Welcome to IVF
Welcome to IVF
Welcome to IVF
-6. What are the steps involved in the IVF procedure?
The basic steps in an IVF treatment cycle are evaluation and pre-treatment of the couple, ovulation induction, egg retrieval, sperm insemination or sperm injection, fertilization, embryo culture and embryo transfer.

(1) Evaluation and Pre-treatment
-  Pre-conception counseling: It is very important for a couple to understand the ART procedure. Our team will guide you through the physical and emotional aspects of IVF.

-  Anatomic assessment: A HSG may be recommended if it has not been already done. Operative techniques such as laparoscopy and hysteroscopy are sometimes suggested in order to maximize the chances of success.

-  Hormonal tests: Such as baseline TSH, Prolactin, FSH, AMH and LH may be recommended.

-  Semen analysis (SA) and sperm storage: SA determines whether IVF,  ICSI or IMSI will be used for in vitro fertilization.
A urology consultation for the male partner is sometimes suggested, in severe male factor infertility.
We recommend freezing semen prior to IVF so we have a "backup" sample to be used in the event that a fresh semen sample is not available on the day of egg retrieval or ovulation.

-  Testing both partners for infectious diseases: Screening both partners for infectious diseases like HIV and hepatitis B & C that can be transmitted from one partner to another or from mother to fetus before birth is essential.

(2) Ovulation Induction
A woman undergoing IVF is given fertility medicines to enhance the growth of the ovarian follicles so she can develop mature eggs.

(3) Hormonal Tests & Ultrasound scan
The developing follicles are monitored for their maturity and size through an ultrasound and correlated with blood hormone tests like Estrogen, LH and Progesterone.

(4) Ultrasound Guided Egg Retrieval
Once the follicles achieve maturity, the next step in the IVF process involves an ultrasound guided egg retrieval. You will be asked to fast overnight. The procedure is done in a sterile operation theatre under mild anaesthesia. After cleansing the vagina, a fine needle is introduced into the vagina under ultrasound guidance and the follicular fluid is aspirated and checked by the embryologist for the presence of eggs. These are handled gently and quickly transferred to the incubator prior to the IVF/ICSI/IMSI procedure.

(5) Insemination of oocytes: IVF/ICSI/IMSI
IVF/ICSI/IMSI: The semen sample is collected in a sterile container and handed over to the lab. It is then processed and prepared to obtain actively motile sperm. The prepared sperm is then used to inseminate the eggs by IVF /ICSI/IMSI in the culture media.

(6) A normally fertilized oocyte
The day after egg retrieval and insemination/injection, the embryologist will examine the eggs and check for fertilization. A fertilized egg will have 2 nuclei in the center, one from the egg and one from the sperm.

(7) Embryo Culture
The fertilized eggs (embryos) will spend about 3-5 days in the laboratory to allow them to develop into the eight-cell or blastocyst stage, at which time they are ready to be transferred into the uterus. We prefer transfer at Day 3 (8 cell stage) and Day 5 (Blastocyst stage) depending on many factors such as the quality of the embryos and the condition of the uterine lining.

(8) Assisted Embryo Hatching
Prior to implantation, the embryo has to escape from its protective shell known as the zona pellucida by a process known as Hatching. If this process is not completed appropriately, implantation will fail and pregnancy will not occur. We offer the Laser technology for Assisted Hatching (LAH), where a laser beam is focused over the Zona Pellucida making a small opening of about 30 to 40 microns to facilitate embryo hatching.

This technique is particularly useful in cases where embryos have a thick zona and also in cases of previous failed cycles. We have the latest Laser machine which utilises the Diode system. It is considered as the safest Laser application in ART. We have the first pregnancy in India using the Diode Laser in 1999.

(9) Embryo Transfer
The resulting embryos are placed back into the uterus with a fine catheter through a simple procedure called embryo transfer. In our centre we perform Cumulus Aided Transfer (CAT) which increases the chances of implantation.

(10) Cryopreservation/Embryo Freezing
Most women who undergo hormonal stimulation for an IVF or related procedure of Assisted Reproduction produce more eggs than necessary for transfer during that cycle. The extra fertilized eggs may be frozen or "cryopreserved" and stored for future transfer.

(11) After Embryo Transfer
We recommend that you take rest for few days after embryo transfer. Strenuous exercises such as jogging & swimming should be avoided until the pregnancy is confirmed. Otherwise, you are free to return to your regular activities. You can take a regular home-made diet. We recommend avoiding eating papaya and pineapple. Please refrain from sexual intercourse.

(12) A blood Pregnancy test
This is done 14 days after embryo transfer. We wish you every success in your quest for parenthood!