There is no distinction between IVF and test tube babies. The term “test tube baby” is a non-medical word that was coined decades ago to refer to IVF, or In-Vitro Fertilisation. The phrase “test tube baby” arose from the popular belief that an embryo is created in a test tube rather than the woman’s fallopian tube. In fact, the egg and sperm are fertilised in a petri dish, thus in-vitro, which means within the glass culture dish, as opposed to in-vivo, which means inside the living body. An embryo created through the IVF treatment is placed into the mother’s womb, and the pregnancy is continued as usual. Because of the rising frequency of infertility or the inability to conceive naturally, IVF treatment is becoming increasingly popular among Indians. Infertility has been classified as an illness that necessitates medical treatment by the World Health Organization. Call and book your appointment for IVF with dr.Kaushiki clinic which is the best IVF clinic in Gurgaon.
What exactly is IVF?
IVF, or In Vitro Fertilization, literally means fertilisation “in glass”/in a test tube/outside the body.” The phrase originates from biological test tube research and refers to the process in which a woman’s eggs are fertilised outside of her body in a laboratory.
Unlike artificial insemination, in which sperm is inserted in the uterus and pregnancy occurs regularly, IVF involves mixing eggs and sperm outside the body in a laboratory. Once an embryo or embryos form, they are implanted in the uterus, where implantation occurs and, if successful, results in pregnancy.
Who is IVF appropriate for?
IVF is especially advised for women who have missing, blocked, or damaged fallopian tubes as a result of disease or surgery.
It is also commonly utilised in cases of unexplained infertility (couples with no evident pathology), in some cases of male factor infertility (low sperm counts/motility), and in cases of severe male factor infertility (ICSI (intracytoplasmic sperm injection).
Some of the causes of infertility include ovulation issues, severe endometriosis, and antibody disorders that destroy sperm or eggs.
In the event of multiple IUI failures, the procedure is escalated.
It is also the primary technology used in embryo donation (donor egg IVF) and embryo adoption cycles.
An IVF cycle consists of four general steps:
Stimulation of the ovaries to promote egg formation and maturation.
The eggs must be retrieved.
Fertilization of the eggs and embryo culture
Reintroduction of the embryos into the uterus
Stimulation of the ovaries to promote egg formation and maturation (Controlled ovarian hyperstimulation to boost the egg supply)
The first stage of IVF is to inject hormones into your body so that you create many eggs each month rather than just one. Under the supervision of a fertility doctor, the lady is given daily fertility meds (injections of fertility drugs) for 10-12 days to stimulate her ovaries to create a large number of follicles.
Follicles are little fluid-filled structures that form on the ovaries and, hopefully, contain an egg. These injections are available at our clinic or from your neighbourhood general practitioner. Some of the shots can be administered by you or your spouse, which we can train you to do. A clinic nurse could potentially be scheduled to come to your home and administer shots. Gonadotropins, which comprise injections of FSH (follicle stimulating hormone) or HMG (human menopausal gonadotropin), are the most commonly used drugs. These include injectable Recagon, gonal-F, Menopur, Menogon, and Bravelle. The goal of these injections is to stimulate the growth of numerous follicles in the ovaries. When you’re taking these hormone injections, most or all of these developing eggs are permitted to grow until they all mature at the same time. In this manner, we make use of all of the eggs that would otherwise have gone to waste. Trans-vaginal ultrasound scans are used to measure and monitor the number and size of growing follicles. The number of follicles that grow varies from patient to patient, although the average is around 10-15. Some blood tests are performed to evaluate hormone levels, while ultrasound is used to monitor follicle growth so that we know when to proceed with oocyte retrieval. During this step, another form of injection is employed. This is known as a GnRH agonist. Egg (gonadotropin-releasing hormone agonist). To block egg release prior to oocyte extraction, use leuprolide/buserelin or a GnRH antagonist (ganirelix/cetrotide). You will then be checked to see if you are ready for egg retrieval. The final step in preparing for egg retrieval is a hormone injection that mimics the natural ovulation trigger. You will be given injections of a medicine that ripens the developing eggs and initiates the ovulation process. HCG (Human Chorionic Gonadotropin) injection is administered 30-35 hours before oocyte retrieval. This results in the final maturation of the eggs in the follicle. The eggs must be collected right as they emerge from the follicles in the ovaries, which is critical. If the eggs are removed too soon or too late, they will not develop appropriately.
Egg retrieval (Oocyte retrieval / Ovum pick up)
When the eggs are mature, they are extracted using an ultrasound-guided technique under mild anaesthetic. You will be recommended to fast for 12 hours before your appointment, given a brief general anaesthetic, and a needle will be inserted through the vaginal entrance and into the ovaries. During the procedure, your doctor will use transvaginal ultrasonography to find follicles in the ovary and retrieve the eggs with a hollow needle. All of the eggs, together with the follicular fluid, are sucked into sterile tubes. There are no incisions or sutures in the abdomen. It takes roughly 20-30 minutes to complete the process. The dangers are low, and recovery takes only an hour or two, however postoperative cramping is usual. The eggs are then analysed at the onsite embryology lab before being fertilised with your partner’s sperm. Efforts are made at this phase to keep the eggs at body temperature at all times. After identification, the eggs are washed and placed on Petri dishes in an incubator with special culture material. The male spouse is advised to abstain for no more than 48 to 72 hours before the retrieval date. This ensures that the sperm has adequate morphology and motility.
Patients are usually discharged after one to two hours of recovery from oocyte retrieval. Other drugs, like progesterone supplements, are started on the day of the retrieval.
Fertilization of eggs and embryo cultivation in the laboratory
When the follicular fluid arrives in the embryology lab, our competent and qualified embryologist will look for the eggs, separate them, and grade them based on their maturity and quality. The eggs are then promptly deposited in new specific nutrition media and transferred to the incubator. At this point, the partner is asked to collect a new sample, which will be analysed. The male partner provides a semen sample, and a concentrated formulation of the best motile sperm is extracted from the semen sample in the laboratory. In the case of IVF, this sperm preparation (containing roughly 150,000 sperm) is added to the dishes containing the eggs. As previously said, the sperm is combined with the egg in a proper proportion (IVF), or an alternate technique of insemination termed ICSI is occasionally necessary, which entails inserting a single sperm into each egg using a very thin needle, rather than combining the eggs and sperm in a dish. Regardless of the method of insemination used, the inseminated eggs are placed in special nutrition media called fertilisation media and incubated overnight before being inspected to see which have fertilised. It takes about 18 hours to ascertain if fertilisation has occurred and another 24 to 72 hours to determine if a viable embryo is growing. During a successful IVF procedure, the oocytes and embryos will be kept in the lab for 2-5 days. After fertilisation, two weak spheres observed in an egg distinguish a fertilised egg from an unfertilized egg. These two spheres (pro-nuclei) contain sperm and egg DNA and will unite to form the embryo’s nucleus.
Transfer of embryos (ET)
You will come to our clinic for the embryo transfer operation two to five days after your oocytes have been harvested and fertilised in our lab. This is a lot faster and easier than retrieving the egg. It is a rather straightforward theatre treatment, and anaesthesia is usually not required. We discuss the number of embryos being transferred, as well as their quality and grade, on the day of the transfer. For transfer, the best one or two embryos will be chosen. A long, thin catheter containing the embryos and a small amount of media is inserted through your cervix and into your uterus during the process. Abdominal ultrasound is used to ensure the correct location of the embryos, hence the lady must have a full bladder during the surgery. Embryo transfer is often performed 3 days after egg extraction when viable embryos reach the 6-8 cell stage, i.e. if day 0 is the day of retrieval, day 3 is the day of embryo transfer. , and the number of embryos transferred could range from 1-3 depending on the circumstances. If a blastocyst transfer is planned for the case, the embryos are grown for another two days before the transfer. Because of the hazards connected with multiple births, the number of embryos is limited. If there are any remaining embryos, they can be frozen for future IVF attempts. Call and book your appointment for IVF with Dr. Kaushiki clinic which is the best IVF clinic in Gurgaon.