In Vitro Fertilization (IVF) Process
In vitro fertilization with intracytoplasmic sperm injection (IVF-ICSI)
In-vitro fertilization (IVF) is a medical reproductive technology designed to assist couples facing infertility. The process involves retrieving a mature egg from the female partner and fertilizing it with sperm from the male partner in a laboratory setting. This external fertilization creates an embryo, which is then cultured in a specialized incubator that mimics the conditions of the human body. When the embryo reaches a suitable stage of development, it is transferred back into the woman’s uterus with the intention of implantation and subsequent pregnancy.
Intracytoplasmic Sperm Injection (ICSI) is an advanced assisted reproductive technology that involves injecting a single sperm directly into an egg. This technique was developed to address cases where sperm struggle to penetrate the egg’s outer layer during traditional in-vitro fertilization (IVF). By bypassing this natural barrier, ICSI significantly enhances the fertilization rate, leading to a higher likelihood of successful IVF outcomes.
IVF/ICSI Procedure and Timeline
Tips for Preparing
Male
- Get enough sleep, manage stress levels, abstain from smoking and alcohol consumption, and maintain a balanced diet that includes all food groups. Consider taking supplements if necessary.
- Undergo a blood test to assess overall health and fertility (an be done on the day of egg retrieval or in advance).
- It is highly recommended to undergo a semen analysis before commencing treatment.
- Semen collection must be performed on the same day as the female partner’s egg retrieval. Please abstain from ejaculation for 3-5 days prior to the procedure.
- The sperm collected on the same day as the egg retrieval will be analyzed to identify the healthiest sperm for fertilization through ICSI.
- For males unable to produce a semen sample via masturbation, EKI-IVF offers testicular sperm extraction (PESA/TESE)” as an alternative option.
Female
The female preparation process involves two distinct phases:
ovarian stimulation and embryo transfer
1. Stimulation Process
- Baseline Appointment: Your first visit should be scheduled within the first 3 days of your menstrual cycle for a blood test to check your hormone levels and to receive ovarian stimulation medication (either oral or injectable, as prescribed by your doctor).
- Medication Administration: Attend your scheduled doctor’s appointments and follow the prescribed medication regimen. (Typically, there will be about 3 follow-up visits before egg retrieval.)
- Duration of Stimulation: Ovarian stimulation involves daily medication for 8-12 days prior to egg retrieval.
- At each visit, blood will be drawn to check hormone levels and a transvaginal ultrasound (TVS) will be performed to monitor the growth of the follicles.
- Trigger Shot and Egg Retrieval: Once the eggs have reached the appropriate size, your doctor will administer a final injection, known as a trigger shot, to stimulate the eggs to mature fully. Approximately 34-36 hours after the trigger shot, the eggs will be fully mature, and you will be scheduled for an egg retrieval procedure (OPU).
- Ovum Pick Up (OPU): An egg retrieval procedure (OPU) involves a minor surgical procedure performed under anesthesia. A thin needle is inserted through the vagina to collect the eggs from the ovaries.
- Post-Procedure Recovery: After the egg retrieval procedure, you will be asked to rest in the clinic for approximately 1-2 hours before being discharged. An overnight stay is typically not required.
- Fertilization and Embryo Culture: The retrieved eggs will be taken to the laboratory where they will be fertilized with your partner’s sperm using a technique called Intracytoplasmic Sperm Injection (ICSI).
- Embryo Development and Transfer: The fertilized eggs, or embryos, will be cultured in the laboratory for approximately 5-6 days. After this time, they will either be transferred to your uterus in a fresh embryo transfer (ET) cycle or frozen for future use.
2. Embryo Transfer Process
- Embryo transfer can be categorized into two types: fresh embryo transfer, where the embryo is transferred to the uterus immediately after fertilization, and frozen embryo transfer, where the embryo is frozen and transferred at a later date.
ET: Fresh Embryo Transfer
- Following the egg retrieval procedure (OPU), you will be scheduled for a fresh embryo transfer (ET) within approximately 5 days.
- A fresh embryo transfer (ET) involves transferring an embryo, created through in vitro fertilization (IVF) in the same cycle as egg retrieval, back into the uterus to allow for implantation and pregnancy.
- There is no overnight stay required after a fresh embryo transfer. Patients can usually go home after resting at the clinic for 1-2 hours.
- A blood test to confirm pregnancy will be performed about 10-14 days after the embryo transfer.
- Fresh embryo transfer has limitations, including the requirement for a receptive endometrial lining, the inability to perform preimplantation genetic testing (PGT), which can be done with frozen embryos, and the potential impact of ovarian hyperstimulation syndrome.
FET: Frozen Embryo Transfer
- After the egg retrieval (OPU) patients can return home and work with their healthcare provider to schedule a convenient time for the embryo transfer.
- Embryos created through ICSI on the day of egg retrieval will be cultured in the laboratory for approximately 5-6 days before undergoing the embryo freezing process.
- Embryos can be stored indefinitely, based on the couple’s preference.
- When you are ready to proceed with a frozen embryo transfer, please contact the clinic on the first day of your menstrual cycle. A consultation with your doctor will be scheduled to discuss the medication regimen required to prepare your uterine lining for the embryo transfer.
- The medication protocol for preparing the uterine lining typically begins on the second day of your menstrual cycle and continues until the embryo transfer, which is usually scheduled between days 17-22. However, the specific timing may vary depending on the individual patient’s condition.
- During the uterine lining preparation phase, you will need to undergo blood tests to monitor hormone levels and transvaginal ultrasounds (TVS) to assess endometrial thickness as per your doctor’s schedule.
- When your uterine lining is adequately prepared, doctor will schedule a frozen embryo transfer (FET) procedure.
- A frozen embryo transfer (FET) is a procedure in which a previously fertilized egg that has been frozen is thawed and transferred into the uterus to allow for implantation and pregnancy.
- After the frozen embryo transfer (FET) procedure, patients are required to rest at the clinic for approximately 1-2 hours before being discharged.
- The doctor will schedule a follow-up appointment to check for pregnancy approximately 10-14 days after the embryo transfer.
Pregnancy rate (IVF/ICSI)
The success rate of achieving pregnancy after an embryo transfer ranges from 30 to 60 %, depending on various factors such as the age of the couple, sperm quality, egg health, and more.
Incorporating genetic screening can potentially increase this rate to up to 70% based on historical data from EKI-IVF.