The medical field has always been persistent in terms of technological advancements for various medical interventions, and fertility treatments are no exception!
Infertility affects approximately 8-10% of couples globally, out of which 15-20 million are within India alone. Infertility often takes a toll on the emotional health of individuals, shattering dreams of millions of couples. But the best part is that there are some modern fertility treatments which can help couples achieve their dreams of conceiving a child.
In-vitro fertilization (IVF) is one among these modern fertility treatments. It has been in use for about 40 years now, therefore, there is a good chance that you are already familiar with it! IVF in simple terms means, fusing an egg with a sperm, outside the body in a test tube or a culture dish, and placing it back in the women’s uterus. However, the entire process is carried out in different steps and takes about 3-4 weeks to be completed.
Let us take a deeper dive into how this process takes place and what happens in each step:
Step 1: Stimulation of egg production
Your doctor will prescribe you with fertility drugs containing follicle stimulating hormones, which stimulate the process of superovulation, allowing your body to produce more eggs/ovaries in a month than normal. Increased production of eggs improves chances of successful fertilization in later stages of the treatment. Your doctor will perform regular ultrasound and blood tests to evaluate your ovaries and hormone levels.
Step 2: Removal of the eggs
Once your eggs are ready to be removed from your body, your doctor will administer a hormonal injection a day or two before the scheduled retrieval of eggs, to stimulate your ovaries to mature faster. Next, a minor surgical procedure called Follicular Aspiration is carried out to remove the eggs. A thin needle is passed through your vagina under ultrasound guidance, to remove one egg at a time. This needle contains a device which produces suction to remove the eggs. You may experience cramping after the procedure, which is relieved within a day.
Step 3: Collection of sperms
During the process of egg retrieval, your partner will be instructed to provide a sample sperm. The quality of sperms are examined along with their fertilization potential. The sperms then undergo a washing cycle to clear out inactive cells and seminal liquid. Then, your doctor will determine the healthiest sperm for fertilization.
Step 4: Fertilization
This is the main part of the IVF treatment. This step involves fusion of the egg and the sperm. Fertilization can be carried out by either of the two methods: Conventional Insemination and Intracytoplasmic Sperm Injection (ICSI).
Conventional Insemination is a process in which one mature egg and several sperms are left in a culture dish and incubated overnight.
ICSI involves injection of one healthy sperm directly into the cytoplasm of the egg.
Your doctor will decide the method based on evaluation, sperm & egg quality and couple’s consent. Irrespective of the chosen method, fertilization is examined on the following day.
Step 5: Embryo transfer into the uterus
The final step involves preparation of your uterus for the embryo to be transferred. Your doctor performs a small surgical procedure to insert a catheter through your vagina into the uterus. One or more embryos may be transferred using a syringe, through the catheter. Now the embryo has reached your uterus.
Following these 5 steps you will undergo a luteal phase to give your embryo time to implant into your uterus lining. This period lasts for about 14 days after embryo transfer. After 14 days, your doctor will perform a pregnancy test by taking a sample of your blood.
The pregnancy test helps the doctor determine if the IVF procedure has been successful. After all, this would be the most exciting moment for the couple and the doctor as well! If you are pregnant, your doctor will refer you to an obstetrician and if you are not, your doctor may suggest some further steps in order to improve your pregnancy chances through IVF.
References:
- 1. In vitro Fertilization. Mayo Clinic.
https://www.mayoclinic.org/tests-procedures/in-vitro-fertilization/about/pac-20384716
Accessed on 6 July, 2021. - 2. A Step-By-Step Look at the IVF Process. Penn Medicine.
https://www.pennmedicine.org/updates/blogs/fertility-blog/2020/april/how-does-the-ivf-process-work
Accessed on 6 July, 2021. - 3. 5 steps of the in vitro fertilization (IVF) process. Piedmont Healthcare.
https://www.piedmont.org/living-better/5-steps-of-the-in-vitro-fertilization-(ivf)-process
Accessed on 6 July, 2021. - 4. Katole A, Saoji A. Prevalence of primary infertility and its associated risk factors in urban population of central India: A community-based cross-sectional study. Indian Journal of Community Medicine. (2019); 44(4):337.
Accessed on 6 July, 2021. - 5. Wang J, Sauer M. In vitro fertilization (IVF): a review of 3 decades of clinical innovation and technological advancement. Ther Clin Risk Manag. (2006);2(4):355-364.
Accessed on 6 July, 2021. - 6. Understanding the Steps of IVF. City Fertility. Global CHA IVE partners.
https://www.cityfertility.com.au/understanding-the-steps-of-ivf/
Accessed on 6 July, 2021. - 7. IVF Process - A Step by Step Guide for In Vitro Fertilization. Femicure.
https://www.femicure.com/blog/ivf-process-a-step-by-step-guide-for-in-vitro-fertilization
Accessed on 6 July, 2021.
