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IVF (in vitro fertilisation) is the fertility treatment that is most well-known for infertility. It means "fertilisation in glass", hence the expression "test tube baby". In the UK, one baby in every 50 born is conceived through IVF. India has few of the worlds most experienced doctors and IVF clinics with success rates approximately 10% higher than those in UK / US
There are various stages involved in IVF treatment:
Boosting the woman's egg supply
You will be prescribed drugs that will help to control when your eggs are produced. You will also take drugs to increase the number of eggs you produce. This means that more eggs can be fertilised and the clinic will have a greater choice of fertilised eggs to use in treatment.
Checking on progress
The clinic will carry out vaginal ultrasound scans to monitor your developing eggs. They will also do blood tests to chart the rising levels of oestrogen produced by your eggs. This helps to track how your eggs are maturing. 34-38 hours before your eggs are due to be collected, you will have a hormone injection to help your eggs mature.
Collecting the woman's eggs
Eggs are usually collected by ultrasound guidance, which takes around 30 minutes. Your doctor will insert a thin needle through your vagina into each ovary. The eggs will be sucked into the needle. Very occasionally, eggs will be collected by laparoscopy (a small telescope with a light attached). This procedure involves making a small cut in your stomach and extracting the eggs with a fine needle, as before.
Collecting the man's sperm
Around the same time that the eggs are collected, the male partner will produce a sperm sample. This will be stored for a short time, and the sperm washed and spun so that the healthiest sperm can be used to fertilise the eggs. If you are using donor sperm, this will be taken from the freezer and prepared in the same way.
Fertilising the eggs
The eggs and sperm are mixed and left in a laboratory dish for 16-20 hours. They are then checked to see if any have fertilised. Those that have (now called embryos) are left for another 24-48 hours before being checked again.
Preparing for pregnancy
Two days after egg collection, the woman will be given progesterone to help prepare the lining of the womb for pregnancy. This is given with pessaries, injection or gel.
Transferring the embryos
Two to five days after the eggs fertilised, the healthiest ones are selected to be put back into the woman's womb. For women under the age of 40, one or two embryos can be replaced. If you are 40 or over, a maximum of three can be used. Remaining embryos can be frozen in case you have further IVF treatment.
What are the risks involved in having fertility treatment?
Like all medical treatment, having fertility treatment does carry some risks and your clinic should discuss these with you. The main risks are adverse drug reactions and having a multiple birth. There are also risks associated with pregnancy, whether through fertility treatment or natural conception, such as having an ectopic pregnancy.
Why is there so much concern about having twins or triplets after fertility treatment?
Having a multiple birth (twins, triplets or more) is the single greatest health risk associated with fertility treatment. This is why the some authorities have imposed restrictions on the number of embryos that can be transferred in IVF to a maximum of two for women under the age of 40 and a maximum of three for women aged 40 or over who are using their own eggs (if you are using donated eggs, the maximum is two).
Multiple births carry risks to both the health of the mother and to the health of the unborn babies. Twins or triplets are more likely to be premature and to have a below-normal birth weight. Studies show that the risk of death before birth, or within the first week of life, is more than four times greater for twins than for a single baby. For triplets, the risk is seven times greater than for a single baby.
What is "in vitro maturation" and why might it be better for me than 'standard' IVF?
In vitro maturation (IVM) is a new technique whereby eggs are matured in the laboratory before being fertilised with sperm. Fertilisation is, therefore, still 'in vitro'.
The difference between IVM and 'standard' IVF is that the eggs are immature when they are collected. This process means that the woman does not need to take as many drugs before the eggs can be collected as she might if using the 'standard' IVF process when mature eggs are collected. This means that this option could be particularly helpful to women who are more susceptible to developing ovarian hyper-stimulation syndrome, such as those with a polycistic ovarian syndrome.
IVM is still a relatively new technique and so far about 300 children have been born worldwide as a result. To date there is no evidence to suggest this treatment is unsafe, neither is there enough evidence to be absolutely certain of its safety. This is something you should discuss with your doctor before making a decision about your treatment
Surgical sperm extraction has not worked for me. Are there any other options?
If your doctors have been unable to extract any sperm, you will probably find the only option is to use donor sperm to fertilise your partner's eggs. Depending on a clinic's availability of donor sperm, it may be possible to use sperm from a donor who shares some of your physical characteristics. A clinic will only use donated sperm that has been screened for infections, such as hepatitis and HIV, which involves a quarantine period of around six months.
The donated sperm can then be used to fertilise your partner's eggs through a process called intrauterine insemination (IUI) or by in vitro fertilisation (IVF). The donor will be identifiable, which means any child born as a result will have the right to ask for information about their donor when they reach adulthood, including the donor's name.
I'm worried that my cancer treatment means I won't be able to have children
Some cancer treatments can have an impact on future fertility, and it is worth discussing this with your doctor before your treatment begins. Men can, for example, freeze their sperm and women can consider creating embryos with their partner (if they have one) or using donated sperm to create embryos which can be frozen and used later.
I have unused medicines from my fertility treatment. What should I do with them?
If you have drugs left over from your fertility treatment, you should return them to your clinic or to a pharmacy for proper disposal.
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(Only for international patients seeking treatment in India)
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Infertility Treatment In India
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