In Vitro Fertilization (IVF) Process

In vitro fertilization (IVF) is a method in which an egg is fertilized with a sperm outside the body, in a laboratory dish, then implanted in the uterus. It is a part of assisted reproductive technology (ART), which is opted by couples in the event of failure to conceive due to infertility. The process involves various steps, and before you consider going for one, you must know all about it. So here is a little information to assist you in your decision.

In Vitro Fertilization

As mentioned earlier, the process involves fertilization of the egg externally, in the laboratory. The term 'in vitro' is a Latin terminology which means 'within the glass', as earlier all the laboratory apparatus was made of glass unlike today. In the process, ovulation is controlled by administering hormones and then the ova is removed from the woman's ovaries to fertilize them externally, with a sperm donated by the male. Dr Robert G Edwards was the one to first develop this technique and was also awarded a Nobel prize in Physiology in 2010, for his unique contribution to the field of science. Babies born with the help of this technique were popularly called, 'test-tube babies'.

Procedure
When a couple opts for IVF, they have to undergo initial tests. These screening tests are done for both partners. The woman has to undergo a test for 'ovarian reserve' before any medication is given. Third day FSH testing is done in which the baseline of follicle stimulating hormone is checked on the third day of the menstrual cycle. An elevated baseline, that is a diversion from normal FSH levels indicates a reduction in the ovarian reserve, that is the number of eggs. Determining this, helps the doctors learn, whether a woman will respond to the administration of drugs when stimulated to produce eggs. The success rate of the IVF process depends on the number of eggs that are retrieved on stimulation.

Steps Involved
The following is a step by step description of the IVF process.

1. Stimulation: A woman is administered with fertility drugs. These drugs stimulate the ovaries to produce several eggs, rather than the normal one egg per month.
2. Egg Retrieval: This involves a small surgical process called 'follicular aspiration'. In this process, with the help of an ultrasound, a doctor inserts a needle through the woman's vagina to reach the follicles in the ovaries, which contain the eggs. The needle is connected to a suction apparatus, which helps in aspirating the eggs along with some fluid. This process is carried out for both the ovaries. The procedure is relatively painless. However, some women may develop cramps after the surgery.
3. Insemination and Fertilization: The eggs are stored at controlled temperatures before fertilization. The best quality eggs are then mixed with the sperm obtained from the male partner. This process is artificial insemination. After a few hours, the sperm enters the egg and this is known as fertilization. If the chances of fertilization are low, doctors opt for direct injection of the sperm into the egg, known as, intracytoplasmic sperm injection (ICSI).
4. Culturing the Embryo: The fertilized egg undergoes stages of division to form an embryo. These stages of division are carefully monitored by the doctors or lab technicians, to assure successful development of the embryo. The embryo has to be maintained in extremely rigid parameters of temperature and also sterility to avoid any sort of contamination. In this stage, the embryo is also screened for genetic disorders. It is necessary to know whether the child will have a healthy genetic constitution, only then can the embryo be implanted.
5. Implantation or Embryo Transfer: The embryo is implanted in a woman's womb three to five days after fertilization. In this step of the IVF process, the doctor inserts a thin tube called the catheter through the cervix, into the womb. The catheter contains embryos. Success rate of the process depends on the embryo sticking to the womb. Sometimes implantation of more than one embryo results in twin or triplet pregnancy.

Associated Risks
Before undergoing any medical procedure, it is necessary to know its pros and cons. IVF also has certain risk factors that one must consider.

• A woman may experience side effects of the fertility medication given for stimulation of the ovaries. This can vary from mood swings, headaches to bloating.
• In very rare cases, a condition known as ovarian hyperstimulation syndrome (OHSS) develops. In this case, there is accumulation of fluid in the abdomen and the chest. A woman experiences abdominal pain, decreased urination, excessive weight gain in a short span of time (nearly 10 pounds in 3 to 5 days) and shortness of breath. In severe cases, the fluid is drained with a needle.
• Multiple pregnancy can be a risk factor, as the chances of premature birth are higher in these cases.
• A study has revealed that when donor eggs are used for fertilization, the chances of pre-eclampsia also increase.
• The process is not likely to cause ovarian cancer in women.

IVF treatment is indeed a boon for many couples who are not able to conceive naturally. Hope this information will help you to take the decision, if you are considering IVF treatment.