Stages involved in In Vitro Fertilization (IVF)
In Vitro Fertilization (IVF) is an excellent tool of Assisted Reproductive Technique (ARt) that applies the procedure of fertilizing the gametes in an incubated laboratory condition. The fertilized egg is safely transferred into the woman’s uterus. IVF has been a boon to many couples who have had problems conceiving naturally. IVF is multi-staged and has the following stages.
STAGE 1- OVARY STIMULATION: IVF begins with the stimulation of ovaries that requires a sequence of hormonal injections. This procedure is done from day 2 or 3 of the menstrual cycle. Initially, ultrasound and blood tests are performed to check the internal status and hormone levels to begin the hormone administration that is given for 10-11days to induce the ovaries to produce more than one mature egg. The dosage of hormones is regulated with regular ultrasound and blood tests. Hormones such as Follicle Stimulating Hormone (FSH), Luteinizing hormone (LH) can encourage follicular development and increase egg production.
STAGE 2- EGG RETRIEVAL: After the ovary stimulation the eggs are retrieved from the ovaries with the help of a small surgical procedure done under anesthesia. Ultrasound guides the IVF doctor to insert the needle through the vagina and retrieve mature eggs from the developed follicles; which can be incubated for fertilization or can be frozen for later use.
STAGE 3- RETRIEVAL OF SPERMS:Sperms are generally retrieved on the same day of egg retrieval. The semen sample can be obtained through normal ejaculation or can be retrieved through surgical sperm aspiration techniques (PESA /TESA).
STAGE 4- FERTILIZATION PROCEDURE:The retrieved mature eggs are mixed with the sperms in a small petri dish in an incubated environment to allow fertilization. Advanced ART such as Intracytoplasmic Sperm Injection (ICSI) can be considered in case of compromised fertility conditions to improve the chances of successful IVF.
STAGE 5: EMBRYO DEVELOPMENT: The fertilized eggs are called embryos. The embryos are given a womb-like environment in the embryology labs where the embryos are meticulously monitored. The embryos develop to a 6-8 celled stage by Day 3 or Day 5 of fertilization, at this stage, the embryos are ready for transfer. Sometimes, the embryos can be frozen and stored for later use.
STAGE 6- EMBRYO TRANSFER: The embryo’s 6-8 celled stage or a slightly more developed stage called the blastocyst can be transferred into the woman’s womb. The embryos sometimes will need to be modified through assisted hatching technology before transfer. This can help optimal implantation. A flexible catheter is used to insert the embryos into the uterus and the process of embryo transfer is accomplished.
STAGE 7- CONFIRMATION OF PREGNANCY:Almost after 12-15 days of embryo transfer, the presence of Human Chorionic Gonadotropin (hCG) can confirm the success of the IVF Stage and commencement of pregnancy.