In vitro fertilisation (IVF) is a process in which eggs are fertilised by sperm in a laboratory or in vitro. Popularly, this procedure is also called ‘test-tube baby’. IVF is an advanced reproductive technology that can help infertile couples to achieve pregnancy.
The process involves the following:
the ovaries are stimulated by hormone injections to produce multiple eggs (in a natural cycle, mostly only one egg is produced every month)
the growth of the eggs in the ovaries is monitored by ultrasound and hormone tests
when the follicles reach large enough sizes, a hormone (hCG) injection is given that causes the eggs to mature
34-38 hours after the hormone (hCG) injection, the eggs are removed (or aspirated) from the ovaries by a needle introduced via the vaginal route under ultrasound guidance
the eggs are mixed with the partner's semen and placed in an incubator to fertilise
the fertilised eggs known as embryos are placed into the uterus 2-5 days after fertilisation
a pregnancy test can be done two weeks later to find out if the IVF procedure has been successful
What is ICSI?
ICSI or Intra-Cytoplasmic Sperm Injection is a microsurgical procedure used in cases of poor sperm count or motility that involves the injection of a single sperm directly into an egg to assist fertilisation. The rest of the IVF procedure remains the same.
What are the success rates?
Two main parameters define success of an IVF procedure.
Pregnancy rate
The pregnancy rates in IVF vary from 25-50% depending on the age of the woman, her ovarian reserve, and the primary reasons for infertility.
Take home baby rate
Just like with natural pregnancy, 10-15% of pregnancies end in abortion and a few in ectopic pregnancy which cannot be prevented. So the take home baby rate is usually about 10% lower than the pregnancy rate.
The success rates of IVF are the highest for women less than 35 years old. Therefore, if you have an indication to undergo IVF, access the services when you are young to avail the best chance of success. Please consult the studies below to understand the reported success rates.
Women who have attempted to get pregnant without success using other techniques such as ovulation induction, intra-uterine insemination (IUI), and surgery for endometriosis or blockage of fallopian tubes are good candidates for IVF treatment. Your doctor might recommend this treatment for you if:
Your tubes are blocked
Your husband’s sperm counts or motility are very low
You have been diagnosed to have endometriosis
Your ovaries do not regularly produce eggs and other treatments have failed
You have unexplained infertility
How long does the treatment take?
The initial consultation is followed by some investigations to assess your ovarian reserve (ability of your ovaries to produce eggs), husband’s semen analysis and other baseline tests to plan the treatment protocol for you. Some of these investigations need to be done at a particular time of your menstrual cycle. The actual IVF cycle can then commence on the Day 2 or 21 of your next menstrual cycle as explained below.
The two most commonly used protocols for ovarian stimulation, recommended to patients on a case-by-case basis are as follows:
Long protocol
The long protocol involves taking hormone (FSH) injections from either Day 2 or 21 of your period. These injections continue for about 4 weeks until you are ready for the egg collection.
Antagonist protocol
The Antagonist protocol is shorter and usually requires injections to be taken for a period of about 2 weeks before you are ready for egg collection.
Overall, the long protocol takes about 6-8 weeks and the Antagonist protocol takes about 4 weeks from the start of injections to the day of pregnancy test.
Why Sitaram Bhartia?
Sitaram Bhartia is a reputed multi speciality hospital and research centre with many advantages that make it a preferred option for IVF treatments:
Combined experience of the team
The IVF clinic is managed by
an IVF specialist trained in India’s
leading teaching hospitals including several decades of experience at the All
India Institute of Medical Sciences.
Complete range of fertility services
The existing services at the Department of Gynaecology offer a comprehensive panel of diagnostic and therapeutic services for basic infertility. Fertility-enhancing surgical treatments including laparoscopic and hysteroscopic procedures are available to our patients under one roof. With the addition of a state-of-art IVF facility, we now offer a complete suite of assisted reproduction techniques.
Focus on ethical and evidence-based practices
At Sitaram Bhartia, we use procedures and clinical practices that have been proven by research trials and accepted by the international medical community. We believe in transparency and keep the patient informed
at all times throughout the treatment cycle.
Our team
We have a highly qualified and trained team of IVF specialists, embroyologists, anesthetists, and nurses at the Sitaram Bhartia IVF clinic.
Dr Renu Misra MBBS, MS, MNAMS is a senior consultant in Obstetrics & Gynaecology. Her areas of expertise are endoscopic surgery and infertility including artificial reproductive techniques (ART). Besides being a competent and compassionate clinician, she is a teacher and academician for over 27 years. Before joining Sitaram Bhartia Institute, she served at the All India Institute of Medical Sciences, New Delhi from 1993-2006.
and at University College of Medical Sciences, Delhi from 1987-1993. Since then she has organized a number of training courses and conferences in endoscopic surgery at the AIIMS and Sitaram Bhartia Institute. She also obtained training in IVF and other ART procedures
at
the university of Manchester, UK and
at Rotunda Hospital Dublin, Ireland. Dr Misra has authored 4 textbooks, contributed chapters to many books, and published scientific articles in national and international journals in Obstetrics & Gynaecology.
She obtained higher training in IVF
at the University of Manchester, UK and the Human Assisted Reproduction Unit at
Dublin, Ireland. The embryology support is provided by a higher experienced
embryologist, well trained in IVF and ICSI procedures.
Videos
A 3-minute video showing the IVF process
Myths
Some common myths that patients hear.
“Are babies born through IVF abnormal?”
No. Children born after assisted reproductive techniques are generally healthy and are developmentally similar to children born after spontaneous conception. IVF per se does not increase the risk for severe cognitive impairment (i.e. mental retardation) or neuromotor handicaps such as cerebral palsy. See scientific studies
“Women are having babies at 40. I can wait for some more time.”
The ability of a woman to get pregnant begins to decline after that age of 30 and plummets after 38 years. This is due to a decline in the number and quality of her eggs with age. Theoretically, a woman is capable of conception till menopause but the success rates of fertility treatment are very low after the age of 38. Delaying pregnancy till the late thirties is not a good idea after all.
“Infertility is a problem of women” Infertility is equally contributed by both men and women. Men may have abnormalities in their semen parameters that contribute to difficulty in conception. Women may have blocked tubes, difficulty in forming eggs, endometriosis or problems in the uterus. About 10% of couples may have unexplained infertility.
“Stop trying and take a holiday and you will conceive”
Infertility is not a psychological disorder and a doctor will generally try and find a medical reason for it. The treatment of infertility involves treating that cause. Coping with infertility is indeed stressful but is not the cause for preventing conception.
