IVF TREATMENT PROCEDURE
The patient is given fertility drugs to increase the number of eggs that can be produced at ovulation (super ovulation). The eggs are then fertilized with the sperm and allowed to develop in the incubator for about 3 days before transfer.
- After registration, Pre-evaluation and fertility profile will be done.
- Consultations with IVF physicians and the Chief Medical Director.
- Commence Ovarian Improvement Regimen (If needed), Bioenergetic Medicine test and other medications as needed.
- Fix an appointment for Hysterosonography (HSN) Procedure on Tuesday or Thursday.
- Start taking syntex as prescribed (or birth control pills based on individual protocol)
- Appointment for baseline ultrasound.
- Commence FSH injection to stimulate follicles (eggs) growth and prepare uterine lining for pregnancy.
- Ultrasound scans will be done on day 7 and 9 of starting FSH to check the body’s response to medication including follicular growth and measurement of uterine lining.
- When follicles have reached a stage of maturation, HCG injection will be given to complete maturation and trigger ovulation.
- HCG injection is time sensitive and has to be done correctly.
- Stop FSH and Superfast Injections.
- Start a course of antibiotics for 5 days.
- Spouse should avoid ejaculation 2-3 days before egg retrieval.
- Egg retrieval procedure is approximately 34-36 hours after HCG injection.
- Appointment for IVF calendar review.
- Luprolide acetate injection or Suprefact injection begins.
A. Egg Retrieval and Fertilization
- The evening before retrieval, do not eat or drink anything after 12 midnight.
- No perfume, hair spray or nail polish. Wear comfortable clothing.
- Semen sample is needed on the day of retrieval or a banked frozen sample. .
- Egg Retrieval is performed in the operating room – under mild sedation. It takes about 15 to 30 minutes. After resting for a while and consulting with the doctor, you will be allowed to go home that day.
- You must have someone to drive you home after the procedure.
- ICS (a single sperm is injected directly into each egg in order to fertilize) will be performed in the IVF lab.
B. Day after Egg Retrieval is day 1 of fertilization
- You will receive a call from the Clinical coordinator with the fertilization report and transfer date and time.
C. Embryo transfer (performed 2,3 or 5 days after Egg Retrieval)
- The morning of the transfer, you will be required to have a full bladder before the transfer; thus you will start drinking water one hour before transfer.
- The doctor will discuss the number and quality of embryos you have; and how many he/she is recommending for transfer to the uterus.
- Embryo transfer will take about 5 minutes.
- You will need to rest at home after the transfer but can resume normal activity the next day.
Taking medications to produce several eggs in one cycle. This medication controls when you ovulate so that the rest of the steps for IVF can be planned. Some of your medications are given by injection. Your nurse will teach you and your partner how to prepare the injections and administer them, so that you will be able to do this on your own at home.
Doctor surgically retrieves the eggs. When the follicles have matured, you will be instructed to give yourself HCG (human chorionic gonadotropins). About 34 to 36 hours later, your doctors will retrieve the eggs from your ovaries. Your doctor will explain the various medication options available to keep you comfortable during the egg retrieval.
FERTILIZATION & EMBRYO CULTURE
Embryologist mixes eggs and sperm. In the IVF lab, the embryologist prepares the eggs and sperm and mixes them together. If fertilization occurs, the embryologist will incubate the fertilized eggs and monitor them for about 2 to 5 days to ensure proper development.
The embryos are transferred to the uterus. Your doctor will discuss the number of embryos to be transferred into your uterine cavity and may suggest freezing any unused embryos to preserve them for future pregnancy attempts. Your doctor will place a speculum inside your vagina (like a pap smear) and insert a small catheter through the cervix to the fundus to transfer the embryo using ultrasound guidance.
Embryo is implanted into the lining of the uterus a few days after embryo transfer, however the pregnancy test will be done two weeks after embryo transfer. A positive result on the pregnancy test means that you are pregnant and a scan will be done to confirm viability location.
Throughout your cycle, you will have several ultrasounds to determine how well the ovulation medications are working. Individuals react differently to these medications. Some people may need an adjustment in their medication or dosage. Vaginal ultrasounds provide pictures of the follicles in which the eggs develop. Your healthcare team will monitor the ultrasounds to see how your follicles and endometrial lining are growing, and to determine when the follicles are mature enough for egg retrieval.
IN-VITRO FERTILIZATION (IVF) PROCESS
This section gives an overview of the steps you will need to undergo in order to complete your IVF treatment. Since every couple is different, there might be additional steps you will need to go through before completing your treatment.
AFTER IVF PROCESS
- Pregnancy blood tests performed is 12 days after the embryo transfer (10 days after blastocyst transfer).
- if you receive a positive pregnancy test, we will provide obstetric monitoring of pregnancy till term at a fee.
- Also we can facilitate your referral to a reputable obstetrician of your choice or our clinic (Mart Medicare) for antenatal and delivery.
- If pregnancy test is not positive, we will schedule an appointment for you with the chief medical director for review of the cycle and next line of management.