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In Vitro Fertilisation

In Vitro Fertilisation

IVF (In Vitro Fertilisation) is a revolutionary advance technique in reproductive science and has blessed more than 8 million infertile couples with babies worldwide till date.

IVF/ICSI: IVF is a technique that involves fertilisation of the egg (oocyte) outside the human body with a partner's sperm and transferring the best developed embryo inside the uterus. This will give the best possible chance of pregnancy for an infertile couple. In IVF, sperms are generally kept nearer to the egg and allow them to fertilise that egg on their own.

ICSI (IntraCytoplasmic Sperm Injection) is a technique of IVF in which a sperm is directly injected inside a mature egg using a micromanipulator. It is boon for those infertile couples where the sperm counts in semen are very low or for surgically derived sperms. But right now this ICSI technique is used for almost all cases in some IVF centres to achieve good fertilisation rates by surety of the sperm injection artificially.

When to consider IVF/ICSI for an Infertile couple?

Main indications are
  • Tubal factor (Fallopian tubes are not functioning / blocked)
  • Male factor (low or no sperm counts)
  • Unexplained Infertility where Artificial Insemination/ IUI (Intrauterine Insemination) failed.
  • Ovarian failure/ Decreased ovarian reserve
  • Endometriosis

Different IVF treatments available:

  • Self IVF:IVF/ICSI using female partner’s own eggs + sperms of her partner or donor sperms (Depending on the indications).
  • Donor IVF:IVF/ICSI using donor’s eggs + sperms of her partner or donor sperms (Depending on the indications).
  • Embryo donation:Transfer of an embryo(s) made using both donor’s eggs as well as donor’s sperms.
  • ICSI-D:When donor’s sperms are used to fertilise eggs.
  • Frozen Embryo Transfer (FET) cycle:When previously frozen excess embryos are thawed and transferred.
  • ICSI with PGT/PGS (Preimplantation Genetic Testing/Screening): This is an advanced treatment where embryonic cells/material are sent for either chromosomal analysis or to find specific genetic abnormalities in embryo(s).

One treatment cycle timeline (of Self IVF):

Success Rates (Chances of Pregnancy):

IVF success rate (positive b-hCG) varies widely from 45-65%. But if we consider the live birth rate (take home baby rate), which is the main outcome desired, ranges from 30-35% in India. Our live birth rate is almost comparable with the worldwide rate of ~30-40%.Self IVF success rate is majorly associated with female age as age is an independent factor determining egg quality. Younger age females have better egg quality and hence higher chances of pregnancy.

Complications/ undesired outcomes of IVF-ICSI

(1) Ovarian Hyperstimulation Syndrome (OHSS)

It can happen in 1-4% of IVF stimulation. This is basically an exaggerated response of ovaries due to excess hormones during IVF stimulation. In this condition, ovaries became larger in size and fluid started to leak into the body spaces resulting in ascites (fluid accumulation in abdomen) or pleural effusion (fluid accumulation outside the lungs) in severe cases.

It is common in women with polycystic ovaries and younger age groups. Proper patient selection, optimum IVF stimulation injection dose, in high risk groups even by avoiding hCG injections for final egg maturation and segmentation of IVF cycle will help to reduce the possibility of OHSS significantly.

(2) Multiple Pregnancy

Twins, Triplets (3 fetuses) and sometimes quadruplets (4 fetuses in uterus) can be seen with IVF pregnancy and majority of time it is directly associated with the higher number of embryos transferred. Generally more number of embryos transferred to increase probability of pregnancy during IVF process. But it comes with the risk of multiple pregnancy.

Risk to mother (Gestational Diabetes, High Blood pressure etc..) as well as to the babies (low birth weight, NICU admission etc..) increases in multiple pregnancies as compared with singleton pregnancy. Less number of embryos and preferably single embryo transfer help reduce multiple pregnancy rates.

(3) Abortion/miscarriage

Chances of abortion are 10-15% not only in IVF pregnancy but it is similar in natural / IUI pregnancies. All the necessary precautions and mediations are generally given to all IVF patients to reduce chances of this mishap.

(4) Ectopic pregnancy

Ectopic pregnancy (Pregnancy outside the uterus mostly in the fallopian tube) chances are also ~0.06% after IVF, which is very low but that is also possible in natural/ IUI pregnancy. This chance is not related to the IVF process itself. Mostly it happens in cases of unhealthy tubes, higher embryo transfer or more use of media during transfer and these all factors can be checked in any dedicated IVF centre, to prevent ectopic pregnancy in IVF.

We at Aarya Women’s Hospital with the team of expert IVF specialists delivered best possible success rates with minimum undesired outcomes.