IVF CLINIC AT AURANGABAD

IVF ( IN VITRO FERTILIZATION )

 In-Vito Fertilization can be easily explained as a “TEST TUBE

BABY”, where the egg of a woman simultaneously the sperm for her
male partner is removed and allowed to fertilize in the lab.
 As the fertilization occurs the zygote (fertilized egg cell) is kept
for 2-3 days and after that, the embryo (divided zygote into a
number of cells) is directly implanted in the mother’s womb in order
to conceive the baby.
Why is IVF used?

IVF can be used to treat infertility in the following patients:

 Blocked or damaged fallopian tubes.

 Male factor infertility including decreased sperm count or
sperm motility.
 Women with ovulation disorders, premature ovarian failure,
uterine fibroids.
 Women who have had their fallopian tubes removed.
 Individuals with a genetic disorder.
 Unexplained Infertility.
What is involved with in vitro fertilization?

There are five basic steps in the IVF and embryo transfer process:
 
Step 1: Fertility medications are prescribed to stimulate egg
production. Multiple eggs are desired because some eggs will not
develop or fertilize after retrieval. A transvaginal ultrasound is used
to examine the ovaries, and blood test samples are taken to check
hormone levels.
 
 Step 2: Eggs are retrieved through a minor surgical procedure that
uses ultrasound imaging to guide a hollow needle through the
pelvic cavity to remove the eggs. Medication is provided to reduce
and remove potential discomfort.
 
Step 3: The male is asked to produce a sample of sperm, which
is prepared for combining with the eggs.
 
Step 4: In a process called insemination, the sperm and eggs are
mixed together and stored in a laboratory dish to encourage
fertilization. In some cases where there is a lower probability of
fertilization, intracytoplasmic sperm injection (ICSI) may be used.
Through this procedure, a single sperm is injected directly into the
egg in an attempt to achieve fertilization. The eggs are monitored to
confirm that fertilization and cell division are taking place. Once
this occurs, the fertilized eggs are considered embryos.
 
Step 5: The embryos are usually transferred into the woman’s uterus
three to five days following egg retrieval and fertilization. A catheter
or small tube is inserted into the uterus to transfer the embryos. This
procedure is painless for most women, although some may
experience mild cramping. If the procedure is successful,
implantation typically occurs around six to ten days following egg
retrieval.
What are the risks associated with in vitro fertilization?
As with most medical procedures, there are potential risks.
More severe symptoms, typically from OHSS, include the following:

 Nausea or vomiting.
 Decreased urinary frequency.
 Shortness of breath.
 Faintness.
 Severe stomach pains and bloating.
 Ten-pound weight gain within three to five days.
 If you experience any of these symptoms above, contact your
doctor right away.
ICSI ( INTRACYTOPLASMIC SPERM INJECTION )

 It is the procedure in which a sharp and delicate needle is used

to immobilize and pick up sperm and it is injected into the cytoplasm
of the egg, and then the fertilized egg (embryo) is implanted inside
the womb. This technique is mostly preferred for the couple in which
the sperm count of the male is less or zero.
 ICSI-IVF is a specialized form of in vitro fertilization that is used
most commonly in cases of severe male infertility, after repeated
failed fertilization attempts with conventional IVF, or after egg
freezing (oocyte preservation).
 Pronounced ick-see IVF, ICSI stands for intracytoplasmic sperm
injection. During regular IVF, many sperms are placed together with
an egg, in hopes that one of the sperm will enter and fertilize the egg
on its own. With ICSI-IVF, the embryologist takes a single sperm and
injects it directly into an egg.
 Some fertility clinics recommend ICSI for every IVF cycle. Others
reserve the treatment for those with severe male infertility or
another medically indicated reason. There are good arguments
against the routine use of ICSI. (The risks of ICSI-IVF are below.)
 With that said, ICSI-IVF has enabled many infertile couples to
get pregnant when, without it, they would not have been able to
conceive using their own eggs and sperm.
What Is the Success Rate for ICSI-IVF?

 ICSI-IVF is typically used in cases of severe male infertility,

including:

 Very low sperm count (also known as oligospermia).
 Abnormally shaped sperm (also known as
teratozoospermia).
 Poor sperm movement (also known as
asthenozoospermia).
 If a man does not have any sperm in his ejaculate, but he is
producing sperm, they may be retrieved through testicular
sperm extraction or TESE.
 Sperm retrieved through TESE requires the use of ICSI. ICSI is
also used in cases of retrograde ejaculation if the sperm is retrieved
from the man’s urine.
Severe male infertility isn’t the only reason ICSI-IVF is used. Other
evidence-based reasons for ICSI include:

 Previous IVF cycle had few or no fertilized eggs: Sometimes, a

good number of eggs are retrieved, and sperm counts look healthy,
but no eggs get fertilized. In this case, during the next IVF cycle, ICSI
may be tried.
 

 Frozen sperm is being used: If the thawed sperm doesn’t

appear especially active, ICSI-IVF may be recommended.
 

 Frozen oocytes are being used: Vitrification of eggs can

sometimes cause the hardening of the egg’s shell. This may
complicate fertilization, and IVF with ICSI may help overcome this
hurdle.
 

 PGD is being done: PGD (preimplantation genetic diagnosis) is

an IVF technology that allows for the genetic screening of embryos.
There is a concern that regular fertilization techniques may cause
sperm cells (who have not fertilized the egg) to “hang around” the
embryo, and that this may interfere with accurate PGD results.
 

 IVM (in vitro maturation) is being used: IVM is an IVF

technology where eggs are retrieved from the ovaries before they
 are completely mature. They go through the final stages of
maturation in the lab. Some research has found that IVM eggs may
not become fertilized by sperm cells at rates comparable to
traditional IVF. More research is needed, but it may be that IVM with
ICSI is a good option.
What Is the Procedure for ICSI-IVF?

 ICSI is done as a part of IVF. Since ICSI is done in the lab, your
IVF treatment won’t seem much different than an IVF
treatment without ICSI.
 As with regular IVF, you’ll take ovarian stimulating drugs, and
your doctor will monitor your progress with blood tests and
ultrasounds. Once you’ve grown enough good-sized follicles, you’ll
have the egg retrieval, where eggs are removed from your ovaries
with a specialized, ultrasound-guided needle.
 Your partner will provide his sperm sample that same day
(unless you’re using a sperm donor or previously frozen sperm.)
 Once the eggs are retrieved, an embryologist will place the eggs
in a special culture and using a microscope and tiny needle, a single
sperm will be injected into an egg. This will be done for each egg
retrieved.
 If fertilization takes place, and the embryos are healthy, an
embryo or two will be transferred to your uterus, via a catheter
placed through the cervix, two to five days after the retrieval.
 You can get more detailed information here in this IVF
Treatment Step by Step.
What Is the Success Rate for ICSI-IVF?

 The ICSI procedure fertilizes 50 to 80 percent of eggs. You

might assume all eggs get fertilized with ICSI-IVF, but they don’t.
Fertilization isn’t guaranteed even when sperm is injected into the
egg.
 Remember that fertilization rates don’t tell you the clinical
pregnancy or live birth rates.
 Once fertilization happens, the success rate for a couple
using ICSI with IVF is the same as a couple using regular IVF
treatment.

IVF (In Vitro Fertilization)

IVF is a fertility treatment that involves using medication to stimulate

egg production and a process where eggs are removed from a
woman’s ovaries and then fertilized by sperm in a laboratory.
 
IVF is used in the following patients:

 Blocked or damaged fallopian tubes.

 Male factor infertility, including decreased sperm count or
sperm motility.
 Women with ovulation disorders, premature ovarian failure,
uterine fibroids.
 Women who have had their fallopian tubes removed.
 Unexplained infertility.
 Failed IUI treatment.
 Ovulation failure with all possible conventional methods.

In Vitro Fertilization, is the most effective form of assisted

reproductive technology (ART) that involves fertilizing the eggs with
a sperm in a laboratory setting. Essentially fertilization takes place in
the woman’s fallopian tube, but in IVF the egg is fertilized in the petri
dish, after which it is transferred into the woman’s womb. The
procedure can be done using your own eggs and your partner’s
sperm. It may also involve eggs, sperm or embryos from a known or
anonymous donor and in some cases, a gestational carrier i.e. a
woman who has an embryo implanted in her uterus might be used
(surrogacy). The pregnancy test is usually performed two weeks after
the embryo transfer.
  
IVF can help infertile patients with the following:-

 Women with bilateral tubal block.

 Women suffering from moderate to severe endometriosis.
 Women suffering from Polycystic Ovarian Syndrome (PCOS).
 Blocked or damaged fallopian tubes.
 Men with low sperm count/mobility.
 
Steps Involved in IVF
The process of In vitro fertilization (IVF) involves several steps
namely:-

 Ovulation Induction
 Egg Retrieval
 Sperm Retrieval
 Fertilization
 Embryo Transfer