Advanced In Vitro Fertilisation (IVF) Treatment
There are times when external help is needed for conception. Ovulation Induction provides this help through hormonal medication in the form of tablets or injections. This is done in order to stimulate ovulation or egg development and release. This treatment is also used to increase the number of eggs reaching maturity in a single cycle to increase chances of conception.
This treatment is often advised to women who undergo irregular menses which result in irregular ovulatory cycles. This treatment is also recommended to women with regular cycles to grow more follicles or to ensure ovulation during IUI cycle.
Ovulation Induction and Cycle Monitoring
In this process, sperms are placed in the woman’s uterus at the time of ovulation to enhance the chances of fertilization.
IUI treatment starts in the first 5 days of the menstrual cycle. Baseline transvaginal scanning is done, to begin with. This is followed by ovulation induction with the help of hormonal tablets and injections. Follicular study is then conducted to monitor the growth of follicles. Meanwhile, the sperm sample is washed and processed to separate the motile sperms from debris. The motile sperms are then injected into the uterus during ovulation.
The follicular study starts in the first five days of the cycle. IUI process happens around the time of ovulation which can occur anytime between 12th to 18th day of the cycle.
Intrauterine Insemination
An intracytoplasmic sperm injection (ICSI) routine is usually combined with a conventional in vitro fertilisation (IVF) procedure and is principally helpful for men who have a low sperm count or poor sperm motility.
A single sperm is injected into the oocyte and the resultant embryo is then implanted into the uterus.
In Vitro Fertilisation
A typical in vitro fertilisation (IVF) cycle lasts between 3 and 4 weeks. The procedure is begun by administering the female partner with fertility drugs for twelve days, through daily hormone injections, from Day 2 or Day 3 of the menstrual cycle. This process stimulates the ovaries into producing more eggs than they would otherwise. During this period, routine ultrasounds and blood tests are performed, to monitor progress.
Once the follicles are developed, the oocytes are extracted from the female and the semen sample is collected from a male on the same day. The eggs and sperms are kept together in a dish giving the sperms time to fertilize the eggs. The resultant embryos are then grown in the lab for 3-5 days after which the frozen embryos are then transferred to the uterus. Post embryo transfer, the patient receives hormonal support in the form of oral tablets and vaginal injections for the next 12-15 days. If the patient is pregnant after this procedure, the support medication continues up to 10-12 weeks of pregnancy.
Intracytoplasmic Sperm Injection
blastocyst refers to an embryo that has grown to a point where it starts to build a core in liquid. This usually happens after 5-8 days of ovulation and is thought a major part of embryo development. A blastocyst transfer is the transfer of one or more of that embryo from the laboratory to the uterus of a woman.
The benefit of blastocyst transfer method is that embryos which are grew using this method have the highest chances of resulting in pregnancy.
Blastocyst Transfer
For this treatment, the uterine endometrium is to be prepared for transfer during the previous menstrual cycle. The treatment begins with medications and injections. After the menstrual cycle, hormonal medication is given to make the endometrium with hormonal evaluation and serial monitoring by USG. When optimal endometrium is ready, frozen embryo transfer is done by a skilled IVF consultant.
It can be done in the natural cycle as well.
Frozen Embryo Transfer (FET)
A hysterosal-pingogram (HSG) is a simple radiological technique that is used to undertake a tubal assessment by assessing the shape and size of the uterine cavity and the patency of the fallopian tubes. It begins with the infusion of an opaque dye into the cervical canal via a catheter. This dye eventually permeates into the uterus and the fallopian tubes, highlighting blockages in the fallopian tubes by staying concentrated in a specific region.
Through an HSG, your doctor can view the structure of your uterus, and also investigate the patency of your fallopian tubes.
Hysterosal Pingogram
While some infertility problems can be solved with treatment, others require surgery. Fertility surgery is offered to infertile women or men for correcting anatomical defects that may harm the ability to conceive.
Women with anatomical factors like fibroids, polyps, pelvic adhesions, endometriosis, cyst, uterine septum, or uterine synechia need to undergo fertility enhancing surgery.
Hysteroscopy and Laparoscopy Surgeries
The procedure may be performed with a fine needle . Sperms are retrieved by Needle aspiration under anesthesia. It is performed in the IVF OT so that the sperms can be identified immediately by embryologist and can be stored immediately.
Surgical sperm retrieval is a perfect fit for men who have undergone
- a vasectomy,
- Severe Oligoasthenoteratozoospermia (very poor quality sperms)
- or for whom ejaculation is problematic, owing to an injury or infection.
- Obstructive or Non-Obstructive Azoospermia. (zero sperm count)
Surgical Sperm Retrieval
In IVF procedure, there are often embryos that remain unused. Cryopreservation is a technique that freeze such embryos. Consequently, these embryos can be used in a future IVF cycle without the female partner having to undergo another round of fertility medication.
When we talk about egg freezing, we are only dealing with the female factor of any pregnancy. In Embryo freezing you need the participation of both male and female factors simultaneously.
Cryopreservation of Embryos
This has become increasingly useful when dealing with fertility issues associated with certain illnesses like cancer. Radiotherapy or chemotherapy tend to cause permanent damage to the ovaries, and thereby the unfertilized eggs, which results in subfertility.
The collected eggs are processed and labeled with the preserver’s details. The temperature of the eggs is then brought down to a level below the freezing point. The eggs are then stored in a controlled environment under strict quality guidelines which ensures their safety.
Vitrification Of Eggs
An endometrial receptivity analysis (ERA) involves
1. ENDOMETRIAL BIOPSY
an endometrial biopsy is performed by your doctor, between the 19th and 21st day of your menstrual cycle. The routine is conducted using a Pipelle catheter.
2. GENE SEQUENCING
Once the biopsy is performed, your doctor will carefully examine the pattern of the 236 genes that play a role in endometrial readiness.
Endometrial Receptivity Analysis
It is an innovative monitoring system that captures digital images of embryos at frequent predetermined intervals, allowing embryologists to track the development of a pool of embryos.
TLEM can reduce the risk of higher order births like twins or triplets, and can help your embryologist to determine the healthiest embryos.
Time Lapse Embryo Monitoring
Laser Assisted Hatching
preimplantation genetic screening (PGS), a technique that evaluates embryos of chromosomally normal genetic parents for structural or numerical chromosomal errors. The second method is preimplantation genetic diagnosis (PGD), a tool that focuses anomalies in embryos whose parents have a known history of genetic defects.
Preimplantation genetic testing is fitted for couples where one or both partners are carriers of sex-linked disorders or genetic or chromosomal abnormalities. The technique is also useful for women who are over 35 years old, or those who have recurrent abortions or failed IVF.
Preimplantation Genetic Testing
A woman not capable to get pregnant with her oocytes can use an egg that is donated by another woman to achieve pregnancy. The ideal candidate for the egg donation process should be between 23 and 33 years of age. The donor should be able to understand the procedure and give consent. Furthermore, the donor should be free from medical or genetic illnesses.
An oocyte donation programme is specifically suited for
- older women,
- women with premature ovarian failure, a genetic predisposition or
- Repeated failed IVF cycles owing to subpar eggs.
Oocyte Donation
