginal wall. With the use of vaginal ultrasound, fluid is removed from the follicles under gentle suction. Immediately after aspiration of the follicle, the oocyte (egg) is isolated from the follicular fluid. The egg is placed in a culture dish containing nutrient media and then transferred to the incubator.
Step 3: Fertilization
The next step of the IVF process is the fertilization of the egg. A sperm sample is secured, either from your partner or a donor, and the most active sperm is mixed with the egg in a special chamber. Sometimes the sperm is directly injected into the egg. Then, the sperm and egg are placed in an incubator and monitored to make sure that a healthy embryo develops.
Step 4: Embryo transfer and Implantation
The final step of the IVF process is the embryo transfer. First, the embryos are examined to select the healthiest ones for transfer. To transfer the embryo(s), a speculum is placed into your vagina and the embryo(s) are transferred via a small plastic tube placed through the cervix into the uterine cavity. After the IVF process is complete, bed rest is often advised for around 24 hours.
Is Infertility a Female Problem ?
Infertility is as likely to be caused by a male factor as well as female factor. Female related problems account for 40% of infertility and male related problems for another 40% . Combined female and male problems account for 10%. Unexplained causes account for the remaining 10% of infertility.
For a woman, getting pregnant is complex; there are many stages and much is involved. With all this complexity, there are many possible causes of female infertility; it’s a very complicated problem. In fact the issues involved with female infertility are far more complex than male infertility.
Reproduction in Women?
The female reproductive system (or female genital system) is made up of a vagina, a cervix, a uterus, fallopian tubes and ovaries. All of these organs work together to help a female menstruate, conceive and carry a baby to term.
IUI (Intra uterine Insemination) with COH
This procedure is performed in cases where the husband’s sperm count or motility is affected. Generally single IUI is performed with in a day’s time of release of egg from the ovary (ovulation ) of the female partner. Some times the procedure of insemination is done twice, just before and after the ovulation.
IUI has two steps:
- Collection and processing of semen
- Insemination of the processed sperm sample into female partner.
1) Collection and processing of the semen sample.
Preferably semen sample is collected in the IVF center after 2-3 days of abstinence as per comfort of the male partner. Sample is to be obtained following hand masturbation and collected in a container provided by the center.
The method and thus the time required for sperm processing depends on the native sperm count. Generally it takes 45 minutes to one hour.
2) Insemination into female partner
The semen sample that is processed in pushed into uterus of the female partner. There is no anesthesia required for the process. the lady can continue all the routine activities before and after the process.
At times the sperm count of the male partner is zero, one may choose to use donor sperm sample in such cases processed in the same way and inseminated as mentioned above.
We maintain donor sperm samples from ICMR approved sperm bank. Where the samples are checked for all major diseases like HIV, HbSAG and properly quarantined.
ICSI (Intra Cytoplasmic Sperm Injection)
ICSI is a ART procedure used when the sperm count is very low.
The female partner is given medicines and ovary stimulated to form more no of eggs, the oocytes are retrieved under anaesthesia. The male partener gives sperm sample which is processes and individual sperm is manually injected into the oocyte using a special machine called manipulator.
Oocytes are then kept in the incubator and embryo development is monitored.
This procedure is hysteroscopy done to see inside of uterus.
This procedure can be done without anesthesia in our unit as we do offer hysteroscopy with small size Hysteroscope so patient can walk away from the hospital in 30 minutes after the procedure is over.
Small growths like polyps can also be removed in same sitting.
Infertility is the inability to conceive a child. A couple may be considered infertile if, after one year of regular sexual intercourse, without contraception, the woman has not become pregnant (and there is no other reason, such as breastfeeding or postpartum amenorrhoea). Primary infertility is infertility in a couple who have never had a child. Secondary infertility is failure to conceive following a previous pregnancy. Infertility may be caused by infection in the man or woman, but often there is no obvious underlying cause. Infertility can be caused by several factors including, ovulatory problems, blocked fallopian tubes, sperm problems or many other male and female factors.
Yes, about 1 in 6 of couples experience some difficulty in achieving a pregnancy.
The risk factors for heart attack include: No, both men and women can have medicalproblems that cause difficulty in conceiving; in about a third of couples, both partners have problems.
This depends on the cause of infertility and each couple´s circumstances. The woman´s age, for example, is a very important factor.
The success of treatment needs to be seen within the context of normal fertility –under the age of 30, about 85% of women will get pregnant within a year of trying.Over the age of 40, the chance each month is about 5%.
Many treatments will simply restore the “normal” chance of pregnancy, so it is stillnecessary to try for a few months. More sophisticated treatments such as IVF have higher individual success rates but, again, this is very dependent on circumstances.
Most cases of female infertility are caused by problems with ovulation (the monthly release of an egg). Without ovulation, there are no eggs to be fertilized. Some signs that a woman is not ovulating may include irregular or absent menstrual periods.Ovulation problems are often caused by polycystic ovarian syndrome (PCOS), a hormone imbalance problem which can interfere with normal ovulation.
Primary ovarian insufficiency (POI) is another cause of ovulation problems. POI occurs when a woman´s ovaries stop working normally before she is 40. POI is not the same as early menopause, as regular periods may still be present.
Some men have reduced numbers of sperm, reduced quality, or both. In some cases, there may be complete absence of sperm. These problems are sometimes related to lifestyle habits, more general medical problems, such as diabetes, or there may be genetic factors.
Infertility can be treated with medicine, surgery, artificial insemination, or assisted reproductive technology (ART), such as in-vitro fertilization (IVF). Many times these treatments are combined.
The treatment will depend on the results of a variety of tests that can be performed to determine the cause of the problem. In many cases, all that will be needed is advice – with regard to timing, for example; sometimes, lack of ovulation can be treated with simple medication. More complicated problems, such as blocked fallopian tubes, or severe male infertility, may require more sophisticated intervention.