In Vitro Fertilization, popularly known as IVF is a process where the eggs are combined with the sperm in vitro. IVF is normally preferred when the other fertility treatments are not working. The success rate of IVF is high and the success rates of IVF are similar to that of normal and healthy fertility. Lets us read about different steps in IVF Cycle.
Step 1: Control Ovarian Hyperstimulation
Controlled ovarian hyperstimulation is a common procedure used for unexplained fertility. For women who are experiencing anovulation, this procedure induces ovulation. It aids in the development of mature follicles and eggs and boosts pregnancy rates by identifying suitable infertility procedures. This procedure gets the sperm and eggs together and finds out what is the root cause of infertility but does not provide any solution or treatment to cure infertility.
However, this treatment will not be effective where the sperm count of men is low or where the age of the woman is over 41. Controlled ovarian hyperstimulation is used early on in the menstrual cycle. After a baseline ultrasound and blood test are made, the medication is started and monitored at regular intervals to notice the changes in the body and identify the cause of infertility. After monitoring the results, when the follicles are mature, an HCG trigger shot is given and either sex or insemination is timed almost 36 hours after the shot.
Step 2: Egg Retrieval
Egg retrieval commences before the ovulation kicks in and during the egg retrieval process the patient is sedated. Follicles are identified by the insertion of an ultrasound probe in your vagina and a thin needle is inserted in the ultrasound guide which thereby extracts eggs from the follicles. A transvaginal ultrasound is initially used to extract eggs and in the case where this doesn’t work, abdominal ultrasound is used to guide the needle and retrieve eggs. The needle inserted in the ultrasound is connected to a suction device and ensures in 15-20 minutes several eggs can be extracted. Once the eggs are extracted, you will feel a slight pressure in the vaginal area where the needle was inserted and you might feel fullness. Out of all the eggs retrieved, the mature eggs are placed in incubation and these healthy eggs are mixed with the sperm to create embryos.
Step 3: Fertilization and embryo culture
The maturity and quality of the retrieved eggs are tested in the laboratory. The mature eggs are placed in an IVF storage till they are transferred to the incubator to be mixed with sperm and the sperm are incubated with the oocytes for almost 15-17 hours after the insemination process. Single sperm is inserted in each of the matured embryos to test out the fertilization process. The fertilized egg will become a 2-4 cell embryo after the egg is retrieved on Day 2 and 6-10 cells on Day 3. On Day 4 the embryo cells contact and turn into a morula. The embryo is filled with a fluid cavity on Day 5 when the fetal tissues begin to separate.
Step 4: Embryo Quality
In Vitro fertilization assesses the quality of embryos and within 72 hours from retrieval, the range of embryo cells turns into 7-10 cells. After the embryos are analyzed and graded, for some women, the embryos get transferred to their uterus on Day 3. On Day 3, the cells in the embryos start to divide and their size does not differ. This stage is referred to as the cleavage stage. During the cleavage stage, embryologists analyze the structure of the embryo, the actress popularly known as morphology. Both the number of embryos and the structure of embryos are analyzed during Day 3. The size of the nucleus is being tested by embryologists during this day. The compaction, cytoplasmic pitting, and vacuoles are examined in the Day 3 embryo or during the cleavage stage.
But instead of Day 3, for some Embryo transfer takes place on Day 5 when the embryo develops into a blastocyst and cells start to form an inner cell mass. The inner cell mass thereafter turns into a fetus. When one set of cells turns into an inner cell mass, the other set turns into trophectoderm epithelium. This TE is required to build tissues of your body that are required for pregnancy.
Step 5: Embryo Transfer
The healthiest-looking embryos are screened and transferred through preimplantation genetic diagnosis (PGD) or Preimplantation genetic screening (PGS). If the embryos get cryopreserved during this process, then the embryo transfer is delayed and postponed to the next cycle. No anesthesia is required for the transfer of embryos and the embryo is transferred via a thin tube or a catheter, which is passed through the cervix. No pain is involved during this process except for minor cramping. Once the embryos are transferred, the next two weeks following that will be a waiting period for pregnancy to happen. Usually, a pregnancy test is ordered within 12 days of embryo transfer, and depending on the result of the pregnancy further steps are taken by the medical expert.