In Vitro Fertilization (IVF) journey can be stressful yet an exciting one. Understanding IVF Step by Step Procedure and knowing what comes along with the treatment can help one through a stress-relieving IVF treatment. IVF is generally considered when other fertility treatments do not give the desired result for the underlying infertility concern. However, IVF Step by Step Procedure can address or treat many issues hampering fertility, pregnancy, and childbirth.
IVF process start to finish is performed in stages and each stage reciprocates the activities occurring within the reproductive tract of the women. It begins with stimulation of ovaries, followed by retrieval of gametes (egg from woman and sperm from the man), fertilization in an incubated laboratory, and embryo transfer.
This article has all the information about the steps involved in the IVF procedure with a glance at the IVF success rates and factors influencing it.
Table of Contents
Feel free to skip ahead if one topic catches your eye:
- What is IVF Process?
- IVF procedure step by step
- The success rate of IVF in India
- Factors affecting the IVF Success rate
In Vitro Fertilization is a widely accepted procedure of Assisted Reproduction Technique that has helped many couples eager to have children. It can be defined as the process of fertilization of the retrieved eggs that are carried outside the women’s reproductive tract. It is one of the most accepted fertility treatments among childless couples.
1. What is IVF Process?
IVF has evolved since its inception in 1978 when the first successful IVF baby, Louise Brown was born. Advanced and latest techniques like embryo freezing, Intracytoplasmic Sperm Injection (ICSI), assisted embryo hatching, blastocyst culture have now been used along with IVF to improve its success rate and pregnancy chances.
Types of IVF: Different kinds of IVF include IVF extensions with varied advanced techniques and donor options that can be considered in IVF.
- Traditional IVF cycle
- IVF with Frozen Embryo Transfer (FET) and/or donor embryo
- IVF with blastocyst Transfer
- IVF with Intracytoplasmic Sperm Injection (ICSI)
- IVF with Donor egg
- IVF with Donor Sperm consideration
2. IVF procedure step by step
The traditional IVF requires diagnostic tests to confirm the cause of infertility. After the initial blood tests, imaging scans, hormonal assays, the IVF procedure is performed step by step. The IVF process, from the starting till completion is described as follows:
- Step 1: Treatment Begins: Once your IVF is scheduled, your doctor will plan your stimulation protocol. Sometimes you may be recommended injectable medications such as GnRH antagonists or GnRH agonists to control or regularise ovulation. As the ovulation process gets regular, the first day of your period will be considered to be the starting day of the IVF cycle.
- Step 2: Ovarian stimulation: Stimulation of ovaries starts from day 2 of your periods. On day 2, blood tests and ultrasound are carried out. This is followed by administration of medications such as Follicle-stimulating hormone (FSH) and Luteinizing hormone (LH) for 8- 10 days that enable follicular growth and maturation. The entire ovarian stimulation process is monitored through ultrasounds and requires blood estradiol assays that help decide the hormonal dosage and requirement.
- Step 3: Trigger injection: After hormonal stimulation of ovaries, the estrogen levels are tested and ultrasound is performed to know the conditions of the follicles. When the mature follicles attain around 18-20mm size and the estrogen levels are more than 2000 pg/mL, a human chorionic gonadotropin (hCG) injection or the trigger shot is administered almost 36 hours before egg retrieval that helps the eggs to mature.
- Step 4: Egg retrieval and semen collection: Eggs are picked up from the mature follicles almost 34-36 hours after the trigger shot. The egg retrieval process is a minor surgical procedure that requires the administration of anesthesia. This step of the IVF procedure is done with the help of ultrasound that helps the doctor to view inside the reproductive tract and retrieve almost 8-20 eggs from the follicles of the ovary. Here, a small needle is inserted through the vagina to recover enough viable eggs and the whole procedure is done in 15 -20 minutes. The semen sample is collected on the same day of the egg retrieval procedure. This is done either through a natural ejaculation process or a surgical retrieval procedure. Sperm retrieval through surgery includes Testicular Sperm Aspiration (TESA), Percutaneous Epididymal Sperm Aspiration (PESA), or microdissection Testicular Sperm Extraction (micro TESE). The semen sample collected is washed and sperms are extracted through a centrifugal process in the andrology lab.
- Step 5: Fertilisation: The sperms and eggs retrieved are mixed and incubated in a petri dish. The fertilization process is allowed to take place in the laboratory and hence the name In-Vitro Fertilization. Sometimes, due to conditions of the sperm, egg, or fertilization problems, Intracytoplasmic Sperm Injection or ICSI is performed that can improve fertilization probabilities. In ICSI, the sperm is injected directly into the egg. The embryo formed as a result of fertilization is allowed to develop in the embryology labs having an environment similar to that of a woman’s womb.
- Step 6: Embryo transfer: Once the embryo has reached a 6-8 celled stage ideally after day 3 or day 5 of fertilization, the fertilized egg or the embryo is transferred into the uterus of the mother. Embryo can be allowed to develop till day 3 or Blastocysts stage and then transferred. The blastocyst is when the embryo grows till day 5 of fertilization. The embryo is transferred with the help of a catheter that allows the placement of embryos into the uterus through the vagina. In the case of frozen embryo transfer (FET), the frozen embryos are thawed before use. Another important thing to be noted here is that assisted hatching can be performed by embryologists in selected patients to help optimal implantation.
- Step 7: Luteal Phase: The phase after ovulation is the luteal phase. Ideally, after egg retrieval, the female reproductive tract needs to prepare itself for the pregnancy. Hence, estrogen supplements, progesterone shots or progesterone vaginal applicators are prescribed for 15 days post implantation and during early pregnancy.
- Step 8: Pregnancy Test: The last phase of the IVF procedure is the pregnancy test that is done around 12-14 days after the transfer of embryos. The pregnancy test or the Beta hCG test is done that will confirm the commencement of a successful conception and accomplishment of a successful IVF procedure.
3. Success Rate of IVF in India
IVF is considered one of the successful fertility treatments especially in India because of its low-cost treatment options and high success rates. IVF can be successful in the first IVF attempt itself. However, sometimes, more than one IVF cycle may be required to achieve the required outcome. And statistics show that the IVF chances can increase with an additional IVF cycle consideration. Experts believe that ideally 3 IVF attempts to be considered to try the odds of a successful IVF. The average IVF success rate in India for 3 IVF cycles is around 50 -60 %.
It is observed that the success rate also increases with frozen embryo consideration. The “Freeze all” Technique in IVF allows you to freeze all the embryos developed during the in-vitro fertilization process and try your IVF chances. The IVF success rate in India for frozen embryo transfer (FET) is almost 60% in women above the age of 35.
4. Factors affecting the IVF Success rate
IVF Success Rate is influenced by a spectrum of factors. A few of these factors are illustrated below.
- Age: One of the major influencing factors of IVF success. Younger women have a higher chance of pregnancy as they have more chances of producing adequate amounts of quality eggs compared to older women. Statistics show that younger women of the age group 24-34 have a success rate of around 50% -60%and around 40 -50 %in women above 35.
Similar to women, aged men especially above 40 are more likely to have lower sperm production and reduced sperm quality. Thus, affecting the IVF success possibilities.
- Use of donor eggs: For the good embryo quality the egg is an important factor. Considering a donor egg can improve the egg quality and the IVF’s success.
- Duration of infertility: One who has been experiencing infertility for a long time needs to understand that prolonged infertility increases the age of woman/man and that can again influence the success rates.
- Type of fertility issue: This is regarded as the prime determinant for IVF success chances. It is observed that certain fertility concerns such as blocked tubes, blocked ducts in men, oligospermia, etc can show fair chances of a successful IVF compared to uterine abnormalities, fibroids, or even recurrent pregnancy loss.
- Ovulatory dysfunction: Ovulatory issues like infrequent ovulation or anovulation occurs mainly due to hormonal imbalance. High levels of FSH and low AMH (anti-mullerian hormone) will require a stronger hormonal stimulation and this may lower the IVF success chances.
- Lifestyle factors: Lifestyle habits such as alcohol abuse, excessive caffeine intake, smoking, excessive cell phone and laptop usage, vigorous exercise or sedentary lifestyle, occupational exposure to radiation, chemicals, pesticides, etc, can affect the egg quality and/or production of quality sperms. This can in turn impact the IVF success rates.
- Dual fertility issues: Dual infertility is where both husband and wife have infertility. This too can show a combined effect and impact the IVF success possibilities.
How can you Maximise the IVF success rate?
IVF success rates can be improved in the following ways:
- Have a well-balanced diet with fertility-enhancing foods, foods rich in lean protein, fresh green vegetables, fruits, and a less carbohydrate diet.
- Exercise moderately as rigorous exercises can harm your pregnancy chances.
- Avoid habits such as smoking, alcohol intake, abusive drugs that can hamper your chances of a successful pregnancy.
- Consult a nutritionist and consider taking supplements such as folic acid, omega-3 fatty acids, vitamins, etc to improve the IVF chances.
- Relax and de-stress with yoga, meditation that can improve your mental stability and IVF success.
- Are There Other Issues With IVF to Consider?
Couples considering a fresh embryo transfer can freeze the remaining embryos for another IVF cycle or future pregnancy. They also need to understand that not every IVF cycle is the same. Every IVF cycle has its odds of success. If the IVF fails in the first attempt, they can look ahead with another IVF attempt with a frozen embryo taken from the first IVF cycle.
- How long is the IVF Process?
A natural IVF procedure from initial tests to the hCG pregnancy test will take about 15to 20 days. But again, the number of days depends on factors such as fresh or frozen embryo consideration and the responses to the hormonal treatment.
- Is it Painful?
IVF is one such fertility treatment where the primary fertilization process is done outside the reproductive system. It is one of the safest and painless procedures of ART. But, people often get nervous because of the injection phase of the IVF cycle. However, the introduction of a fine needle for fertility medications ensures less pain and discomfort.
- How many times can one try IVF?
IVF has been successful in the first attempt for many. But, for those who have had a failed IVF cycle, statistical findings suggest that they can try for around 3 attempts for a successful IVF beyond which the success rate graph becomes a flat plateau and we have to look for other options.
- What is the difference between IVF & ICSI?
Intracytoplasmic Sperm Injection is an extended procedure of IVF which allows you to select sperm without morphological defects. In IVF, the retrieved gametes are mixed and allowed to fuse in a petri dish. In ICSI, the egg is held under a microscope, and the selected sperm is injected into the egg’s cytoplasm with the help of a specialized hollow needle.
We assume that the IVF procedure step-by-step explained in this article with the FAQs answered has given you a clear picture of the sequence of events and an idea of what to expect during an IVF procedure. We, however, advise you to consult us at the OMYA fertility center, to help you clearly define the entire process and commence the IVF procedure without any further delay. We look forward to providing you the necessary assistance, treatment solution for your fertility concern and help you through a successful IVF treatment at our best IVF centre in Delhi.Omya is your IVF destination that provides the best infertility treatment in Delhi where cutting-edge technology culminates with experienced hands to deliver the best-desired result. We offer a full suite of embryological, nutritional, psychological, gynecological, and andrological fertility services all under one roof.