What is IVF?

In Vitro Fertilisation (IVF) is an Assisted Reproductive Technology (ART) where sperms and eggs are placed in a dish and sperm are allowed to fertilise the egg overnight. “In Vitro” means “In the glass” Colloquially called “test tube” Thus, the term “Test Tube Baby”. In IVF, the eggs and sperms are combined in a controlled environment inside a laboratory in the glass dish.

The fertilised eggs after growing and developing into embryos are transferred into the womb of the female partner.

What is ICSI?

ICSI stands for Intracytoplasmic sperm injection is an Assisted Reproductive Technology (ART) where a sperm is injected directly injected into the egg. Of all the available sperms, the embryologist picks up the healthiest one that is then injected into the egg under the microscope in the laboratory.

After successful fertilisation, the embryo is transferred into the womb (uterus) in the same way as in an IVF procedure.

Who needs IVF / ICSI?

IVF or ICSI treatment procedure is recommended to couples for whom natural egg fertilisation isn’t feasible or hasn’t happened inside the body of the female partner. This may be due to male or female fertility disorders as mentioned below:

Female Factors:

1. Damaged, blocked or absent (post-op) Fallopian tubes
2. Previous multiple unsuccessful IUIs
3. Previous tubal sterilisation
4. Patients with endometriosis
5. Unexplained where no reason is found

.

Male Factors:

1. Poor sperm quality
2. Low sperm count
3. The inability of sperm to penetrate or survive the cervical mucus
4. The inability of the sperm to fertilise the egg
5. When the semen or ejaculate has no sperms but sperms can be taken directly from the testes

IVF-ICSI procedures are also suggested in cases of unexplained infertility. It is also recommended for couples who present with genetic disorder in the family or their previous child where preimplantation genetic testing for aneuploidy PGT-A or Preimplantation genetic testing for monogenic disorder PGT-M is performed.

Are there any alternatives?

What happens during IVF / ICSI?

There are multiple steps involved in this process.

1. Initial investigations for the couple
2. Daily hormone injections
3. Tracking scans
4. Egg Collection
5. Fertilisation
6. Embryo transfer
7. Pregnancy test after around 14 days – Pregnancy only occurs when the embryo attaches to the lining of the uterus.
8. Hormonal support continued … 12 weeks pregnancy

Are there any side-effects of IVF?

Like most other medications and surgical procedures, IVF also has a few side-effects like:

1. Bloating
2. Cramping
3. Headache
4. Breast tenderness
5. Mood swings

All are mild and short lasting. They do not have any long term continuing side effects.

Following are the points to be remembered:

1. Approximately 40% chance of multiple births if more than one embryo is transferred at a time
2. Risk of premature delivery and low birth weight, again, with multiple pregnancy i.e. twins.
3. Ovarian hyperstimulation syndrome, where numerous follicles develop in women, especially in women with polycystic ovaries. Ovaries are enlarged, there is fluid in the abdomen, bloating and discomfort. See OHSS for further details.
4. Bleeding, infection or damage to bowel and/or bladder during the egg retrieval procedure, but the chances of such happening is very rare.
5. Approximately 2% to 3% of women have ectopic pregnancy where the embryo implants outside the uterus, in the tube, which very likely need laparoscopy and removal of the tubes. Sometimes it can be managed with medication

Other than the physical pains, IVF procedures can also be emotionally draining. Most couples get quite anxious especially because of the built up expectations. We at Genesis Fertility and Laparoscopy Centre, always ensure to keep the couple informed at all stages of the IVF process and this helps them be at comfort throughout the treatment. We also inform them to be prepared with realistic expectations and every couple is clearly informed of the success rate.

Yes, there are alternatives for every situation. There are couples who get pregnant naturally while they are waiting to start IVF. There are also couples who naturally get pregnant after unsuccessful IVF cycles. This might happen due to optimisation of the couples reproductive health status during IVF treatment such as cutting down weight, correcting thyroid hormone levels, stopping smoking and alcohol etc. IVF cuts short the time to get pregnant. IVF increases the success rates

Alternative depends on the reason for IVF. Natural pregnancy, IUI, adoption are alternatives. However, your fertility expert can explain which alternative is suitable for your situation.