For patients with irreparably damaged fallopian tubes profound oligospermia (Low Sperm counts )or failure to conceive after adequate attempts of intrauterine insemmination, In Vitro Fertilasationhas become the treatment of choice. The technology involves incubating the oocytes(eggs) & sperm in the laboratory & allowing the resulting embryo (s) to develop for a number of days prior to transferring them into the endometrial cavity (uterus).
In the 1980’s pregnancy rates for IVF were relatively low, approx 15%. As the nutrition requirements for the embryo growth within the Laboratory became better understood, conception rates began to increase. As we head into the new millenium, anticipated pregnancy rates for many patients may exceed 50 percent
Increased emotional stress because of high cost & time consuming with success rate of 40%. Risks of multiple pregnancies & hyperstimulationsyndrome are all increased.
Patient needs to be in constant touch with the IVF center for about one and a half month from starting medication upto the result of IVF. Out of this period active treatment takes ten to fifteen days during which patient has to visit the IVF Lab. No hospitalizations essential during the treatment cycle.
Prior to collection of eggs, patient is given medication in the form of daily injections starting from day 2 of menstrual cycle & response to these injections is monitored with frequent blood tests & Vaginal ultrasound. Eggs are retrieved from the ovaries by a needle with the help of transvaginal sonography guidance. It is done under mild anaesthesia & is a day care procedure. It is done 32-36 hours after
Semen is required soon after collecting the eggs. A fresh semen sample is preferred. However if difficulty is anticipated in semen collection, the problem is sorted out in consultation with embryologist by cryofreezing the sample in advance.
Embryo transfer is usually done two or three days after egg collection. Even on day five it can be done as desired by the embryologist. Normally no more than 3embryos are transferred into the uterine cavity by a special catheter. Patient is advised to rest for a few hours.
Following ET patient is given Progesterone (hormone) Support & asked to get a blood test done 14 days after E.T. to confirm pregnancy.
The spare embryos can be frozen & these cryopreserved embryos can be used in subsequent cycles & patient need not take the injections for egg formation.