IVF
IVF means In Vitro (Greek Word means outside body) Fertilization. It is often called as test tube baby treatment as well.
In Females, following factors indicate the need for IVF:
- Bi-lateral Tubal Block
- Long Standing infertility with 3 IUI failures
- Pre-mature ovarian failures where ovary is not functioning
- Certain cases of PCO (Poly Cystic Ovary) where IUI has failed to give results
- Multiple abortions with associated genetic disease
In Males, following factors indicate the need of IVF:
- Long Standing infertility with normal semen analysis
- Less than 10 million count and less than 10% motility in semen analysis
- 0% count in semen analysis
In today’s scenario, with respect to female, the AMH levels depicts the fertility power which is more important than age. If the AMH levels are less than 2.0, than it suggest that individualized approach is required to treat the infertility in such cases. However, off late I have noticed that many a times the AMH levels is interpreted in a wrong manner and therefore the clinical diagnosis with 2nd-3rd day Transvaginal Sonogram should be co-related with the results. So if the follicle count is less than 7 in both ovaries than IVF is the choice of treatment.
It can be summarized that in cases of age above 35 years or/and marriage life of 10 years with infertility should be considered for IVF.
Success rate in IVF suggests the positive pregnancy rates after transferring 2-3 Grade-1 embryos in the uterus in each attempt.
As per my experience, transferring embryos in the same cycle immediately after pick-up will never increase the success rate of IVF on continuous basis. It varies from batch to batch and it is anywhere between 35 to 45%.
However, freezing the embryo and transferring in the natural cycle two months after the ovum pick-up can have more than 60% results in the same cycle. The indicate rates of success may also increase depending on the level of experience and technical excellence of the organization.
Steps of IVF:
Step 1 Consultation:
Includes,
- Thorough history of the patient
- Basic counselling about IVF
- Lab tour
- Consultation with IVF specialist doctor
Includes,
- Trans-Vaginal Sonography
- Protocol Selection – For making eggs
- Success rate consulting
For each couple, at WINGS we are always explaining the transparency regarding the take home baby plan.
Step 2:
Financial Consultation to make sure transparency about treatment & cost
Step 3:
- Counselling + Explanation for injections.
- Our injection team will explain patients about how to take injections & at what time to take injections.
- If there is any query among patient for injections telephone support is available.
Step 4:Follicular monitoring
Injections will start on this day, as prescribed patients have to take injections.
- 1st follow up: 7th day of menses vaginal sonography will be prepared & will assess the size of follicles in both the ovaries. If there is 4 follicles in both side size will be more than 13mm.
- Another injection will be started in the evening for taking control over the rupture
- 10th day – 3rd follow up for the maturation size if 4-4 follicles in both ovaries reach >18mm than triggering injection is given
Step 5:
- Ovum pickup / egg collection.
- Always after 36 hrs. of triggering injection.
- Pre requisite- Meal by mouth for atleast>6 hrs.
- OPU after 36 hrs. under short GA protocol.
- It is very easy procedure takes maximum 15minutes.
- Discharge on same day. No food restriction after 2 hrs of the procedure.
Step 6: Embryo formation
- After collection of eggs, eggs are washed.
- Sperm will be selected by IMSI & inserted by ICSI technique. We are pioneer in blastocyst culture (Day-5 transfer)
Step 7: Embryo transfer
We will only transfer embryo,
- If age is <30 years
- AMH is > 3
- Egg collection is less than <20
- Short protocol is < 1.5 on triggering day
- If no previous failure
- If embryo quantity is between 5 to 9
- If endometrium is > 7mm
Simple technique
Only 35 seconds procedure
No anesthesia required
Discharge on same day
Step 8: After procedure
We will only transfer embryo,
- Embryologist will explain embryology report
- Will be counsel for rest & diet
- Assistant will explain how to take medicines
- Follow up after 15 day s of report