In Vitro fertilization (IVF)
What Is IVF?
With the advancement of modern science in the last few decades, assisted reproduction has become a successful and common course of treatment for infertile individuals and couples. In-Vitro Fertilization, IVF, is one such assisted reproductive technique that has been employed successfully as a solution to a range of infertility issues. The IVF process is both safe and effective, and it has been used as far back as the early 1980’s in helping infertile individuals and couples achieve their goal of becoming parents.
In vitro is Latin, meaning “in glass,” referring to the dish that is used to introduce the sperm to an egg. The term “IVF” includes a whole spectrum of assisted reproductive treatment possibilities that can be used separately or together to increase the chances of success. Whenever possible, IVF is used to fertilize an egg with a sperm, thereby forming an embryo.
The first baby conceived via IVF was delivered on July 25th, 1978. The initial indication was in women with blocked tubes as it effectively bypassed the tubes. There presently exist a whole range of indications for IVF. These include: blocked fallopian tubes; low sperm count; retrograde ejaculation; polycystic ovaries and even when all other forms of treatment fail. Because naturally one egg is released out of 1000 that initially begin the journey, we aim to give fertility drugs to recruit more eggs from the remaining 999 to join the one dominant egg. For this reason IVF is not associated with depletion of the eggs and therefore menopause will not set in earlier than expected.
If the numerous follicles (eggs) are allowed to grow without control, it is possible for one follicle to grow much faster than the others. The effect is that the follicle might reach maturation much earlier leading to the release of the hormone by the brain responsible for ovulation. This effectively leads to poor quality of all the other developing follicles as they had not attained full maturity before the release of this “ovulation” hormone. To prevent this, we usually would first suppress your ability to ovulate on your own by giving you other fertility drugs prior to the ones that stimulate egg production. We usually recommend that the drugs, which are in injection form, be taken at about the same time every day. The IVF nurses would usually administer the first shot. Because the needles and syringes are the same as those used by diabetics, the injections are associated with minimal discomfort. We also recommend that the drugs, whether injections or tablets, should be kept in the refrigerator.
The roundish follicles are measured repeatedly until they attain an average of about 17mm. Another hormonal injection responsible for final egg maturation and ovulation is administered. After 35 hours we usually would aspirate the fluid from the follicle and pass this on to the embryologist who confirms the presence of the eggs under the microscope. The process of egg collection lasts about 10-15 minutes. Local anesthetic is commonly used and the egg collection process involves the use of a Trans-vaginal ultrasound scan. The process usually does not require admission and you usually can go home after about 30 minutes to one hour.
The embryologist would inseminate the eggs with specially prepared sperms. We expect fertilization to have taken place within 16 hours. Division takes place thereafter, showing signs of life. The product now called an embryo is transferred 48-72 hours after the eggs were first collected into the womb. The embryo transfer process should be painless. We encourage you to go home thereafter and carry on with your normal activities while avoiding over exertion. You will usually continue with your medications until you perform a pregnancy test after 2 weeks.