The IVF Protocol of Clinic Nirvana
After careful selection of couples for IVF a detailed counselling of the Procedure is done by us.
IVF needs a lot of emotional.mental and financial planning.It is advisable to meet atlas a month in advance prior to planning the IVF cycle.
Certain blood works ( hormonal, preconceptional and investigations to rule sexually transmitted infection) the protocol of IVF stimulation is decided.
Based on the AMH levels and antral follicle count it is decided by me whether we should proceed with Long Protocol ( agonist protocol) or Short Protocol ( antagonist protocol).
Women with low AMH levels and antral count are more suitable for long protocol where the medicine is started on day 21 of the previous cycle and gonadotrophin are added on day 2nd or 3rd of the periods.From day 6th onwards Follicular tracking and estradiol levels are measured to keep a track of overstimulation in order to prevent hyper stimulation of ovaries.Once majority of follicles are 18 mm , a trigger in the form of injection HCG is given to mature the follicles.36 hours later the ovum is picked up under short general anaesthesia at Artemis hospital. Not every follicle contains mature ovum. After pick up the couple is introduced to the embryologist who is the backbone of any successful IVF programme.Based on the recommendations of the embryologist a day 3 to 5 embryo transfer is performed.
In the short cycle Gonadotrophins are started from day 2 or 3 of the periods.from day 6th another injection to prevent premature rupture of ovum is given along with till the trigger is given.The follicle tracking and estradiol levels are measured like in long protocol.In this case we have the liberty of using HCG or another agent called GnRH agonist as the trigger.Maturation with GnRH is helpful in preventing ovarian hyper stimulation.
The embryos can be frozen for a transfer in cycles to follow when the body of the lady is out of the stress of hormones given for ovulation induction.It is a proven fact that Frozen embryo transfer has better success rates as the hormonal milieu of the female is more optimised.
The ICMR recommends a total of 3 embryo transfer at a time.At Clinic Nirvana we never transfer more than 2 embryos and single embryo transfer is also encouraged.
The luteal phase is supported by Progesterone gel and after 2 weeks serum beta HCG is advised.
At clinic Nirvana we pay emphasis on mild stimulation,2 embryo transfer and Frozen embryo transfer to minimise Hyperstimulation and multiple pregnancy which can complicate the IVF cycle.
Our success rate is 27 % (take home baby rate and not positive HCG rate).There hasn’t been a single case of hyper stimulation since may 2016 i.e since Dr Dwivedee stated practising IVF in India.There has been any case of foetal reduction as we don’t transfer more than 2 embryos ever.