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In Vitro Fertilization (IVF)

IVF or In vitro fertilization refers to the process of achieving fertilization between a sperm and an egg in an IVF laboratory and placement of the resulting embryo into the uterus of the mother.

This process is also commonly known as Test Tube Baby. Usually IVF is undertaken in cases of blocked tubes, sperm defects in the male partner or prolonged unexplained infertility.

Who needs IVF?

  • Women with blocked or damaged fallopian tubes which make it difficult for the sperm and egg to fertilize.
  • Men who have low sperm counts or poor motility. As a result sperm cannot fertilize the egg without assistance
  • For Couples with Unexplained infertility - when pregnancy does not occur despite all the factors seeming healthy
  • Premature ovarian failure - some women may stop producing eggs at a younger age. Couples like these may need donor eggs to have a child.
  • Women with problems with their uterus - which prevents conception

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Intrauterine insemination (IUI)

In Vitro Fertilization (IVF)

IVF Step by Step

ICSI Treatment

Blastocyst Culture

Frozen Embryo Transfer

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Step by Step IVF for the patient

Initial Assessment and Investigations

Ovarian Stimulation and Cycle monitoring

Egg Retrieval and Sperm Collection

Fertilization (IVF or ICSI)

Embryo Development

Embryo Transfer

Embryo Cryopreservation (Embryo freezing)

Post Embryo Transfer Care and Pregnancy Test

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Initial Assessment and Investigations

Before the start of an IVF procedure, the couple undergoes some basic investigations  such as a semen analysis for the male and a few blood tests for both the female and male partner to establish suitability for IVF. If necessary, an evaluation of the fallopian tubes for the female partner may also be advised. Based on the results of these tests, we are able to design the best treatment strategy for you. Our individualised approach means that every couple will vary in how their treatment is planned and managed. 

Thereafter, the couple registers at the IVF centre, where they go through an extensive counselling session with our IVF counsellor. The patient is informed about all aspects of the IVF procedure they will be undergoing and is given an opportunity to ask questions and clarify doubts regarding the IVF treatment cycle.

Ovarian Stimulation and Cycle monitoring

The IVF cycle begins on day 2 or 3 of a woman’s cycle, which involves undergoing a round of blood tests and an ultrasound at the IVF lab, after which hormonal injections called Gonadotropins are prescribed. These hormones are given to stimulate the growth of multiple follicles in the ovaries. These follicles contain eggs. It is essential to take these injections daily for 8 to 12 days at the prescribed time to ensure optimal follicle growth. These injections are relatively painless, simple to administer and can be taken by the patient herself. During this period, the couple needs to visit the IVF center about 4 to 5 times for repeated blood tests and ultrasounds in order to monitor follicle growth. Once the follicles have reached a appropriate size, a final injection is given for maturation of eggs. This injection is usually taken at night following which an Egg pick up is scheduled 36 hours later.

Egg Retrieval and Sperm Collection

Egg pickup is a safe and relatively simple day care procedure performed in the IVF operation theatre under anaesthesia where eggs are retrieved through an ultrasound guided needle without any surgical cut or stitch. This process doesn’t require any hospitalization and the patient is discharged after a few hours of the egg pick up. 

The male partner also provides his semen sample by masturbation on this same day for further processing for IVF. Processing of semen involves removal of non-motile or dead sperm and only healthy motile sperm are separated for further use in IVF.

Fertilization (IVF or ICSI)

During the process of fertilization, the sperm is added directly to the eggs kept in a petri dish, thus allowing sperm to penetrate the egg and fertilize it. Alternately, sperm may be injected into each egg in a process called Intracytoplasmic Sperm Injection (ICSI). ICSI is generally performed for couples who either have low sperm counts or had a poor or failed fertilization in a previous attempt. On an average, only 60-70% of eggs that are retrieved will fertilize. Once an egg fertilizes, it produces a zygote the next day.

Embryo Development

Subsequently, the resulting zygotes develop into cleavage stage embryos on day 3. Not all embryos are alike, with some having better quality than others. The embryologist identifies embryos with good quality and separates them from the remaining poor quality embryos that may be slow growing, or fragmented or showing abnormal growth patterns.

Finally, on day 5 or day 6, an embryo forms a Blastocyst which is the final stage of an embryo. Not all embryos form a blastocyst. Only top quality embryos are able to reach the Blastocyst stage, and therefore these embryos have the highest chance of producing a pregnancy. Please click on the success rates tab to know more about the pregnancy rates after blastocyst transfer.

Embryo Transfer

Embryos may be selected for transfer into the patient on days 2, 3, 5 or 6 after her egg pickup. The day and number of embryos to be transferred is decided after discussion with the patient. Typically, only one or two, good quality embryos are transferred into a patient. Embryo transfer is a simple and painless procedure that does not involve the use of anesthesia. The developing embryo is transferred into the patient’s uterus with the help of a fine soft catheter inserted through the vagina. The patient is required to rest for only 10 – 15 minutes after the embryo transfer. At the time of leaving the center, the patient is given a date for the pregnancy test and written instructions about medicines to be taken up till the day of the test.

Embryo Cryopreservation (Embryo freezing)

After embryo transfer, any extra embryos remaining in culture can be frozen for future use. The technology used for freezing embryos is called ‘Vitrification’ which is a very robust technology, ensuring high survival rates of embryos after freezing. In case, an embryo transfer doesn’t result in a successful pregnancy, frozen embryos come in handy, as they provide the couple with an additional chance at conception, without having to go through another IVF cycle. Embryo freezing is also a very good option in cycles where either the number of eggs retrieved is too high, or the endometrium is found to be too thin or too thick on the day of embryo transfer. In such cases, it is advisable for all embryos to be frozen and embryo transfer to be performed in the next cycle to increase the chances of pregnancy.

Post Embryo Transfer Care and Pregnancy Test

Medicines are given to maintain hormone levels after embryo transfer to ensure that the uterus lining remains satisfactory. This improves the chance of implantation of embryos and thus of success. There is no evidence that prolonged rest improves the success rate of IVF.2 weeks after ET, a blood test will be performed to detect pregnancy. If the test result is positive, ultrasound is scheduled 3 weeks later to confirm the developing pregnancy.