In IVF, this process of fertilisation happens outside the woman’s body. A woman’s eggs are surgically removed and fertilised in a laboratory using sperm that has been given as a sperm sample. Next, the fertilised egg, called an embryo, is implanted into the woman’s womb.
All IVF treatments begin with a course of hormone therapy to stimulate the development of several follicles in the ovary. These are collected as eggs, which are then fertilised in a test-tube (‘in vitro’) to create several embryos. After between two and five days in an incubator, one or two of these embryos are transferred through the vagina to the uterus, where implantation occurs and pregnancy begins. However, in IVF as in natural conception, not every embryo implants to become a pregnancy, which is why surplus embryos are frozen – so that a subsequent transfer might be tried if the first one fails. Freezing is now an essential part of every clinic’s IVF programme.
- Bilateral blocked Fallopian tubes
- Severe endometriosis
- Pelvic inflammatory disease with severe adhesion
- Premature Menopause
- Failed reversal of Vasectomy/ Tubectomy
- Obstructive azoospermia
- Genetic diseases
- Surrogacy (Traditional/ Gestational)
- Unexplained infertility
Typically an IVF cycle consists of ovarian stimulation, egg collection, fertilization , embryo culture and embryo transfer. Ovarian stimulation consists of daily injection of hormones to the female partner with frequent clinical and ultrasonographic monitoring. This usually continues for 10-15 days. Egg retrieval is performed under anaesthesia through the internal route. There are no incisions or scars. The egg and sperm are either mixed (IVF) (Figure 1) or the sperm is injected into the egg (ICSI –intracytoplasmic sperm injection). The fertilized egg forms the embryo. The embryo is cultured in the laboratory for 2-3 days. Two-three best embryos are selected and transferred into the womb (uterus) on the second or the third day. The pregnancy test is done 14 days after the day of embryo transfer.