Best IVF Centre in Chennai
In Vitro Fertilization (IVF)
In vitro fertilization (IVF) treatment is the most popular and successful assisted reproductive technology (ART). It consists of ovulation induction using fertility medications, egg retrieval, Sperm processing, fertilization in a laboratory, and transferring embryos into the uterus.
History of IVF:
This procedure was first successfully used in humans in 1977 in England by Drs. Steptoe and Edwards. The scientific importance of this discovery was recently recognized with the awarding of the Nobel Prize in Medicine to Dr. Edwards. It is interesting to note that an Indian Dr Subhash Mukherjee, working simultaneously, delivered India’s First Test-Tube baby Durga on 3rd October 1978 in Kolkata. Unfortunately, he did not get recognized for his pioneering efforts!
To date, millions of babies have been delivered worldwide as a result of this treatment. The procedures to achieve IVF pregnancy have become increasingly simpler, safer, and markedly more successful.
Who needs IVF?
Patients who suffer from ovulatory dysfunction, blocked or damaged fallopian tubes, pelvic inflammatory disease, recurrent miscarriage, unexplained infertility may be candidates for IVF treatment. IVF is the treatment when Frozen eggs of the patient are to be used or in cases of Donor eggs or with LGBTQ couples.
Each of these problems can naturally sound quite terrifying. However, it’s worth noting that men can also have fertility problems, which might include issues such as:
- Low sperm count, meaning that there is not enough sperm produced to be fertile.
- Poor sperm movement, suggesting that nobody wins the ‘sperm race’ during conception.
- Problems with erectile strength or quality, reducing the chances of conception.
- Suffering from azoospermia, reducing your chances of success.
- Physical injury and/or trauma otherwise to the testicles or scrotum.
However, it’s also important to note that studies show that both partners can be the cause. With around a 40/40/20 (both) split, it’s hard always to accept the limitations of your own body.
The IVF Process Broken Down Step-By-Step
There are many steps in the IVF cycle, which begins at the start of a patient’s menstrual period. Once it’s time for your IVF cycle, your fertility specialists and doctors will require pre-treatment tests, which may include blood tests, ultrasounds, and semen analysis.
- Hormonal suppression or ‘down-regulation’ of your menstrual cycle with birth control pills or other drugs.
This process allows us to take charge of your ovaries so that there is no follicular growth occurring at all and helps to synchronize your follicles to allow multiple eggs to develop at once. Depending on the medications used, there is a chance you will temporarily undergo some of the symptoms of menopause, but these symptoms will go away during the stimulation phase. This will then make sure that during the next stage of the treatment we have full control of the stimulation.
- Stimulation of the ovaries to produce several eggs.
During this phase of your treatment cycle you need to continue the drugs that ‘switch off’ your bodies own control of your ovaries and also start taking medication that will stimulate them. The reason for continuing the suppression medications is to stop the chance of you ovulating before we get to the egg retrieval, so it is very important that you keep taking those drugs. The stimulation is carefully controlled to allow for the most optimal follicle recruitment possible – the dosage is decided based on all of the workup that you did before starting the cycle.
You will be monitored during this phase of your treatment to make sure that you are responding appropriately by doing blood draws to check your estradiol levels and by vaginal ultrasound scans to measure the follicle sizes. There are times when we either increase or decrease the drug dosage depending on what we see, and you will be informed accordingly.
It is very important that you continue to follow your calendar very closely during this period and to follow any and all changes that we may make depending on your response. You will need to make sure that you are flexible to allow for appointments at short notice and that you are available via phone each day.
- Retrieval of the eggs from the ovaries
Once it has been determined that your follicular growth is optimal then we will schedule your egg retrieval. This is achieved by the administration of a carefully timed ‘trigger shot’ that allows for the final maturation of the follicles and readies the eggs for release. The exact nature of the shot depends on your response to stimulation and you will be given full instructions at the time. You will be given a precise time for the trigger and it is very important that you stick with this time.
You will be under deep sedation anesthesia for the egg retrieval procedure, under the care of an MD anesthesiologist. The anesthesiologist will keep you asleep for the procedure. You will be given instructions as to when we need you to arrive at the clinic and how to prepare for the case.
The retrieval itself utilizes the same vaginal probe ultrasound that was used during the monitoring phase of treatment but with a guide attached to it. That guide allows a needle to be passed through the back of the vagina and into the ovary under direct visualization. The needle itself allows both the contents of the follicle to be aspirated and then media to be pushed back into the follicle to ‘rinse it out’. Then the fluid is passed to the embryologist in order to look for the egg. They are very visible within the fluid from the follicle, and they can be separated and placed into culture media.
4. Preparation of the semen
Partner’s semen: The male collects the semen sample on the day of Embryo Transfer. On occasions, frozen semen samples are used.
Donor semen: The semen sample comes from our sperm bank where the most suitable donor will be selected in accordance to current legislation.
The cryopreserved semen is thawed in the Andrology Laboratory and will be processed for use in in vitro fertilisation. Regardless of the source, the sample will be processed to remove all the seminal plasma and to concentrate the motile sperm.
- Fertilization of the eggs and cultivation of the embryos in the laboratory
Once the eggs are retrieved, they are brought into the laboratory they are placed into new culture media and are placed into the incubator.
The insemination procedure is carried out during the afternoon – timed to take place 6-8 hours after the scheduled retrieval start time. In conventional IVF, the processed sperm is simply added to the dish with the eggs.
The morning after the egg retrieval (Day 1) is when we check the eggs to see which ones have fertilized, and you will be given a call that morning to update you about the status. After this point the embryos are left in the incubator, evaluated at specific times and moved into fresh culture media as their developmental requirements change.
The embryos will be grown in the incubators until day 5, 6, or 7 of development. The length of time can vary depending on how fast the embryos develop. This allows biology to filter out which embryos are more likely to be normal. In other words, a higher proportion of day 5, 6, or 7 embryos will go on to be a successful pregnancy than earlier stage embryos.
- Biopsy and Cryopreservation of appropriate embryos
Here at PSFC, we adopt cutting-edge ideas and approaches. In freeze-all protocols, all suitable embryos obtained from a “fresh” IVF cycle are frozen on either day 5, 6, or 7 with no embryos being transferred that cycle. The transfer will then be planned for a later date in a separate FET cycle.
Emerging research is indicating that freeze all protocols significantly increase pregnancy outcomes over traditional fresh cycles where the embryo is transferred back during the same cycle as it was retrieved.
There are many likely reasons for this:
First, hormone values and inflammation are vastly different in a fresh IVF cycle than in a FET / non-IVF cycle. During a fresh cycle, the women’s ovaries are hyper-stimulated with hormones to allow for more mature eggs to be retrieved. These hormones/medications alter the woman’s normal biochemistry for the duration of their cycle. Until recently, this was thought to be of no consequence, but strong evidence is starting to show the opposite. Waiting to transfer the fertilized embryo(s) back into the uterus during an unstimulated cycle (FET cycle) result in increased pregnancy outcomes in all age groups as well as increased birth weights of around 200 grams.
Another important reason that PSFC has gone to a “Freeze-All” approach is that emerging research is showing that approximately 20% of uterine linings in a fresh cycle are NOT ready for the embryos, even when the lining looks excellent by ultrasound.
- Placement of the embryo into the uterus
We now practice dual embryo transfers on all IVF patients. Instead of transferring many best-looking embryos, we now transfer only two genetically normal embryos, thereby reducing risk of multiple pregnancy while improving the chance of conception. Preimplantation Genetic Testing (PGT) allows us to determine which embryos are chromosomally normal. This practice has an increased chance of success and is safer for both the mother and the growing embryo as pregnancies with multiples are high risk.
The first part of the transfer is where the physician finds the best route into the uterus through the cervical canal and places the outer sheath of the catheter into your cervix under abdominal ultrasound guidance. The embryo is then quickly loaded into the catheter and the embryo is expelled into the uterus. After it has been transferred, we carefully check the catheter to make sure nothing has been left behind before the procedure is complete.
After the transfer, you will be asked to remain lying down for about 15-20 minutes and then you are free to go about the rest of your day. You will be given full follow-up instructions regarding what activities should be avoided and what new medications you will take.
After the eggs are retrieved, our laboratory treats the eggs and fertilizes them with sperm to create embryos. If desired, the embryos are biopsied for chromosomal abnormalities. When the time is right for the transfer, an embryo is selected and implanted into the uterus of the patient or surrogate to create a pregnancy.
8. Pregnancy test
The pregnancy test is performed 10 days later. It consists of the determination of a hormone: the beta hCG in the blood.
Its level will be examined to know more precisely how the pregnancy is developing.
Is IVF safe?
IVF is generally safe, but like any medical procedure, it carries some risks. The likelihood of complications can vary based on individual factors.
How can I prepare for an IVF treatment cycle?
Preparing for IVF treatment involves lifestyle changes, fertility assessments, medication and hormone management, and emotional support. Consult an IVF specialist in Chennai.
How can I choose the best IVF clinic for my needs?
Research thoroughly, check success rates, read patient reviews, consider location and cost, and consult with a fertility specialist to choose the best IVF clinic in Chennai.
What is the process of IVF treatment?
IVF treatment involves retrieving eggs and sperm, fertilizing them in a lab, and then transferring the resulting embryos into the uterus.