IVF (In Vitrofertilization)

IVF is a process in which egg is fertilized outside the human body. Embryo developed is then via a special plastic catheter into the female’s uterus.

IVF treatment helps couples who have difficulty conceiving. Your sperm and eggs are combined in petri dishes and placed in an incubator in a laboratory, to fertilise. After two-to-five days in the incubator, one to two of the resulting embryos are transferred to the woman’s uterus, and hopefully they will then implant and develop as they would in a normal pregnancy.

IVF has a success rate of 35-40% and steps included in the treatment are:

  • Ovarian Stimulation
  • Follicular monitoring
  • HCG trigger
  • Egg retrieval and semen collection
  • Embryo development and Fertilization
  • Embryo culture
  • Embryo transfer
  • Luteal support
Ovarian Stmulation

In a natural cycle ovaries produce only one egg per cycle in most of the cases. In IVF ovulation induction is practiced to produce a favorable amount of follicles, to have a better chance of pregnancy. Injections are started to the female partner either from day 21 or day 2 of menstrual cycle depending on the protocol your Physician has decided for you. Follicular growth is monitored by a series of transvaginal scans that help the Physician to adjust the dose of the injections according to the follicular growth. The day follicles are matured egg retrieval is planned after HCG trigger (that helps egg undergo final maturation steps and eventual ovulation).

Egg Retrieval

Egg retrieval is done under GA (general anesthesia) using transvaginal ultrasound guided needle. You will have to come empty stomach after 6 hours fast for the GA. All follicles are aspirated using transvaginal ultrasound guided needle and examined under microscope to identify the eggs.

Semen Sample

Semen sample is required on the day of egg retrieval. Abstinence of 2 to 6 days is advisable for the sample. Sample should be preferably produced in the center, but if necessary could be brought from home (you will have to reach the center within 45 minutes of producing the semen sample).

Embryo Fertilization & Development

In the incubator, eggs are bathed in a sperm rich bath; embryos hence formed are cultured for two to five days.

Embryo Transfer

Day 3 or day 5 transfer is done using special catheter. Catheter is loaded with embryos, speculum is inserted in the vagina, cervix is exposed and through cervix the catheter is inserted and embryo is delivered to the middle of endometrial cavity. The embryo transfer procedure seems very similar to a Pap smear or IUI for the woman. There should be no pain and no sedation or other drugs are required. We use a moderately full bladder for embryo transfer. After the embryos are transferred, the catheter is slowly withdrawn and checked under a microscope for any retained embryos. If an embryo is retained in the catheter (uncommon) the transfer procedure is repeated immediately and the catheter is checked again.

HCG Pregnancy Test

Pregnancy test is advised after 2 weeks of embryo transfer. We don’t recommend doing a urine pregnancy test (HPT) after IVF. The reason is that there are a lot of falsely negative results. We have seen many beautiful babies born after the female partner called us to say that she took a home urine pregnancy test that was negative. A blood test is needed because it is much more sensitive and reliable.

IVF Success Rate

IVF success rate is around 35-40%.

Activity Restrictions & Bed Rest After IVF Transfer

At our IVF clinic, we have the woman lie on her back for 2 hours after embryo transfer before going home. We request that she also limit physical activity for the remainder of that day. This means bed rest after the IVF transfer for the rest of the day and that night. It does not necessarily mean total “bed rest” but can be hanging out on the couch or in the Lazy-boy recliner – watching videos, reading, bossing hubby around, etc.

We allow “normal activity” such as working, walking around, etc. beginning the morning after the embryo transfer. Heavy bouncing of the uterus is restricted until after the pregnancy test. Therefore, water skiing, jogging, “uterus bouncing sex”, and other high impact activities are probably not a good idea until after the pregnancy test. Once pregnant, we should be OK to start all that fun stuff again.

IVF Embryo Transfer & Travel

For our couples that travel here from out of town or out of country for IVF and embryo transfer, we recommend that they do not fly out on the day of the transfer, but wait until the next day. For patients that are diving back home – it is acceptable to drive home (regardless of the length of the drive) after two hour of bedrest in our office following the transfer procedure.