IVF – In Vitro Fertilisation

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IVF In Vitro Fertilisation

• What is IVF ?
• Explained by renowned Infertility Specialist
• Dr. Suparna Banerjee.

www.drsuparnabanerjee.com
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How does an IVF cycle work?
IVF is one of the primary treatments offered for
couples experiencing infertility and is a more
involved procedure than it requires stimulating
your ovaries to produce eggs, retrieving your
eggs, having an embryologist fertilize them with
your partners sperm or donated sperm in a
laboratory, followed by close observation of any
developing embryos, until the optimum time for
transfer which ensures only the best quality
embryos are placed back into your uterus so that
they can continue growing as with a normal
pregnancy.
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Step 1 Ovulation Induction
Hormone injections (Follicle Stimulating Hormone)
are given to stimulate the ovaries to produce
multiple follicles (each follicle potentially
containing an egg). These stimulation injections
are given daily subcutaneously (under the skin)
and we ensure you are comfortable with this
injection process before you start. A second type
of medication (injection) is also given to stop
you releasing these eggs (ovulating) before we
collect them.
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Step 2 Monitoring response
Over a period of approximately 2 weeks, whilst
taking these injections, you will be scanned on
average 4 times to monitor the number and size of
the follicles. These scans along with blood tests
taken at each scan will help us correctly time
when we should collect them and allows us to
increase / decrease drug doses as needed to
optimize your outcome.
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Step 3 Preparing for collection
When the leading follicle reaches the optimum
size (17-22mm), preparations will be made for egg
collection. The final preparation for egg
collection involves a hormonal injection given 36
hours pre-operatively. This triggers the eggs to
reach maturity, making them ready for
fertilization.
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Step 4 Egg collection
The eggs are collected using a minor vaginal
procedure performed under ultrasound guidance
where a special needle is directed alongside the
ultrasound probe, through the vaginal wall and
into the follicles growing in the ovary. The
fluid in each of the follicles that usually
contains an egg is then aspirated into a test
tube for the embryologist to assess. To minimize
discomfort this is usually performed under a
light general anesthetic or sedation.
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It is difficult to predict the number of eggs
available from the ultrasound scan picture. We
therefore frequently collect fewer eggs and
occasionally more eggs than we had anticipated
pre-operatively. In rare circumstances we fail to
collect any eggs despite the appearance of
follicles on the scan picture. If this occurs,
the treatment cycle cannot proceed to embryo
transfer and you will be given an appointment to
see the doctor to discuss your future options.
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Step 5 Fertilization embryo culture
After the eggs are collected, if the sperm
numbers are adequate then placed with each egg in
a culture dish and incubated overnight to undergo
fertilization. If there are concerns with regard
to sperm quality ICSI will be recommended to
fertilize the eggs. Embryos cultured in the lab
and their development monitored for between 2-5
days.
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Step 6 Embryo transfer
Embryos will usually be transferred on Day 3 0r
Day 5. The number we transfer will depend on your
age, the quality of the embryos and your previous
history trying to maximize success rate while
minimize the risks of a multiple pregnancy.
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Step 7 Post-transfer
It can be a stressful time waiting for the test
day so we encourage women to resume normal
activities. The pregnancy test will be two weeks
after egg collection. You will be taking
progesterone supplementation and other medication
prescribed by your doctor in this time to support
the lining of the uterus and in the event of a
positive pregnancy test, progesterone
supplementation is continued until week 12 of the
pregnancy, usually.
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