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IVF – In Vitro Fertilisation

What is IVF?

In vitro in Latin is for “in glass” and refers to the laboratory Petri dish in which the egg and sperm are mixed. In vitro fertilization can overcome most causes of male and female infertility. IVF has a high rate of success because it allows for a controlled interaction of eggs and sperm. Medications increase the number of mature eggs a woman can produce at a single time. Each developed embryo can be evaluated to determine which ones are most likely to result in pregnancy. IVF offers a high chance of pregnancy in a short period of time. 

In vitro fertilization (IVF) is an assisted reproductive technology that begins by collecting a woman’s eggs and a man’s sperm and combining them together outside the woman’s body in a laboratory dish for fertilization. After the eggs are fertilized and become embryos, the best embryo(s) are transferred to the woman’s uterus. If IVF treatment is successful, the embryo will implant in the uterus and result in a pregnancy. Any remaining embryos can be frozen and stored for future use. 

How is IVF process done?

IVF is a complex technique involving five basic steps:

  • Superovulation, the process of stimulating a woman to grow multiple healthy eggs, as opposed to the single egg a woman normally ovulates.
  • Egg retrieval and sperm collection.
  • Insemination and fertilization of the eggs by the sperm.
  • Embryo development
  • Embryo transfer into the woman’s uterus.

IVF-ICSI treatment starts from the 2nd or 3rd day of the periods. Hormone injections will be started from 2nd or 3rd day from the start of the periods. She needs to take injections daily for 8 to 9 days at around the same time. Internal scans will be done on 2nd day, 6th day, 8th day and 10th day of the periods to monitor the follicular growth. This will also help us to adjust the dose of the injections.

Husband needs to provide semen sample on the day of egg retrieval. (Usually any one day between 11th to 13thday, with abstinence period of 2-3 days). Oocyte (egg) retrieval procedure takes 20-30 minutes. It is done under general anaesthesia. She will not feel any pain during the procedure. Internal scan is done and under ultrasound guidance, all follicles were aspirated with egg retrieval needle and eggs will be obtained.

After the procedure, she will be drowsy for nearly 2 hours due to anaesthesia medicines and after 5 hours, she will be discharged. Oral medicines, vaginal gel and vaginal capsules will be prescribed at the time of discharge which should be taken regularly without fail. Embryologist will discuss the findings to you both before you get discharged and explain the details of the egg quality, sperm quality, number of mature eggs and IVF or ICSI procedure done. Embryologist will call you and will give information regarding the fertilisation and embryo quality status every alternate days from the next day after the procedure (day 1 after the IVF procedure, day 3 and day 5 of the embryos).

Embryo transfer will be done ideally on day 3 or day 5. Normally we do embryo transfer on day 5 (Blastocyst). Embryo transfer procedure takes around 10 minutes. It is similar to IUI procedure. She should not feel any pain during the procedure. Routinely women do not need anaesthesia for embryo transfer procedure. Full bladder will help in doing the procedure easily and will be less uncomfortable to the women.

After the procedure, she will be advised to take rest for 30 minutes. Oral Medicines, vaginal gel and vaginal capsules which are already been prescribed before need to be taken regularly on time. Pregnancy test need to be done 12 days after the embryo transfer date. On confirmation of pregnancy test, discuss with the doctor and these above medications need to be continued until 12 weeks of pregnancy

Who should consider in vitro fertilization?
  • Advanced age: Woman’s egg quality diminishes with age. IVF can give an older woman a better chance to conceive by growing all the eggs available in that month, enhancing selection of good quality embryos.
  • Unexplained infertility: One fifth of infertile couples are diagnosed with unexplained infertility. After 3-4 failed IUI cycles, these couples often achieve pregnancy using IVF.
  • Damaged or blocked fallopian tubes: If significant tubal damage exists, the only fertility treatment options are surgical repair, which has a low success rate and alternatively bypassing the fallopian tubes using IVF treatment.
  • Male infertility factors: Typically, male infertility factors involve low quantity (less than 5 million / ml) or quality of sperm. In these cases intracytoplasmic sperm injection (ICSI) treatment is recommended.
  • Endometriosis: Endometriosis can cause infertility but can be successfully treated using a combination of surgery and medication. If the first round of surgical or medical treatment fails, IVF is an appropriate next step especially in severe endometriosis.
  • Low ovarian reserve: If a woman has a low number of eggs in her ovaries, the IVF process can be used to stimulate eggs to develop and collect mature eggs directly from the ovaries. In particular, younger women with low ovarian reserve who generally have good egg quality would have better success rates with IVF treatment.
  • Anovulation: If a woman is not ovulating (anovulation, especially PCOS patients), ovulation-inducing pills often aid in achieving pregnancy. If she is unable to achieve pregnancy with these conservative measures, IVF can be used, which has very high success rates.
  • Recurrent pregnancy loss/miscarriage: Depending upon the underlying issue for recurrent pregnancy loss, IVF may be an effective treatment in helping to begin a successful pregnancy by increasing the number of candidate embryos and possibly using PGD or PGS to enhance successful implantation.
What are the Risks of IVF?

The most widely reported risk associated with IVF is a multiple birth pregnancy (twins or more). This can result in pregnancy and labour complications mainly premature delivery and resulting in prematurity of the babies and its long term complications.

Egg retrieval procedure risks: IVF carries the normal risks of surgery including reaction to anaesthesia, internal bleeding, infection, damage to tissue and organs.

Fertility medications can have a number of side effects including

  • Mild bruising and soreness at the injection site,
  • Nausea and, occasionally, vomiting,
  • Temporary allergic reactions, such as skin reddening and/or itching at the injection site
  • Breast tenderness and increased vaginal discharge
  • Headache, abdominal pain and bloating
  • Mood swings and fatigue
  • Ovarian hyperstimulation syndrome (OHSS)  

Most symptoms of OHSS (nausea, bloating, ovarian discomfort) are mild. They usually go away without treatment within a few days after the egg collection. In severe cases, OHSS can cause large amounts of fluid to build up in the abdomen (belly) and lungs. This can cause much enlarged ovaries, dehydration, trouble in breathing, and severe abdominal pain. Very rarely (in less than 1% of women having egg retrieval for IVF), OHSS can lead to blood clots and kidney failure.

Fertility medications and cancer: Earlier reports from several decades ago suggested a link between ovarian cancer and the use of fertility medicines. Recent and well done studies no longer show clear associations between ovarian cancer and the use of fertility medications.

If I conceive with IVF, will my pregnancy be more complicated?

Having a multiple pregnancy (pregnancy with more than one baby) is more likely with IVF, particularly when more than one embryo is transferred. These pregnancies carry significant risks, including:    

  • Preterm delivery: premature babies are at higher risk for health complications such as lung development problems, intestinal infections, cerebral palsy, learning disabilities, language delay, and behaviour problems.
  • Maternal haemorrhage
  • Intra uterine growth restriction of the baby / Low birth weight of the baby
  • Delivery by caesarean section (C-section)
  • Pregnancy-related high blood pressure
  • Gestational diabetes
Will IVF increase the risk of my child having a birth defect?

The risk of birth defects in the general population is 2%-3%, and is slightly higher among infertile patients. Most of this risk is due to delayed conception and the underlying cause of infertility.

Whether or not IVF alone is responsible for birth defects remains under debate and study. When intracytoplasmic sperm injection (ICSI) is done along with IVF, there may be an increased risk of birth defects. However, it is uncertain if these risks are due to the ICSI procedure itself or to problems with the sperm themselves.

Men with sperm defects are more likely to have chromosomal abnormalities, which can be transmitted to their children. However, these disorders are extremely rare. Rare genetic syndromes called imprinting disorders may be slightly increased with IVF.

Will taking hormone injections during ivf cause any long term health effects? Current studies have shown no increase in any cancers with the use of fertility medications. 

Will Miscarriage and Ectopic pregnancy happen with IVF treatment?

The rate of miscarriage after IVF is similar to the rate following natural conception, with the risk going up with the mother’s age. The rate of miscarriage may be as low as 15% for women in their 20s to more than 50% for women in their 40s.There is a small risk (1%) of an ectopic (tubal) pregnancy with IVF. There is a 1% risk for a heterotopic pregnancy after IVF.

IVF Success Rate: A woman’s age is a major factor in the success of IVF for any couple along with man’s age, sperm quality, woman’s weight and other factors. Woman who is under age 35 and undergoes IVF has 60% chances of pregnancy and 40% chance of having a child, while a woman over age 40 has 12% chance of having a child. 

How many times can a woman do ivf treatment?

60% of couples have successful ivf treatment. Some couples are lucky after the first cycle, but a large percent are not. For this reason, you may need to keep on trying. The research suggests most couples will need approximately 6 embryo transfers before they achieve a pregnancy!

There are no limits to the number of IVF cycles you can have. This decision is entirely up to you and the fertility specialists. Most doctors recommend that you shouldn’t try more than three times without changing something.

It might be worth it to try the same IVF procedure again, assuming that your body and mind are ready. You can decide on the number of IVF cycles you have, but you need to be aware of the costs associated with IVF.

Arguably, the most important things you will need while undergoing IVF treatments are patience and a strong support system of friends and family behind you as you work your way through this.

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What Our Client Say

We love that our patients feel inspired to write about the care they received here at Vishvas Fertility! Here are some of the wonderful letters and comments we have recently received.

pramod kr
pramod kr
We visited Dr. Basavaraj for our treatment. We had to visit for over an year and couple of procedures. Doctor is very knowledgeable and has vast experience. Nurses and other lab staff are good. Initially the wait time was less ,however off kate the wait time is on higher side since doctor does scan and procedures in parallel. The wait time doesn't change even with prior appointment . This is especially true in Marathahalli centre. This can be improved. I feel cost here for treatment is much lesser than any corporate hospitals or other centres. Doctor is mostly straight forward and not verbose. Also doctor prescribes just enough medication which might or might not be good, hard to judge.
Rajeev Kothamachu
Rajeev Kothamachu
I highly recommend the doctor if there any complications. I visited him and we got very good results. He has very good patience and listen all the problems. Doc is not that commercial he is collecting the same from last 4 years. We are now visiting him again for 2nd pregnancy..
Divya Sharma
Divya Sharma
Dr Basavaraj is amazing and genuine person. Report asked by him are only needed one, no additional like many other place. All clinic staff are even good n helpful, Appointment recommended Over all very good Dr for fertility.
Vinay K
Vinay K
Very good doctor , provides good information about the procedures ,
Abhijit Sarkar
Abhijit Sarkar
We worship God and many says that Doctors are possibly the one. We (me and my wife) evident that in our difficult time. Thank you Dr. Basavraj for your treatment and care. You will always be there in our heart and any word of gratitude is not enough. We have blessed with a baby boy and he is doing great. we were struggling from almost 3 years and finally we have been blessed. We (me and my wife) can never forgot what you did for us. When in difficult time people goes away, you have been our hope and belief. we were really very lucky enough that we got a chance to meet you in person and got the treatment. Our Best wishes to you Doctor and may you help many more people who are suffering from fertility issues. We were really amazed that even after such a busy schedule doctor finds the time to respond whenever it was required (in panic situations). Thank you once again doctor for your personal attention. Our best wishes for you and your family. We will surely come and meet you very soon, I am sure my son also will be blessed by just seeing you. You have given us the reason to Smile 🙂
Bharath Konegadde
Bharath Konegadde
Dr Basavaraj Shetty take care and advice till 3 months pregnancy . One of the best doctor in hsr
Dr Chetan Kumar N.G
Dr Chetan Kumar N.G
Dr Devarshetty has a midas touch in his treatment apart from his knowledge skills as a infertility specialist. I recommend all patients to be open minded while consulting him. My wife had a very difficult phase in conceiving after getting ectopic pregnancy twice in 2015-16 because of her PCOD . Being a Dr myself i couldn't cope up with the stress with which i and my wife underwent during those times,later in 2016-17 after Dr Devarshetty advise and treatment we finally became parents and it was the most joyous moment of our married life. Now we have a healthy baby girl 10m old..posted mother and baby image.

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