ADVANCED INFERTILITY IVF TREATMENT

IVF


Infertility Treatment - IVF TreatmentIn cases of damaged tubes or failure of Basic Infertility treatment, you will be asked to consider In Vitro Fertilisation or IVF Treatment. In this method, the eggs are collected from the female partner by doing a minor procedure called Trans Vaginal Oocyte Retrieval (TVOR) or Ovum Pick Up. These eggs are then mixed with the sperms. This leads to fertilization resulting in the early pregnancy called embryo. Of the available embryos, the good quality ones are chosen and inserted back into the womb (Embryo transfer). If the embryo is accepted by the lining of the womb, the infertility treatment is successful.

 

 

Patient Instructions

Medication

Once your cycle has been planned, you will be given/mailed your IVF treatment cycle schedule. Mostly, you will be prescribed to take an oral contraceptive 1 month prior to cycle. Injections for down regulation will be started a few days prior to stopping the OC pills and you will have to come to the hospital for the first dose. The remaining injections can be taken at home and administered subcutaneously.

As per the schedule you will have to stop the oral contraceptive pill and await periods. According to the date of periods, you will be asked to come to the hospital for starting stimulation. The injections for stimulation are preferably given at the center but in case of travelling issues, they can be taken near home.

Monitoring of cycle

You will have to come 3-4 times in the stimulation phase to the hospital to get follicular monitoring done. This involves doing a sonography trans-vaginally to know the sizes of the follicles/eggs. This will be repeated on alternate/ every third day to know the progress of the follicle. Simultaneously you will be asked to do a blood estradiol level for monitoring the cycle.

Ovum Pick Up/ Trans Vaginal Oocyte Retrieval

Once the follicles are ready, you are advised to take an injection for final maturity of the eggs. Generally the timing of this injection would be in the night at 11pm or so. Accordingly, your Egg retrieval will happen at an interval of 36 hours. For e.g. If you receive the HCG injection on Saturday at 11pm, your TVOR will take place on Monday around 9am.

On the day of TVOR, you are expected to come with overnight fasting and get admitted at 7am approximately. The procedure is very simple, painless and needs no cut. It is done under short General Anesthesia and you are ready to go home by afternoon.

Semen sample

On the day of the TVOR, a fresh husband semen sample will be required with an abstinence period of 3 days. The sample can be collected at The Origin hospital, on the third floor. Adequate arrangements are made for the same.

Sometimes due to stress, it is difficult to obtain a fresh sample on the day of pick up.

To avoid a complication on that day, a pre frozen back up sample is kept handy. For the same, the husband will have to give a sample with a 3 day abstinence during the period of stimulation.

Embryo Transfer

The eggs retrieved will be then fertilized in the lab by our embryologist and allowed to grow. The quality and number of eggs/ embryos will be informed to you by our embryologist.

The embryo transfer procedure itself is very simple and painless requiring no pricks. So please come to the hospital stress free. You will be asked to hold urine to allow an easy transfer. Prior to the transfer, the number of embryos to be transferred / frozen will be discussed with you. The choice of Assisted Hatching will also be given to you.
The embryo transfer is done with a thin needleless plastic cannula and needs no anaesthesia. You can immediately get up post procedure and evacuate your bladder. You can go home after sometime.

Post IVF Treatment care

The post procedure period requires no extra care or precautions. You will be advised to take rest for first few days. Following which you can do all your household activities. There are NO FOOD RESTRICTIONS. Supportive injections and medicines will be prescribed to you for the next fifteen days.

Pregancy Test

After 15 days of embryo transfer,you are expected to do a blood pregnancy test.

ICSI


Infertility Treatment - ICSIIf the sperm is abnormal, the couple may need ICSI treatment. ICSI or Intracytoplasmic Sperm Injection is done in the laboratory, wherein a sperm is injected into the egg. The fertilized eggs lead to embryos, which are then transferred into the womb. This sophisticated technique is only available in the most advanced centres. The procedure for the patient remains same as in IVF.

 

PESA / TESA


In case of Azoospermia, sperm retrieval can be done by a minor surgical procedure. Percutaneous Epididymal Sperm Aspiration or Testicular Sperm Aspiration is done under local anaesthesia and minor sedation. A needle is used to aspirate the sperms directly from the epididymis or testicles.

Patient Instructions

You have to come in overnight fasting state and get admitted at ‘The Origin’ around 7:30am. The surgeon will numb the area before inserting the needle. The procedure itself takes only 30 mins. You will feel no pain and will be able to resume work immediate

ASSISTED HATCHING


It is an advanced process which creates a hole in the outer lining of the embryo. It has been found to help the implantation of embryos in the womb. It may be offered to you, depending upon your situation, to enhance chances of success. It is done just prior to embryo transfer.

BLASTOCYST TRANSFER


Normally the embryos are transferred into the womb on day 2 or day 3 after egg collection. But there is an option of allowing the embryos to grow further till day 5 and for formation of Blastocyst. The risk of the day 5 Blastocyst transfer is the arrest of growth and loss of embryos. This might be offered to you as per situation and need.

EMBRYO FREEZING and FROZEN EMBRYO TRANSFER(FET)VF


On the day of Embryo Transfer, after deciding the number of embryos to be transferred, the remaining embryos are assessed. In case of good quality embryos that can survive the freezing option might be given to you to freeze these embryos. The frozen embryos can be utilized for later transfer without undergoing the full IVF cycle. Freezing is not mandatory and choice will be the couple’s.

In case this cycle is unsuccessful, then the next FET( Frozen embryo transfer) cycle can be planned.

Patient Instructions

Medication


Once your cycle has been planned, you will be given/mailed your IVF cycle schedule. Mostly, you will be prescribed to take an oral contraceptive 1 month prior to cycle. Injections for down regulation will be started a few days prior to stopping the OC pills and you will have to come to the hospital for the first dose. The remaining injections can be taken at home and administered subcutaneously.

As per the schedule you will have to stop the oral contraceptive pill and await periods. On the 2nd or 3rd day of periods, you will be asked to start a estrogen tablet to create a good lining of the womb.

Monitoring of cycle


You will have to come once or twice to assess the endometrial thickness. This involves doing a sonography trans-vaginally and might be repeated if growth is inadequate.

Embryo Transfer


The Frozen embryos will be then thawed in the lab by our embryologist. The quality and number of embryos will be informed to you by our embryologist.

The embryo transfer procedure itself is very simple and painless requiring no pricks. So please come to the hospital stress free. You will be asked to hold urine to allow an easy transfer. Prior to the transfer, the choice of Assisted Hatching will also be given to you.

The embryo transfer is done with a thin needleless plastic cannula and needs no anaesthesia. You can immediately get up post procedure and evacuate your bladder. You can go home after sometime.

Post ET care


The post procedure period requires no extra care or precautions. You will be advised to take rest for first few days. Following which you can do all your household activities. There are NO FOOD RESTRICTIONS. Supportive injections and medicines will be prescribed to you for the next fifteen days.

Pregancy Test


After 15 days of embryo transfer, you are expected to do a blood pregnancy test.

 

EMBRYO DONATION


The couples suffering from severe egg/sperm factor and with history of previous failed self IVF cycles maybe advised to go for Embryo Donation. They will not need to undergo the full IVF procedure. Medications will be given to prepare the womb for the embryo transfer. The procedure is identical to Frozen Embryo Transfer stated above.