In Vitro Fertilization (IVF)
What is IVF?
IVF or In vitro fertilization in simpler terms means fertilization of woman’s eggs and man’s sperms meeting outside the body in a test tube (Test Tube Baby). The fertilized egg (embryo) is then inserted in the uterine cavity. The whole process from starting to end is individually done by Dr. Prerna Gupta herself.
Who needs IVF?
For normal conception to happen a healthy sperm with good motility should pass through cervical mucus, swim through uterus and reach fallopian tube to meet egg around the time of ovulation (when the egg is released in the body). Eggs and sperms meeting in the fallopian tube form an embryo which goes to uterine lining and implants there. It means for normal conception to happen there is a need for healthy motile sperms, open fallopian tubes, good eggs, ovulation happening on its own and good uterine lining. If there is an issue with any of them, then there might need to think about assisted reproduction.
So, one might need IVF if one is suffering from:
Male Infertility: Sperms less in number (oligospermia), sperms not motile (asthenospermia), sperms abnormal in shape (teratospermia), or all three issues (Oligoasthenoteratospermia or OATS). It might also be possible there are no sperms seen in the routine analysis (Azoospermia)
Female Infertility: A female might be sub-fertile due to number of reasons like issues with blocked fallopian tubes, fluid in tubes (hydrosalpinx), adhesions issues with eggs- Polycystic ovarian syndrome (PCOS)- no egg releasing or anovulation; low number of eggs – advanced age, low AMH; endometriosis-cyst in ovary issues with uterus – fibroid, adenomyosis, poor endometrial lining or thin ET (endometrial thickness), adhesions in uterus (Ashermann syndrome)
Who does IVF?
IVF is done by only trained IVF treatment specialists, who have worked in the field of Reproductive Endocrinology. It is very important to choose the right doctor with impeccable qualifications. Dr. Prerna Gupta is trained from All India Institute of Medical Sciences (AIIMS), New Delhi for 14 years and is a Commonwealth fellow from Bristol Centre of Reproductive Medicine, UK.
Are there any investigations required before IVF?
Besides routine investigations and viral serology, the treating IVF doctor needs to do a transvaginal ultrasound to look at the uterus and ovaries. The doctor will have a look at an endometrial thickness (ET) as well as the number of eggs in Ovary (Antral follicle count or AFC) Also, hormonal investigations including AMH (Anti Mullerian Hormone) will be done Hysteroscopy might be required prior to IVF if there are issues with the uterine lining.
How much time does the process of IVF take?
If the process is started from Day 2 of the cycle, the whole treatment till embryo transfer is completed in a duration of 15-20 days.
What are the steps involved in the process of IVF treatment?
Initial Consult: In her first consult, Dr. Prerna Gupta will be taking a detailed history, have a thorough look at the patient’s old records and investigations. Also, a Transvaginal examination will be undertaken. It is always a good idea to bring all the old records including any Hystero-salpingogram (HSG) X-ray if any. A follow-up detailed plan will be accordingly made on the patient’s first visit. Consult the doctor and get the best IVF treatment in Delhi.
Ovarian Stimulation: For an IVF cycle to succeed, there is a need to get more eggs, to have more good quality embryos and to increase the chances of success. This is done by taking hormonal injections. These are pen-style injections and can be self- administered by the patient.
Ultrasound Monitoring: To see the response of hormonal injections, transvaginal ultrasound (TVS), is done at an interval of 4-5 days by Dr. Prerna Gupta.
EGG Retrieval: After the follicles are ready, the eggs are retrieved under anesthesia using the vaginal approach. So, there is no incision, no mark. This surgery is quite safe.
Embryology lab: The day the patient’s eggs are taken, the same day the patient’s husband’s sperm sample is taken. Eggs are then fertilized by sperms using conventional IVF or advanced techniques like ICSI (Intracytoplasmic Sperm Injections), IMSI, PICSI, etc. The next day the number of eggs fertilized is seen under a microscope or embryo scope. Embryos are then developed to day 2, day 3 or day 5 (Blastocyst) stage. The lab keeps the patient updated about the progress and accordingly plans for embryo transfer.
Embryo Transfer: Embryo transfer is done under ultrasound guidance and is just like IUI procedure and there is no need for anesthesia. The best embryos are transferred and if there are any surplus embryos left; they are cryopreserved or frozen.
How much does IVF cost?
The cost of IVF treatment is variable and depends on multiple factors:
Patient factor: Age of the patient, weight of the patient. As there is an increase in the age of the patient or weight of the patient, there is a need for more hormonal injections and therefore increased in the cost.
Need for advanced techniques: If an advanced technique like ICSI, Blastocyst culture, Embryo Freezing, PGD, Embryoscope is used, there is an increase in the cost of the IVF cycle.
Third-Party Reproduction. IF there is a need for egg donor or surrogacy, there is a substantial increase in the cost of the IVF cycle.
Conventional IVF costs one lakh forty thousand approximately but the cost increases if any of the above factors are involved.