Assisted Reproductive Technology is a method of using scientific knowledge to help the needful couple to conceive and have a child. It is a technique where the human gametes are handled outside the body, fused and the formed embryos are put back to the uterus for future development.
Why do you need IVF?
IVF is likely to be suggested for the following fertility problems:
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If you have damaged or blocked fallopian tubes.
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If the male partner has infertility issues like Oligozoospermia, Teretozoospermia or Athenozoospermia.
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In case of premature ovarian failure.
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If you have been trying to conceive for at least two years and a cause has not been found to explain why you have not become pregnant.
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Multiple cycles of failed IUI.
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To choose an embryo in genetic diseases.
What are steps do I need to undergo?
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Ovulation Induction
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Egg Collection
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Embryo Formation
Ovulation Induction: Every month women release one egg, which can be fertilized to form an embryo or goes waste otherwise. In IVF we give a hormonal injection to get a maximum number of good quality eggs. This will increase the number of embryos. Hence the pregnancy chances too.
Egg Retrieval: Under Anesthesia
The hormone injections are started usually from day 2 or 3 of the cycle and administered for about 10-12days.
A very thin needle is passed through the upper vaginal wall into the ovaries with the help of ultrasound. Fluid in the follicle eggs with (sucked) from each ovary. Immediately after aspiration of the follicles, the oocyte (egg) is isolated from the follicular fluid.
Fertilization: The collected eggs and sperms are left in a single dish where the sperm fertilizes the egg by natural process or ICSI (Intracytoplasmic Sperm Injection) can be used where the sperm is directly injected into the egg. In special situations. Later they are incubated so that they grow into embryos.
Embryo Transfer and Implantation: First, the embryos are examined to select the healthiest ones for transfer, the embryo is transferred through a small tube placed through the cervix into the uterine cavity.
The embryos which are prepared in the lab are directly transferred on day 3 or day 5 into the uterus without freezing, called fresh embryo transfer. In special cases like when the lady is heading towards hyperstimulation, the uterus lining is not good or if the fresh embryo transfer is failed in such cases we will freeze the embryos, prepare the endometrium, and transfer in a subsequent cycle. This is called frozen embryo transfer.
Implantation is the rate-limiting step of the IVF process. Lots of research is progressing in the field of implantation. How a healthy seed sown in fertile soil yields a beautiful tree, for pregnancy to happen, good embryos and good endometrium is a must.
What is the success rate of IVF?
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We have the best result for IVF with the success rate on par with the topmost IVF Centers across the world.
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The success rate depends upon the cause of infertility patient parameters, Lab condition, the skill of the clinician, and also the embryologist.
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Hence I need the couple to know the answers to these questions.
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What will be my success rate if I undergo IVF?
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Will I get excess embryos to freeze?
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Do we get adequate embryos for transfer?
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How many cycles do we have to undergo?
Sakra World Hospital is one of the best assisted reproductive technology centres in Bangalore having IVF experts take on an individualized, comprehensive approach to IVF, fertility and reproductive services.
Male Infertility: Infertility is a problem of the couple where every partner plays a vital role in establishing fertility. Hence the evaluation of a male partner is as important as that of evaluating a female partner. Analysis of the semen is the most trusted and one of the Gold standard investigations done to check the fertility of the male party. It is easy, less expensive and readily available. Depending on which the treatment is decided. Male infertility includes sexual dysfunction azoospermia, oligozoospermia, varicocele, etc. We have IVF doctors in Bangalore, who can understand the problem and treat them to enhance their fertility. And the expert embryologist overcomes the barrier of male infertility and helps in fertilizing the oocyte.
The psychotherapist can give excellent counselling for psychosexual problems to have a way for happy family life.
Age & Fertility: Due to the fast-moving era and career-oriented lifestyle, the age of bearing a first child is increasing and hence the trend of infertility has increased by 50% in the last 2 decades. Age has a significant effect on the fertility of both partners, especially the female partner. A woman is born with a certain fixed amount of egg reserved. And as the age advances, the ovarian reserve starts depleting. After 35 years the ovarian reserve and the quality of oocytes start depleting drastically and hence higher infertility rates. In such cases, it is recommended to freeze the oocyte at the lower age group and use it when she is ready to bear a child. This will increase the fertility rate and decrease the rate of anomaly. Sakra World Hospital is one of the best IVF centre in Bangalore, which is well equipped and has a good success rate in freezing such eggs.
Family Counselling: Family is a group of people who are living together with affinity, affection and love. They give birth to progeny and also create a better environment for the dwelling of that child. Any sort of difference or disappointment in any of the above can lead to disharmony in family life. This can have a significant effect on the mental health partner relationship and also on fertility. Here comes the role of family counselling, where they differentiate the organic causes from the psychological causes, held to achieve a stable relationship. Our Sakara IVF not only aims to give pregnancy to infertile couples. But also reestablishes the harmony in the family through their fantastic counselling skills. So that a happy family awaits a happy kid.
Pre-genetic Testing:
Overview:
This method is used to test whether the embryo is chromosomally normal or not. Chromosomes form the genetic material of a cell. The test is done after doing a biopsy from these embryos which tells the details about every embryo.
This pre-genetic testing is of 3 types PGT-A/PGT-M/PGT-SR.
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PGT-A: Tells if there are any changes in the number of chromosomes. Usually, a normal human will have 48 chromosomes. If there is any change in the total number of chromosomes that are detected by PGT-A.
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PGT-M: The genes in a human body are arranged in a particular sequence. If any change in the sequence can lead to abnormality in the progeny. PGT-M will identify if there is any change in the sequence of these genes.
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PGT-SR: Sometimes there can be an exchange of genetic material from one chromosome to another and within each chromosome. This will be mapped by PGT-SR.
Why it is done?
As the age advances, the rate of chromosomal anomaly increases after the age of 35yrs, it attains its peak. In such cases even though the embryo implants, it will result in early pregnancy loss or failure of implantation, which might result in infertility. In such cases doing PGT and transferring healthy embryos can give a success rate.
If both parents are carriers for a particular genetic syndrome. In such cases, the embryos are screened and a normal embryo is transferred to prevent the same genetic disease in the progeny.
How to prepare?
The couple needs to undergo an IVF procedure, on an average of 6 blastocyst needs to be biopsied. This might happen in a single IVF or multiple IVF might be needed.
What can you expect?
After the embryo biopsy is sent, it might come normal or abnormal embryo. 1/3 of all the embryos will be usually abnormal. This procedure specifically helps to avoid unnecessary transfer and negative results. It also decreases the time to achieve pregnancy.
Result
Post Procedure: In elderly women > 35year, it increases the chances of pregnancy and decreases abortion rates. In couples with a known genetic disorder like beta-thalassemia major, selecting the embryo and transferring will avoid their progeny having similar diseases.
What is the risk?
Sometimes when we do embryo biopsy to send for testing there is a minimal risk of damage to embryos.
Sometimes all embryos might be reported as abnormal and hence no embryos left for transfer.
Even after genetic testing, there is a minimal risk of transmission of disease to the baby, which needs prenatal diagnostic testing during pregnancy.
Preparation of Sperm:
Overview:
The principle techniques of sperm preparation consist of direct swim-up, Pellet and swim-up method, and density gradient method. All the methods used to prepare sperm will depend upon the motile sperm count, volume, and presence of leucocytes, cells, and debris.
Why it is done?
A normal ejaculate a large number of defective spermatozoa and granulocyte which on centrifugation generate a high number of reactive oxygen species.
The aim is to select the best method for sperm selection in order to obtain a higher pregnancy rate.
How do you prepare?
The first step through sperm preparation is the correct sperm collection.
The semen collection is strongly recommended after an abstinence period of 2-7 days. A sterile container is used and the collection of the semen will occur in a private room. After collection, the name of the couple should be clearly written on the container and the UHOD number.
Then comes the choice of the best technique for semen preparation which depends on the quality of the sample.
The swim-up technique is preferred if the sample has a normal number of good sperms.
What do you expect?
When we compare the pregnancy rate after artificial insemination obtained with sperm washing, advanced spar preparation methods offer a higher rate of pregnancies.
Result:
Which method one should choose to select the functionally competent sperms depends on the features of the samples.
INSEMINATION:
Overview
Intrauterine insemination (IUI) is a type of artificial insemination that is a procedure for treating infertility. Intrauterine insemination is a relatively less expensive treatment compared to other treatments such as IVF.
Why it is done?
Insemination helps the sperms to get closure to the egg which reduces the time and distance the sperm has to travel to fertilize an egg.
How do you prepare?
Sperms that have been washed and concentrated are placed directly in your uterus close to the time your ovary releases one or more eggs to be fertilized. IUI is quick & painless and does not require anesthesia.
What can u expect?
The more cycles of IUI you undergo, the higher the chance is for pregnancy, with 3 to 6 cycles of IUI, Pregnancy rates can be as high as 80%.
Result
The process can higher the likelihood of pregnancy in certain couples who have had difficulty getting pregnant.
Risk
There is a slight risk of infection following the IUI procedure. We have to use sterile instruments, so infection is very rare.
If medicines are used to induce ovulation, there is a risk of pregnancy with multiple babies. Sometimes the ovaries over-respond to fertility medications and a condition known as ovarian hyperstimulation syndrome may result.
IVF
Overview:
It is a process of fertilization where an egg is combined with sperm outside the body (In Vitro) It is a type of assisted reproductive technology used for infertility.
Why it is done?
The intention of this procedure is to establish a successful pregnancy to infertile couples. IVF is used to overcome female fertility when it is due to problems with the fallopian tubes, making in vivo fertilization difficult.
It can also assist in male infertility, in those cases where there is a defect in sperm quality, the use of ICSI has been found to increase the success rate of IVF.
How do you prepare?
The process involves monitoring and stimulating a women’s ovulatory process removing eggs from the women’s ovaries and letting the sperm fertilize them in culture media in the lab.
After the fertilized egg undergoes embryo culture for 3-5 days, It is implanted in the woman’s uterus.
What do you expect?
IVF success rates depend on the diagnosis, age, and medical history of the individual. In a study, it was found that after six IVF cycles, the cumulative live-birth rate was 65.3%.
Result
The endometrial injury performed in the month prior to ovarian induction appears to increase both the live birth rate and clinical pregnancy rate in IVF compared with no endometrial injury.
Risk
The biggest risk with IVF is multiple births. Multiple births are related to increased risk of pregnancy loss and neonatal morbidity with the potential for long-term damage.
INCUBATORS:
Overview:
Incubators depend on the principle of thermoelectricity. The incubator has a thermostat that maintains a constant temperature by creating a thermal gradient.
Why it is done?
The main function of an incubator is to provide a stable environment to optimize gamete function & embryo development in vitro to attain the goal an incubator must relate several environmental variables including gas concentration temperature & humidity.
What is the success rate of IVF?
We have the best result for IVF with the success rate on par with the top-most IVF centre across the world.
The success rate depends upon the cause of infertility, patient parameters, lab condition, the skill of the clinician & also the embryologist.
Hence I need the couple to know the answers to these questions
-
What will be my success rate if I undergo IVF?
-
Will I get excess embryos to freeze?
-
Do we get adequate embryos for transfer?
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How many cycles we have to undergo?
