A Journey through an In Vitro Fertilization (IVF) for infertility treatment by best gynaecologist in north delhi

IVF procedure has helped countless couples achieve their life-long dream to become parents to healthy children.

What is in vitro fertilization (IVF)?

In Vitro (Latin) means “in the glass” or “in the laboratory”. In vitro fertilization means “fertilization in the laboratory”, or the procedure in which the sperm and eggs are placed together in the laboratory and fertilization occurs, resulting in fertilized eggs (embryos).

Who needs IVF?

While damaged or absent fallopian tubes were the original indication for IVF, most IVF procedures are now performed because of abnormalities in the sperm (male factor infertility). Unexplained infertility is the second most common factor leading to IVF, followed by tubal factor, ovulation problems, endometriosis, and uterine factors. Generally, couples with severe male factor infertility, damaged fallopian tubes, prolonged infertility (more than 3 years), severe endometriosis or scarring (adhesions), or with failure to get pregnant after using other fertility procedures, are suitable candidates for IVF.

The IVF Journey

This is a lengthy, stressful, expensive journey without guarantee for success. This is also a quest for the most precious reward that a couple may ever seek – a baby. The doctor’s role as a physician is to guide you confidently and competently from start to finish, trying to reduce unwarranted stress and apprehension. Good preparation is very important, as with any important journey. Once the physician or best gynaecologist in rohini determines that IVF is medically appropriate, the couple must then determine if IVF is the appropriate procedure for them from their own ethical, spiritual, physical, and financial standpoint. An extensive consultation with us is therefore warranted.

Preliminary evaluation for IVF must include evaluation of the uterus and fallopian tubes, preferably by hysterosalpingogram (HSG, x-ray of the uterus and tubes) or sono-hysterogram (ultrasound with fluid).

Abnormalities of the uterus such as fibroids, polyps, scar tissue, or distortions from birth must be repaired before the IVF procedure. If the female partner is older than age 35, evaluation of her ovarian reserve should be performed and assessment of antral follicles by ultrasound. Poor or marginal ovarian function merits serious consideration for alternatives to IVF with the female partner’s eggs, such as egg donation or adoption.

A special semen analysis performed under the same conditions as during the IVF process (the semen “IVF screen”) should help in determining whether conventional IVF, or IVF with intracytoplasmic sperm injection (ICSI), is appropriate.

The IVF process usually lasts about 15 days. In the first few days of the designated menstrual period for cycle start, the patient is seen for an ultrasound and transfer catheter trial. This is called “mapping and mock cannulation”, a “dress rehearsal” to the actual embryo transfer.

The patient will take several injections per day to stimulate the formation of several eggs in the ovaries. She is usually seen 4 times for brief visits consisting of an ultrasound and blood work.

On approximately day 10-14 , egg retrieval and embryo transfer will take place. The egg retrieval procedure is performed under mild anaesthesia and lasts 20-40 minutes. Under ultrasound guidance, while the patient is asleep, a needle will be inserted twice in the vagina and ovarian follicles containing eggs will be emptied.

After approximately one hour of recovery, the patient will go home, usually resting for several hours before resuming activities. Three to five days later, embryo transfer will be performed while the patient is awake. This simple procedure, similar to the “mock cannulation” earlier, lasts 10 minutes. The patient will then rest at home for 2 days. The pregnancy test is performed 14 days following the egg retrieval procedure.

Will it hurt?

Yes, but you will tolerate it well. The vast majority of patients do. Remember – shots are scary but when you see short and thin needles that children with diabetes use 2-3 times daily, you will tolerate self-injection . Besides, it is only for several weeks. The progesterone daily shots after the egg retrieval are uncomfortable but most patients tolerate them. After egg retrieval, your abdomen will ache for several days (much like menstrual cramps) but most patients do well even without pain medications. The embryo transfer is not painful.

How many embryos are transferred?

We try to transfer no more than 2 embryos in patients younger than 35 or if the embryo quality is good at an older age. This will be discussed with you before the IVF cycle and right before the embryo transfer. I will make a recommendation- you have the veto power. In most cases, we have no problems transferring less embryos than recommended, even one, than transferring more than we initially recommend. Remember- multiple births may be a tremendous challenge!

Birth defects? Chromosomal abnormalities?

Usually no more than non-IVF conceptions, except in cases with severe male factor, which may be caused by a genetic defect that may be transmitted to the children.

Why is it so expensive?

What happens behind the scenes, especially in the laboratory, is not usually apparent to the patient but may be the most expensive aspect. Meticulous quality control measures, technician time, materials, regular lab inspections, anesthesia, lab work, medications, and other issues make IVF expensive.

What can I do as a patient to improve my success in IVF?

Reduction of stress and other adverse environmental factors is important. Stop smoking. Drink no more than 2-3 alcoholic drinks per week. Take prenatal vitamins. Engage in stress-reducing activities or therapies (moderate exercise, yoga, pilates, acupuncture, massage).