Invitro fertilization ( IVF ) is a technique in which egg cells are fertilized by sperm outside the woman's womb. IVF is a major treatment in infertility when other methods of achieving conception have failed . The process involves hormonally controlling the ovulatory process, removing ova ( eggs ) from the woman's ovaries and letting sperm fertilize them in a fluid medium. The fertilized egg ( zygote ) is then transferred to the patients uterus with the intent to establish a successful pregnancy.
The term in vitro, from Latin, is used, because early biological experiments involving cultivation of tissues outside the living organism from which they came, were carried out in glass containers such as beakers, test tubes, or petri dishes. Today, the term in vitro is used to refer to any biological procedure that is performed outside the organism it would normally be occurring in, to distinguish it from an in vivo procedure, where the tissue remains inside the living organism within which it is normally found. A colloquial term for babies conceived as the result of IVF is test tube babies.
Initially IVF was developed to overcome infertility due to problems of the fallopian tube, but it turned out that it was successful in many other infertility situations as well. The introduction of intracytoplasmic sperm injection ( ICSI ) addresses the problem of male infertility to a large extent
Assisted reproductive technology ( A.R.T. ) which includes ( IVF, ICSI, ZIFT, etc ) now provides hope for many infertile couples who previously could not be treated.
Basically the aim of ART treatments is to stimulate the ovaries to produce several follicles so that more than one egg can be retrieved during egg pick-up, fertilize them in the laboratory under strict and monitored conditions and put the fertilized egg back into the uterus, thus hoping to achieve a successful pregnancy in conditions where a natural pregnancy would be difficult or impossible to achieve.
STANDARD I.V.F. ( or In Vitro Fertilization ) The eggs are collected and placed in special culture medium. Prepared sperm is added (i.e. insemination) and then fertilization is assessed. The resultant embryos are transferred into the woman's uterus approximately 2-3 days after the egg pick-up. This is the most common procedure. EMBRYO TRANSFER ( E.T. ) The embryos are replaced into the uterus 2-3 days after egg pick-up ( for standard I.V.F. ) A maximum of 3 embroys are replaced, to reduce the chance of multiple pregnancy, although sometimes there will be exceptions based on clinical grounds.
INTRACYTOPLASMIC SPERM INJECTION ( ICSI )In this treatment one sperm is injected into the cytoplasm of an egg. It provides hope for couples who have had poor or absent fertilization in previous I.V.F. attempts and for men with severe male factor infertility.
ART treatments include procedures such as ZIFT ( Zygote intrafallopian tube transfer ), SIFT ( Semen Intrafallopian tube transfer ) and a few others . However these are hardly ever done now with IVF and ICSI being the treatment in nearly all cases. Further advanced procedures which could be done along with IVF or ICSI include Assisted Hatching, Blastocyst Transfer, and Preimplantation Genetic Diagnosis
SOME LIFESTYLE RELATED POINTS TO BE KEPT IN MIND WHILE GOING THROUGH YOUR IVF CYCLE Ensure that you have a healthy balanced diet and maintain a sensible weight for your height and frame. Recent research has shown that women who are overweight often have lower fertility rates than other women of the same age group. Avoid excessive alcohol and avoid beverages that contain caffeine such as tea, coffee and coca cola. Avoid using oils in aroma therapy as there is evidence that some of these are embryo toxic. Natural and herbal therapies should not be used without consultant's knowledge. Folic Acid 5 mg daily is recommended for women to reduce neural tube defects in the fetus. Sleep regular hours. Exercise on a regular basis. Find way that help you relax. Smoking is harmful to your health generally and during your treatment cycle may jeopardize the outcome of any pregnancy. Many studies have indicated that smoking decreases both male and female fertility. Ensure that you have immunity against Rubella ( German Measles ) and this may involve having a Rubella antibody test. This avoids abnormalities caused by contracting Rubella in early pregnancy. Do not use chemicals before Egg Pick Up or Embryo Transfer i.e. dyeing hair, chemicals around house or garden.
ADDITIONAL IMPORTANT INFORMATION It is a Medico - Legal requirement that you do not drive or operate machinery for 24 hours after an anaesthetic. In addition, you must notify the clinic immediately if you experience any untoward side effects from any of the artificial reproductive technology medication or procedures. A Detailed Cost Sheet is available in addition to this pamphlet and we advise patients to go through this and discuss any queries related to the cost prior to starting the treatment cycle. Sometimes the details of the treatment cycle appear at first to be rather complicated, but the doctors and the entire IVF Pune staff are there to help you at every phase of your treatment and you will be given precise instructions for injections, blood tests, scans, semen analyses and admission as they are needed. In order to provide patients with more flexibility, the unit encourages patients to have some of their injections at home, thus reducing the time spent at the clinic. Patients will be instructed in injection techniques by the doctors and the nurse co-ordinator. There are sometimes unavoidable delays during the treatment process and there may be some waiting involved. It is important to discuss this with us before commencement of treatment if you have any concerns about your work schedule or other commitments. The unit also encourages husbands to be part of the treatment process and they are always welcome to accompany their wives for injections and scans. It is also a requirement that all patients and their husbands undergoing IVF treatments have tests to ascertain their Hep B and Hep C and HIV status and we request that these tests are repeated every year, if continuing treatment. Universal Infection Control Measures to minimize the transmission of pathrogens are used at all times both in the laboratory and medical rooms. Pregnancy and Live Birth Statistics also have to be submitted at regular intervals and this is one of the reasons we ask you to inform us of your pregnancy outcome and any change of address. We would also like to advise couples of the unit's mechanism for handling feedbacks and complaints. IVF Pune encourages patients to bring any concerns or complaints to either their individual consultant, nurse coordinator, or submit their feedback at the reception desk. Any complaints are investigated and processed and the patient advised of the outcome. We also request that you respect other patients' confidentiality as obviously during the treatment process, you will be in a waiting room with other infertility patients. We have a qualified counselor to address anything that you may or your emotional needs. We encourage you to meet the counselor as it will definitely help you cope better with the process. We wish you success in your endeavour to get pregnant and we hope you feel free to discuss any of your problems with either your Consultant, or the Counselor.