IVF – What is in vitro fertilization?
The in vitro fertilization is the union of the ovum with the spermatozoon performed in the laboratory – in vitro – in order to obtain embryos already fertilized to be transferred into the maternal uterus. Egg fertilization in IVI assisted procreation clinics can be performed by conventional IVF technique or by intra-cytoplasmic sperm injection (ICSI); this technique allows to reach conception in couples with a negative quality diagnosis following the analysis of the sperm sample.
Ovarian stimulation in IVF consists in the administration of daily injections that will ensure that the ovaries produce more eggs, instead of producing a single egg – as happens spontaneously every month in normal situations – so that doctors can get more embryos out of them.
Treatment is carried out in IUI assisted reproduction clinics and lasts between 10 and 20 days, depending on the protocol used and the response of each patient. During the course of the treatment, ultrasounds are performed in series (approximately 3 or 4), and the rate of estradiol in the blood is determined to check that the growth and evolution of the follicles are normal.
When, by means of ultrasound, it is ascertained that the follicles have reached the adequate size and, in the case of availability of a sufficient number of eggs, oocyte sampling is scheduled, approximately 36 hours after the administration of an injection of hCG hormones which induces the oocyte maturation in a similar way as in the natural cycle.
Follicular puncture is performed in the operating room and with sedation to avoid discomfort to the patient; the procedure takes about 15 minutes.
Once the eggs have been obtained with the oocyte sample, and the sperm from a semen sample of the male component of the couple, the eggs are inseminated.
This process can be carried out by means of the conventional IVF technique which consists in placing on the culture plate an egg surrounded by spermatozoa or utilizing the ICSI technique, which consists in introducing a live sperm into the egg employing a puncture made with a cannula.
Embryo culture in the laboratory
The embryos obtained from the fertilization of the eggs are observed in the laboratory day after day and classified according to the morphology and the ability to split. Embryos that become blocked during development are discarded as they are considered unsuitable.
The transfer consists in introducing the best quality embryos into the maternal uterus with the aid of a special cannula. The procedure is carried out in the operating room; in this case, it is not necessary to administer anesthesia as it is a fast and painless process.
Vitrification of the remaining embryos
Once the embryo is transferred, the remaining good quality embryos are vitrified in order to be able to transfer them in the next cycle without the need for ovarian stimulation.
The most severe complication of gonadotropin therapy is ovarian hyperstimulation which, as its name indicates, is the disease that occurs when the ovaries are excessively stimulated. Although in most cases it is a mild and transient disorder, in severe cases it can be life-threatening. Such situations occur only when hCG has also been administered to induce ovulation. For this reason, it is mandatory to do check scans that show the state of the ovaries and the measurement of estrogen in the blood.
The best IVF centers in India are located at Max Healthcare in Delhi and Hiranandani Hospital of Mumbai. Apart from these, Apollo Hospital chain operates IVF clinics at every facility they have. Though the cost varies widely from city to city, the average cost of IVF treatment per cycle is estimated at about INR 2.5 lakhs or USD 3,500. ICSI treatment is an added USD 2,000. In cities such as Kolkata, the cost is as low as INR 1 lakh or USD 1,400.