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With the advent of latest technology, clinical expertise, cost effectiveness and zero waiting lists, India has become first choice for IVF & infertility treatment. Concept of standalone super specialty IVF clinic is mushrooming in India for example Apollo, Max, BLK hospital, NOVA IVF clinic, Ferticity fertility clinic etc. Cost of IVF treatment in India is ranging from 3500 USD to 5000 USD depending upon the type of centre you choose with success rate at par with global standards.
What is infertility?
Inability to conceive naturally after 12 months of unprotected sexual intercourse is called infertility.
How common infertility is among us?
Infertility is now considered as global healthcare issue with diminishing fertility rates. 15% couples are infertile and every seventh couple needs help of infertility clinic.
When do you visit infertility clinic?
One should visit infertility clinic when a woman is unable to conceive even after having unprotected sexual intercourse for over a year, or after 6 months if woman’s age is more than 35 years, in some other specific cases of infertility the tests of both male and female is needed earlier.
What are the common female causes of infertility?
Hormonal imbalance, overweight, infections, tubal blockages may lead to infertility.
What are the common causes of male infertility?
Any problem in testis which causes a failure of the production of sperm or transportation of the spermleading to no or poor sperm count.
What all investigations may be done to rule out female infertility?
Battery of female tests are required for any hormonal, tubal or uterine problems etc.
What all investigations are required to rule out male infertility?
Semen Analyses followed by other related tests if required.
In vitro fertilisation, or IVF, is a type of fertility treatment in which sperm and eggs are mixed together outside of the body in a laboratory. It’s a technique utilized by those who require assistance getting pregnant. IVF is a successful type of assisted reproductive technology that entails numerous difficult steps (ART) explains Dr Ila Gupta , Clinical Director at Ferticity Fertility Clinic, New Delhi.
A type of assisted reproductive technology (ART) known as in vitro fertilisation (IVF) involves the fertilisation of sperm and eggs outside of the human body. IVF is a challenging procedure that requires taking eggs out of the ovaries and manually mixing sperm and eggs in a lab to fertilise the eggs. The fertilised egg, which is now known as an embryo, is implanted inside a uterus a few days after fertilisation. When this embryo embeds itself in the uterine wall, pregnancy results.
People choose IVF for a variety of reasons, such as infertility problems or when one partner has a pre-existing medical condition. Some people will try IVF if other fertility treatments haven’t worked for them or if they’re past the prime of pregnancy. IVF is an option if you or your partner has:
Step 1:
Birth control pills or estrogen: Your IVF specialist might recommend oestrogen or birth control before you begin IVF treatment. This is used to regulate the timing of your menstrual cycle and prevent the growth of ovarian cysts. It enables your IVF specialist to manage your care and increase the quantity of mature eggs throughout the egg retrieval process. While some people are prescribed birth control pills that include both oestrogen and progesterone, others only receive oestrogen.
Step 2:
Ovarian stimulation: An egg batch starts to grow each month during a healthy person’s natural cycle who is of reproductive age. Usually, only one egg develops to the point where it can ovulate. The remaining eggs in that group that are still immature shattered. You will administer injectable hormone drugs throughout your IVF cycle to encourage the batch of eggs to mature all at once and fully. This indicates that you might have numerous eggs instead of just one (as in a natural cycle). Your medical history, age, AMH (anti-mullerian hormone) level, and reaction to ovarian stimulation during prior IVF cycles will all be taken into account when determining the type, dosage, and frequency of medications that will be prescribed for you specifically.
The other steps in the ovarian stimulation process include:
Step 3:
Egg retrieval: A tiny needle is inserted into each of your ovaries through your vagina by your IVF specialist using an ultrasound as guidance. Your eggs are extracted from each follicle using suction equipment that is attached to the needle. You put your eggs in a dish with a unique solution. Next, the dish is placed in an incubator (controlled environment). For this treatment, light anaesthesia and medication are utilised to lessen discomfort. The “trigger shot,” your last hormone injection, is given 36 hours before egg retrieval.
Step 4:
Fertilization: The embryologist will attempt to fertilise all mature eggs using intracytoplasmic sperm injection, or ICSI, the afternoon after your egg retrieval operation. This implies that each developed egg will get sperm injection. ICSI cannot be conducted on immature eggs. The undeveloped eggs will be put in a dish with sperm and food. Rarely do immature eggs complete their development in the dish. The sperm in the dish can then attempt to fertilise the egg if an immature
Step 5:
Embryo development: Your embryos’ growth will be closely watched during the ensuing five to six days. Before it is ready to be transferred into your uterus, your embryo must clear many obstacles. 50% of fertilised embryos typically reach the blastocyst stage. The best time to transfer to your uterus is at this stage. Three or four of seven fertilised eggs, for instance, might progress to the blastocyst stage. Usually, 50% of the remaining candidates do not advance and are eliminated. On day five or day six after fertilisation, all viable embryos will be preserved in preparation for upcoming embryo transfers.
Step 6:
Embryo transfer: Fresh and frozen embryo transfers are the two different types of embryo transfers. Depending on your particular circumstances, your IVF specialist can help you determine if using fresh or frozen embryos is ideal for you. The identical transfer procedure is used for frozen and fresh embryo transfers. The name already makes the primary distinction clear.
A fresh embryo transfer occurs three to seven days following the egg retrieval operation, when the embryo is put into your uterus. This embryo is “fresh” because it hasn’t been frozen.
A frozen embryo transfer entails the thawing and implantation of frozen embryos (from an earlier IVF cycle or donor eggs) into your uterus. Due to practical considerations and the higher likelihood of a live birth, this approach is more widespread. Years after egg retrieval and fertilisation can pass before frozen embryo transfers take place.
There is no need for anesthesia during the simple embryo transfer procedure. It has a comparable sensation to a Pap smear or pelvic exam. A tiny catheter is introduced into the uterus through the cervix using a speculum positioned within the vagina. A syringe with one or more embryos inside it is connected to the catheter’s other end. Through the catheter, the embryos are inserted into the uterus. Usually, the process is finished in under ten minutes.
Pregnancy
When the embryo embeds itself in the uterine lining, pregnancy results. About nine to 14 days following embryo transfer, your doctor will perform a blood test to see if you’re pregnant. The same procedures are followed if donor eggs are being used.
FAQs as described by Dr Shushma Sinha , Senior IVF Specialist at Indraprastha Apollo Hospital New Delhi.
Is an IVF baby normal?
In general, YES; there is not much difference in the anomaly rate of the babies born by IVF or naturally.
Can I have baby even when my testicular biopsy report says nil sperm count (Azoospermia)?
Yes; if testis are producing sperm, which due to obstruction are not coming out, causing nil sperm count then one can conceive by ICSI following testicular sperm extraction (Micro TESA). Whole procedure will cost you an additional 1650$.
Can I have IVF in case of tubal blockage?
IVF was started for such cases only so it makes a real indication for IVF.
Can we save our eggs or sperms or embryos for future use?
Yes; you can freeze them for future use. The cost of freezing is US$ 500 for one year. Your surplus embryos freezing will give you chances to conceive at a very low cost say 1000$.
What is the most fertile period of a woman?
Women are most fertile two weeks before the next menstrual cycle. For example, a woman with 34 days menstrual cycle is likely to ovulate at 20 days. We recommend unprotected intercourse around that period starting at least four days before ovulation.
How long does an IVF procedure take?
Whole procedure will take around 4 weeks. Husband can go after sperm donation and freezing,
What is IUI?
A safe and non-invasive procedure, carried out by infertility expert doctor where husband ‘s or donor’sprepared sperm is inserted in uterus with the help of a syringe. The Success rate of IUI vary according to the indications, and are in the range of 15 -20 %.
How is ICSI different from IVF?
ICSI is intra cytoplasmic sperm injection in which a single healthy sperm is injected into each egg to enhance the chances of fertilization. Advanced microscopes with a needle is used to detect the sperm (with normal morphology) & insert to the Egg to ensure normal fertilization.
What is Pre Implantation Genetic Testing?
It is required for older women who have a higher chance of producing chromosomally abnormal baby, also done in cases of repeated IVF/ICSI failures, history of recurrent miscarriages, in cases of any parental genetic diseases etc.
Assisted Hatching: It is carried out in case of two or more IVF failures, advanced age of woman and poor quality of embryos.
50 – 60 % success rate is achieved in India. India is emerging as a cheap and frontline destination for assisted reproductive techniques with state of the art equipment and internationally trained qualified doctors. Apollo hospital, in India ranked 1st in IVF is now 37 years old centre with a very good success rate according to Dr Shushma Sinha, Senior IVF specialist at Indraprastha Apollo Hospital, New Delhi, India.
The cost of IVF in top Indian hospital is 3500$, donor egg IVF will additionally cost you around 1000$ extra.
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