How is IVF Performed?

 “How is IVF Performed?”

How is IVF Performed

In vitro fertilisation(IVF) and is a form of assisted reproductive technology (ART). It involves extracting eggs from a woman's ovaries and fertilising them with sperm. An embryo is a fertilised egg that has been fertilised. The embryo can then be frozen or transplanted to a woman's uterus for storage. IVF has a varying success rate. Women under the age of 35 who undergo IVF have a live birth rate of 41 to 43 %. For women over the age of 40, the incidence drops to 13 to 18 % (American Pregnancy Association).

In vitro fertilisation (IVF) is the world's most successful, widely used, and final infertility treatment. It's frequently used when other ways of attempting to conceive have failed.

Why IVF is performed

IVF aids people who are trying to have a child but are unable to do so due to infertility. Because IVF is costly and intrusive, many couples attempt alternative reproductive therapies first. Taking fertility medications or undergoing intrauterine insemination are two examples. A doctor injects sperm straight into a woman's uterus during this procedure. Infertility problems that may necessitate IVF include:

  • Women over the age of 40 have lower fertility 

  • Obstructed or damaged fallopian tubes.

  • Ovarian function is impaired 

  • Uterine fibroids 

  • Endometriosis

  • Low sperm count or abnormal sperm shape (male infertility).

  • Unexplained infertility

Parents may also choose for IVF if they are concerned about passing on a genetic disease to their children. In a medical lab, the embryos can be tested for genetic abnormalities. After that, a doctor only implants embryos that are devoid of genetic abnormalities.

Preparation for IVF

Before beginning IVF, women will have their ovarian reserve examined. This requires drawing a blood sample and examining it for follicle stimulating hormone levels (FSH). The doctor will be able to tell the size and quality of the eggs based on the findings of this test. The uterus will also be examined by a doctor. An ultrasound, which utilises high-frequency sound waves to generate a picture of the uterus, may be required. A scope may be inserted via the vaginal canal and into the uterus by a doctor. These tests can reveal uterus's health and assist the doctor in determining the best approach to implant the embryos.

Sperm testing will be required for men. This entails providing a sperm sample, which will be analysed in a lab to determine the amount, size, and form of the sperm. If the sperms are weak or damaged, an intracytoplasmic sperm injection (ICSI) procedure may be required. A technician injects sperm directly into the egg during ICSI. ICSI may be used as part of the IVF procedure.

The decision to use IVF is an extremely personal one.There are a few points to consider:

  • What to do with any embryos that aren't used?

  • How many embryos to be transferred? The larger the number of embryos transplanted, the greater the chance of a multiple pregnancy. Most doctors will only transfer two embryos at a time.

  • Thoughts on having twins, triplets, or a higher order multiple pregnancy.

  • The legal and emotional consequences of utilising surrogate or donated eggs, sperm, and embryos.

  • The financial, physical, and emotional effects of IVF.

How IVF is performed

In in vitro fertilisation, there are five steps to be performed:

  1. Testing and Stimulation

Before you start IVF, your uterus and fallopian tubes will be examined to make sure there are no problems that need to be fixed surgically. During each menstrual cycle, a woman typically produces one egg. IVF, on the other hand, requires the use of several eggs. The odds of generating a viable embryo are increased when several eggs are used. Fertility medications will be given to help the  body produce more eggs. During this period, your doctor will conduct frequent blood tests and ultrasounds to check egg production and determine when they should be retrieved. For ovarian stimulation, most women will take fertility medications for 8-14 days; the average is 10-11 days. In most cases, 10 to 20 eggs are extracted during IVF. However, not all of them are suitable for use, since only around two-thirds of them are mature enough. The doctor will develop a plan to help get the most eggs possible while avoiding ovarian hyperstimulation syndrome (OHSS).

  1. Egg retrieval

Follicular aspiration is the term for egg retrieval. A surgical procedure is required to extract the eggs from follicles in the ovaries thirty-four to thirty-six hours after receiving the trigger injection — before the eggs ovulate. It's an anesthetic-assisted surgical procedure. An ultrasound wand will be used to guide a needle into the vaginal canal, into the ovary, and into an egg-containing follicle. Each follicle will be suctioned for eggs and fluid, which will be collected in a test tube. In most cases, the complete procedure takes less than 30 minutes. Minor cramping is possible on the day of the surgery, but it generally goes away the next day.

  1. Insemination or Fertilization

Experts check eggs after they arrive at the lab to assess their age and quality. The male spouse will now be required to provide a sample of sperm. Insemination or intracytoplasmic injection are the two methods for fertilising an egg (ICSI). Your IVF team will decide which method to utilise based on a variety of criteria relating to the couple undergoing IVF. The success rate of both techniques is almost the same. In a petri dish, a technician will combine the sperm with the eggs. If that fails to generate embryos, your doctor may opt for ICSI. 

The conventional technique involves placing sperm in the culture medium of a tiny petri dish containing an egg, then incubating the sperm and eggs together in the lab, enabling the sperm to enter the egg on its own. Using a needle and a sophisticated operative microscope, one sperm is injected into the cytoplasm of the egg for ICSI.

  1. Embryo culture

Mature eggs are placed in a specific culture medium, placed in an incubator, and fertilised with sperm within a few hours following egg retrieval. On the second and third days following retrieval, they will be examined. If enough embryos show good growth and development, they may be chosen to develop to the blastocyst stage in a specially formulated culture medium. There are numerous advantages to blastocyst cultivation. Because embryos at this stage have a better likelihood of implantation, fewer embryos can be transferred on day 5 to avoid multiple pregnancies. The doctor will take note on the fertilised eggs to make sure they're dividing and developing properly. At this point, the embryos may be tested for genetic disorders.

  1. Transfer

Typically, 3 to 8 cells are transported to an outside lab for testing, while the embryos are frozen and kept at the IVF lab. The chosen embryo is chosen, thawed, and transferred into the uterus after obtaining the genetic test results, generally 1 to 2 months following the egg retrieval. The embryos can be implanted once they are mature enough. Three to five days after fertilisation, this happens. A tiny tube called a catheter is inserted into the vagina, through the cervix, and into the uterus during the procedure. The embryo is subsequently implanted into your uterus by a doctor. An abdominal ultrasound is utilised to ensure that the embryo is implanted in the best possible spot by the tip of the catheter. Good embryos that aren't utilised for transfer are generally kept in case the cycle fails or if a couple wishes to have multiple children after a successful initial cycle.

Deciding whether or not to attempt in vitro fertilisation, as well as how to proceed after the initial attempt fails, is a difficult decision. This procedure can have a financial, physical, and emotional toll. Consult a doctor to learn more about the options available and whether in vitro fertilisation is the best decision.





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