In Vitro Fertilization (IVF)
In vitro fertilization or IVF is a technology to treat infertility through assisted reproduction in which fertilization does not happen inside the body but in a laboratory dish. It is a process that is composed of a number of steps and each step has to be monitored very carefully because everything is happening manually and the time interval between two consecutive steps also has to be determined by the doctors.
The first step involves the collection of mature and healthy eggs from the ovaries. To increase the success rate of this step, the patient whose eggs are being retrived is given several fertility medicines. These include injections of gonadotropins after menstruation occurs to trigger the release of eggs. This is done to calculate the exact timing of egg retrieval and if not examined properly, this important time will pass and no eggs would be retrieved. The process would have to be repeated.
The medications are discontinued when it is confirmed that eggs are now available. The next stage of IVF is called egg retrieval. This process takes about 10 minutes to complete and involves suction of egg from the ovarian follicle through a special needle that is passed through the vaginal wall. It is an ultrasound-guided procedure and does not cause any pain as the patient is given intravenous sedation before it starts.
The next step is the most important step of all. It is known as fertilization and it is performed by an embryologist. Sperm sample is collected separately and both specimens are kept in special media to keep them healthy and active. In a carefully controlled environment, the two specimens are combined and left for about 18 hours to syndicate and fertilize. The embryos are cultured in the IVF laboratory 3-5 days.
The final stage of the IVF process is known as embryo placement and it is again a short one like egg retrieval. The patient does not feel any discomfort during the entire procedure. The embryos are passed through the cervix into the uterine cavity by means of two catheters. Once the embryos are safely deposited, the catheters are pulled out.
Intracytoplasmic Sperm Injection (ICSI)
There can be many complications behind failed pregnancies or an inability to conceive altogether. Micromanipulation is a term used to describe several additional techniques that are employed in conjunction with IVF to address these complications. These techniques include ICSI or intracytoplasmic sperm injection, assisted hatching, and PGD or preimplantation genetic diagnosis. Male factor infertility is treated very successfully by using ICSI in which single and healthy sperm cell is injected directly into the egg, greatly improving the chance of fertilization. The process starts like IVF till the stage where eggs are retrieved and stored in special media. Instead of waiting for the sperm and egg to fertilize on their own, in ICSI technique, the sperm cell is injected right there and then. There is no need to wait for a period of 18 hours for fertilization to take place.
The success rate for ICSI is almost the same as standard IVF in which the sperms are healthy and active. In this case, however, there is male factor fertility involved and ICSI is adopted to treat that. There is no guarantee about the quality of sperm in this case but since the sperm is being injected directly, the chances of fertilized eggs greatly improve. It is one of the most successful artificial reproduction techniques when male infertility is diagnosed.