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IVF Treatment in Delhi

The technique of IVF consists of bringing about the fertilization of the oocyte and the spermatozoa in the laboratory instead of in the woman’s fallopian tube. IVF involves induction of ovulation in order to obtain multiple oocytes, thus making available more embryos with which higher pregnancy rates can be achieved. Serial determination of plasma estradiol levels and daily monitoring of ovarian follicular growth by ultrasonography would indicate the response to ovarian stimulation. At the appropriate moment of follicular growth, the follicles are aspirated to obtain the oocytes. The oocytes are mixed with appropriately capacitated spermatozoa from the husband (or the donor, if the medical condition indicates the use of donor sperm) and is kept in an incubator for fertilization which is observed microscopically after 16 to 18 hours. Embryos are transferred into the uterine cavity between days 2 to 6 after oocyte aspiration. If implantation ensues, pregnancy can be confirmed by 14 to 16 days after embryo transfer by determining the presence of HCG in a blood or urine sample.

Common indications:

  • Blocked or absent fallopian tubes– Fertilisation of the egg occurs on its journey through the fallopian tube so if the tubes are blocked or absent, this process cannot occur.
  • Endometriosis – This is when the lining of the womb can be found covering other pelvic structures such as the ovaries, pelvic ligaments, peritoneum (lining of the pelvis), bowel, and bladder. This causes irritation and inflammation which can lead to scarring. It is also associated with infertility, although the reasons for this are not fully understood.
  • Irregular ovulation – For ovulation to occur, part of the brain prompts the pituitary gland to secrete hormones for the ovaries to ripen eggs during the menstrual cycle. If the menstrual cycle does not occur or is irregular, ovulation may also be irregular or absent.
  • Low sperm count or motility – If there are not enough sperm released in the semen or the sperm that are released are not mortile enough to make it to the woman’s reproductive system, conception is not possible.
  • Unexplained Infertility – In some cases, after all investigations have been completed, no medical reason is found to explain the inability to conceive

Steps in IVF Treatment

1. Stimulation of the Ovaries – A series of injections of a hormone called FSH are given to stimulate the ovaries to produce more than the usual one egg per cycle.

2. Prevention of Premature Ovulation – This is achieved by shutting down communication between the brain and the ovaries to gain control of the ovulation day so that the eggs are not released before they can be collected.

3.Triggering Ovulation – An injection is given to trigger the ovulation process.

4.Collection – The eggs and sperm are collected to begin fertilization. (Egg collection done under short general anesthesia transvaginally under ultrasound guidance)

5.Culturing – The eggs are sorted in the laboratory. The mature ones are selected and placed with the sperm in a plastic container. If more embryos are created than are required for transfer, the strong healthy ones may be put in cryo-storage (frozen) for transfer at a later date if required.

6.Transfer – The embryos are transferred through the cervix and into the uterus. The success of IVF dependents upon a number of factors including a woman’s age, the cause of infertility, and the quality of sperm.

Transfer

ASSISTED HATCHING
After an egg is fertilized in the laboratory, the cells begin to divide. During these initial stages of development, the embryo is contained in a layer of proteins known as the zona pellicuda. In order to successfully implant into the uterine lining, an embryo has to hatch out of the zona pellucida and attach to the walls of the uterus.

Assisted hatching is a newer lab technique that was developed when fertility experts observed that embryos with a thin zona pellucida had a higher rate of implantation during IVF. With assisted hatching, an embryologist uses micromanipulation under a microscope to create a small hole in the zona pellucida.

Indications

Assisted hatching is helpful for couples with a poor prognosis whose embryos are thought to lack sufficient energy to complete the hatching process.

Assisted hatching may be indicated for women with:

  • Advanced maternal age (older than 38)
  • Two or more failed IVF cycles
  • Thick zona (covering) of embryo