IVF - In vitro fertilization
It involves the stimulation of the female partner's ovaries such that all the follicles (about 10-12 in an average patient) present in them in that particular menstrual cycle start to develop (as opposed to only one follicle in a natural cycle and 1-2 in an IUI cycle). The stimulation is done with the help of hormonal injections and the growth of the follicles is monitored using ultrasound scan and blood levels of specific hormones at regular intervals.
When the follicles are mature and ready to be harvested a final ‘trigger’ injection is given but just before the follicles rupture(ovulate) in the body they are ‘retrieved’ vaginally, using a fine needle, ultrasound scan and a suction pump. This procedure is done under a short sedation and doesn’t require admission for the entire day.
After all the oocytes are counted, examined and tagged by the embryologist in the lab it is then prepared to be fertilized by the male partners sperms. There are a few methods to do this:
IVF - In vitro fertilization
The term “in vitro”, from the Latin root meaning in glass. It so a process where egg cells are fertilized by sperm outside the body: in vitro (in a glass or test tube). IVF treatments is one of major and effective treatments in infertility where methods of assisted reproductive technology have failed. The stages of treatment involves hormonally controlling the ovulatory moving (eggs) from the ovaries fluid medium. The fertilized egg passed to the patient’s uterus with an intent to establish a successful and healthy pregnancy.
Test tube baby procedure is mainly used to beat female infertility in the woman due to problems of the fallopian tube; it may also help in male infertility, where there is deficiency in sperm quality.
ICSI - Intracytoplasmic Sperm Injection
Intracytoplasmic Sperm injection (ICSI) is a method used as part of an IVF treatment, when the sperm count is either nil or very low in the semen or the quality of sperm is very poor. In this process a powerful individual sperm injected into the center of an egg to process fertilization.
This treatment can help men whose sperm cannot mover the right way or even where the sperm can enter the egg, but are unable to fecundate egg for other reasons. With ICSI, the sperm is not required to travel to the egg or penetrate the outer layers of the egg-it is artificially injected to the egg. In male fertility treatment ICSI has become the most successful technique. ICSI may be recommended when there is a reason to suspect that achieving fertilization may be difficult. ICSI is most often used with couples who are dealing with male infertility factors.
Male infertility factors can include any of the following problems:
Low sperm counts Poor motility or movement of the sperm
Poor Sperm quality sperm that lack the ability to penetrate into an egg.
IMSI - Intracytoplasmic Morphologically Selected Sperm Injection
This is similar to ICSI except that the sperm to be injected is selected under a highly powered microscope such that the structure of the sperm is visualized in detail and only healthy sperms are selected. This is used in cases where the semen parameters are such that the viability of the sperms is doubtful.
After the oocyte is fertilized using any of the above procedures, it is kept in the incubator for three days and cultured. After three days it is removed and checked for signs of normal embryonic development.
Embryo Transfer
This procedure involves the transfer of the developed embryos into the uterus of the female partner. It is a fairly painless procedure, very similar to IUI. Usually doesn’t require anesthesia (except in difficult cases), bed rest etc. It can be done in the same cycle as the ovarian stimulation- called Fresh embryo transfer or a few months after the ovarian stimulation and oocyte retrieval- called Frozen embryo transfer. Each of these methods have their respective Pros and Cons and the clinician decides between the two based on many factors.