What is IVF or test tube baby?
IVF stands for in vitro fertilization. It refers to the process by which a woman’s eggs are collected and then fertilized outside her womb in the laboratory.
This is done in a Petri dish (“in vitro” is Latin for “in glass”) where the collected eggs are kept and the washed semen containing sperms is added to it so that one of the sperms fertilizes the egg.
The fertilized eggs (embryos) are cultivated and grown in the laboratory and after appropriate growth, they are transferred back to the uterine cavity.
Who Requires ICSI?
ICSI has proved to be very useful in couples who have failed to achieve fertilization or had very poor fertilization following standard IVF treatment & in couples where the male partner has abnormal sperm parameters like severe oligospermia (very low count), severe asthenozoospermia (very less motility), severe teratozoospermia (high percentage of abnormal sperms) or a combination of abnormalities like oligoasthenoteratozoospermia (very low count, poor motility, abnormal sperms).
ICSI also can be performed in azoospermic men (where semen sample contains no sperms).
In such cases the testis are producing sperms but due to block in the tubules or in the path through which the sperms come out from the testis, the sperms produced in the testis cannot come out.
What is the Purpose of IVF?
The purpose of IVF is to:
By pass the fallopian tube where fertilization normally occurs, so that we can overcome tubal factor if it is one of the factors causing infertility.
IVF / ICSI can also bypass mechanical factors, sperm defects like acrosome defect or oocyte defects like zona pellucida being too thick. With IVF/ICSI, subtle hormonal defectsget corrected and endometrial receptivity improves. Unexplained infertility may be due to one of the above factors and may get corrected by IVF/ICSI.
In the natural course, the follicle ruptures when the egg is mature thus releasing the egg, this egg is picked up by the fallopian tube which propels it forwards to the ampullary part(outer one third ) of the tube where fertilization happens.
Pre IVF Preparation
In the month prior to the IVF stimulation cycle, medications/injections are given to suppress the body’s natural hormones so that the subsequent stimulation of ovaries is better controlled.
You may be put on birth control pills in this cycle. This may seem strange – you are trying to get pregnant and we are putting you on birth control pills. Actually, though, using birth control pills before a treatment cycle has been shown to decrease your risk of ovarian hyperstimulation syndrome (OHSS) and ovarian cysts and hence may improve the chances of success.
How is Pre IVF Evaluation Done?
This is the most important part of IVF/ICSI. If this is done correctly the chances of success increase markedly.
Pre IVF evaluation is done for both male & female partners.
For Female Partners.
A transvaginal sonography is done to assess the ovarian reserve (how many follicles of 2-3 mm size on day 2/3 of cycle), endometrial thickness, subendometrial blood flow, to look for any other abnormalities that may be present like fibroid in the uterus, uterine septum uterine polyp adhesions.
Hormonal tests like serum FSH, LH, TSH, Prolactin and AMH.