Causes Of Infertility:
- Male Factor: 40%
- Female Factor: 40%
- Combined: 10%
- Unexplained: 10%
Simply speaking you need – egg, sperm, uterus and tube to make a baby and if there is a problem with any of these, one is likely to suffer from infertility
When should you start thinking about IVF or ICSI?
- If both your fallopian tubes are blocked or badly damaged.
- If you have been diagnosed with unexplained infertility (that means all your tests are normal)for more than 2 years
- Other techniques such as fertility drugs or 2-4 cycles of intrauterine insemination (IUI) have not been successful.
- If you have Moderate to Severe Endometriosis.
- If you have reduced ovarian reserve, which means lower quantity (and sometimes quality) of eggs. It is usually treated with either IVF, or with IVF with egg donation.
- If you have premature ovarian failure than you need IVF with egg donation
- If you have a problem with your uterus than you need IVF with surrogacy
- If you are using embryo testing (PGD/PGS) to avoid passing on a genetic condition to your child.
- The male partner has sperm problems, as low sperm count & motility or abnormal shape sperms
- If your husband has zero sperms in semen, than sperms from testis can be retrieved and used in IVF-ICSI
- If your husband has ejaculation problems
IVF – IN VITRO FERTILISATION, TEST TUBE BABY Art of making babies
IVF treatment involves the fertilization of an egg (or eggs) outside the body in the lab .The treatment can be performed using your own eggs and sperm, or using either donated sperm or donated eggs, or both.
The Entire IVF procedure is divided broadly into Five Stages:
- Ovarian stimulation and monitoring
- Egg retrieval
- Fertilization and embryo development in lab
- Embryo transfer
- Pregnancy test
In a normal ovulation cycle, one egg usually matures per month. In an IVF cycle, the goal is to have as many mature eggs as possible, as this will increase your odds of success with treatment. In the stimulation phase of the IVF cycle, injectable medications are used for approximately 8-12 days to stimulate the ovaries and produce many eggs. Monitoring consists of Transvaginal Ultrasound, which measures the growth of the egg follicles and the thickness of the uterine lining, both of which should be increasing as youtake the injectable medications. Hormonal tests – Measures the estrogenlevel. The levels of estrogen in the blood are another indicator of the growth and maturation of the eggs – rising as the follicles grow.
The stimulation phase ends with a trigger shot. The trigger shot provides final maturation to the developing follicles. Timing is crucial in this phase because the egg retrieval must be preformed prior to the expected time of ovulation. The egg retrieval itself takes only about 10- 20 minutes. During the procedure, an ultrasound is used to guide a needle into each follicle and remove the follicular fluid and egg. This fluid is than handed over to the embryologist.
There are two ways that fertilization can occur Conventional Fertilization or IVF Frequently used in cases such as blocked fallopian tubes,endometriosis ,egg donation cycles ,surrogacy cycles etc. Here eggs and sufficient number of eggs are mixed in a dish and left for fertilization on their own in the incubator. Intracytoplasmic Sperm Injection (ICSI): In ICSI, single motile healthy sperm is caught with the help of fine needle and injected directly in to the egg ,to ensure fertilization.
ICSI is needed in cases
- When the quantity or quality of sperm is poor and therefore unable to effectively penetrate the egg on its own
- When sperms are retrieved from testis
- In cases of unexplained infertility
- Where in previous IVF cycles total fertilization failure happened
- In cases requiring PGD/PGS so that extra sperms do not interfere with genetic analysis
IVF success depends on many factors as depicted below in the diagram