Hi, I am Dr. Ankita Srivastava. I am a gynaecologist and obstetrician with over 10 years of experience. I currently practice at the Sir Ganga Ram Hospital in New Delhi and at Zoe Nutrition For Life. I am the co-creator of the conceive effortlessly online program. It is a 3 month online program designed to provide personalised care and attention to you from leading experts in the country and help you get pregnant faster, naturally, easily & most definitely. 😊
With today's modern lifestyle, unhealthy eating habits, stress, and couples trying for conception at a later age, many people face a challenge in their pregnancy journey. One of the most common questions I get asked from a lot of my patients is about IVF. So here is a detailed article for you to understand everything you need to know about IVF.
What is IVF?
IVF ("In Vitro Fertilization"), also popularly called the 'test tube baby', is a technique in which a healthy egg is taken from the female partner's body and a healthy sperm is taken from the male partner's body. The term "In Vitro Fertilization" literally means fertilization outside the body. The healthy egg and sperm are then fertilized outside your body, and the embryo is planted within the uterus. In addition you are given injections for HCG and Progesterone to support the pregnancy.
There are essentially 5 steps that happen in an IVF treatment cycle.
Step one is ovarian hyperstimulation.
The first thing that is done is, hormonal injections are given to the woman to help the development of several follicles instead of the usual one follicle. The growth of the follicles is monitored by serial trans vaginal scans. The doses of the injections are adjusted by the fertility specialist or doctor according to just the right number of eggs for you.
Step two is OPU or ovum pick up.
Once the follicles have grown to the desired size, an injection called ‘trigger’ is given for the maturity of the follicles. You are given a date and time when the ovum, or egg pick up is scheduled. This is a short painless procedure done under anesthesia. In this the doctor will retrieve the eggs from within the follicles by a needle. No cut or stitch is required in this procedure.
Step three is semen preparation.
The husband gives a semen sample in the IVF lab. The semen is washed, filtered and prepared to get the best quality sperms.
Step four is fertilization.
The eggs are incubated with the prepared semen sample in a conducive environment for fertilization to occur. Sometimes, eggs are individually fertilized by injecting a sperm in them microscopically. This process of fertilising an egg by injection of an individually selected sperm is called ICSI (Intracytoplasmic sperm injection). An embryologist is a team member who conducts and oversees this process. Fertilization is confirmed after about 18 hours.
Step five is embryo transfer.
After 3 to 5 days, the embryos are ready to be transferred. They are still microscopic. With the help of a long, thin catheter a pre -decided number of embryos are placed in the woman’s uterus. This is a simple, painless process that needs no anesthesia. Some rest is given after this procedure in the lab itself. And thereafter the couple can return home. Medication is prescribed to the woman to help support the implantation and growth of the embryo or embryo within her uterus. This medication is in the form of tablets, injections and gels.
About 14 to 16 days later, a blood test called serum beta HCG is done to check for pregnancy. If it’s positive, the medications are continued. If it is negative, the medications are stopped and another embryo transfer is planned.
So, if in a cycle, say 10 eggs are retrieved from a woman and after incubation, say 8 embryos were formed. If 2 embryos are transferred on day 3 or 5, the rest of the 6 embryos are frozen for use later if needed.
If the pregnancy test is negative, in the next month, instead of going through the whole process again, the uterus is prepared with medicines, and at the right time only, the embryo transfer process is done in which, say 2 more embryos are thawed and placed in the woman’s womb. Medication to aid implantation and support the growth of the embryos is advised. And again after 14-16 days the pregnancy test is done. This is called a Frozen Embryo Transfer cycle and it increases the chances of success by 5 to 10% over and above a fresh embryo transfer.
How many IVF cycles should I go for?
If you are less than 40 years old, you can go for 3 full IVF cycles. And in between the IVF cycles it is recommended you keep a 1 month gap. So if you have done an IVF cycle this month, then don't do another cycle this month. Go for the next cycle, next month. So that there is a 1 month gap between the cycles. This will help the ovaries to replenish.
After 40 years of age, it is recommended that you only go for 1 cycle.
What is the success rate of 1 IVF cycle?
If you are 37, 38, 39 years old, the success rate of 1 IVF cycle can be around 20%. Now some people think that this is a very low success rate. But if you are going for 3 cycles, this gives you a cumulative success rate of about 60%.
If you are trying naturally you have a 5-6% chance in each cycle. So IVF definitely increases your chances of conception.
Should I go for an IVF treatment?
Which couples is IVF best suited for? IVF is a good treatment option for you if you have one or more factors that I am just going to mention.
1) Blockage of both tubes.
2) Very low sperm count or poor semen parameters.
3) Ovulation disorders like PCOS or poor ovarian reserve, which means low number of potential eggs in the ovaries.
4) Uterine factors like endometriosis.
5) Unexplained infertility. If all your test results are normal but you haven’t conceived despite trying for a reasonable length of time or despite other treatments like say 3 to 6 cycles of IUI.
Here is an article I had written about a patient of mine who had a low AMH count and multiple failed IUI and wanted to know whether she should go for an IVF or not.
What are the possible side-effects of IVF treatment?
In an IVF treatment you are taking embryos and planting them into the ovaries. So if more than 1 embryo is planted, it can lead to multiple pregnancy.
IVF treatment requires stimulation of the ovaries through injections of HCG and Progesterone. This can sometimes lead to hyper stimulation of the ovaries, which may lead to hypertension in the future.
IVF treatments are also linked with pre-term labour and miscarriages.
All these side-effects can be there. So you need to consult a very good gynaecologist and only after proper review go for an IVF treatment.
What kind of preparation is needed before IVF?
This can be divided into three broad categories:
1) Physical preparation, that is, preparing your body.
2) Mental or psychological preparation, that is, preparing your mind.
3) Logistics, that is, social, financial and professional preparation.
I have written a detailed article on this subject , which you can read here.
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I hope you found this article useful. If you want a detailed consultation with me, you can write to me or drop me a whatsapp.
Love and good health,
Dr. Ankita Srivastava
Gynaecologist & Obstetrician
MBBS, MS, DNB, MRCOGII (London)
Email: email@example.com | Whatsapp: 8527198370
At Zoe we have created an online program to help you improve fertility and get pregnant faster by adapting small lifestyle changes that focus on weight, nutrition, sleep and mindset. This video series is your and your partner’s perfect pregnancy planner. Check it out here.