A couple seeking for IVF treatment needs to undergo the following screening procedures:
1. Ovarian reserve analysis: for analysis of eggs, a physician tests the concentration of follicle stimulating hormone, estradiol and antimullerian hormone by taking the female’s blood cycle in the initial days of her period. The received results are used with ultrasound of her ovaries to determine their response to fertility medicine.
2. Semen testing: The semen testing is performed prior starting the IVF treatment procedure
3. Infectious disease test: A couple needs to undergo test to determine if any infectious disease such as HIV, hepatitis B and C, VDRL.
4. Mock Embryo Implant: A specialist may do an implantation of mock embryo to find the uterine’s depth and technique to safely keep the embryo into uterus.
5. Uterine depth: Doctor will evaluate your uterine cavity prior starting IVF. It may include a trasnvaginalultrasound to produce photos of uterine cavity or it involves a hysteroscopy that includes thin, lighted telescope that is inserted to vagina and cervix into uterus.
The count of transferred or implanted embryos generally depends on female’s age and count of collected eggs. In young couples two to three embryos are implanted. Because of the risk of damage in older ladies, more than three embryos are transferred. Many specialists follow certain instructions to avoid a larger order of multiple births. Even laws are made in few nations to prevent implantation of many embryos in a single cycle. The doctor should do it in your confirmation. In India, maximum three embryos can be transferred in women’s womb
Unused embryos are frozen and stored for later use in the later time. Through cryopreservation the later IVF treatment can be done at lower cost and less insidious. Through modern virto techniques, pregnancy success rates are same with fresh and frozen embryos. Couples can also decide to donate extra frozen embryos to other couples or a research use or they can be disposed.
In case multiple embryos are transferred in the female’s uterus, IVF results in multiple pregnancy that however increases health risks for babies. In some conditions, fetal loss can be utilized to enable females deliver multiple babies with reduced health hazards. Through fetal limitation, although it is a chief decision with sensitive and emotional results.
A professional counselor with skills in donor issues can recognize the lawsuit, ethical, sentimental and procedural facts of these methods.
A patient is prescribed with several medicines like:
1. Ovarian stimulation drugs for ovary stimulation An FSH injection is given and a luteinizing hormone or both are given. These are used to stimulate eggs for growth. The specific count of eggs for IVF success is five to fifteen percent. It ensures sufficient count of embryos for fresh and frozen implant.
2. When follicles are ready for egg collection, normally on tenth or eleventh day of stimulation, you will receive 1000 IU human chlorionic gonadotropin or other tablets for eggs development.
3. Medicines to avoid early ovulation. These medicines control body to release eggs in advance. It is crucial that eggs do not release prior to collect them from ovaries.
4. Medicines to make uterus lines ready. At the time of egg retrieval or at the moment of embryo transfer, your doctor recommends that you start receive progesterone supplements to prepare uterus lining to make it more responsive to implantation. The medicines prescribed are aspirin, folic acid, small molecular weight heparin injections and estradiolvalerate etc.
Generally, a patient needs to wait for single or double weeks for ovarian stimulation prior eggs are ready for collection. To recognize the eggs preparation for collection, doctors will conduct trans vaginal ultrasound, a process including sound waves to produce an image of ovaries to analyze the growth of fluid filled ovarian sacs of developed eggs. The blood samples to determine the response to ovarian stimulation medicines, estrogen levels generally improve as follicles produce and progesterone levels are kept small as long as subsequent to ovulation. Progesterone will also be determined on the day of HCG night activation.
In rare cases the treatment is cancelled after confirmation with patient due to various issues such as:
1. Insufficient production of follicles
2. Early ovulation
3. Several follicles are developed, pausing ovarian hyperstimulation syndrome risk.
Your specialists may also suggest changing medicines to accelerate enhanced performance while the new IVF procedures. Or accepting an egg donor may be suggested.
Egg collection is done inside the IVF operation theater within 34 to 36 hours of injection and prior the ovulation. While the egg collection process, a patient is sedated and taken pain relief medicine. The Transvaginal ultrasound aspiration is the standard collection procedure followed in all fertility centers. In this process, an ultrasound probe is introduced in female’s vagina to determine follicles. Subsequently, a thin needle is introduced into an ultrasound direction to move across the vagina and into the follicles to collect the eggs that are removed from the follicles using needle linked to a suction equipment. Several eggs can be retrieved within ten minutes.
Subsequent to egg collection process, a patient may face extreme pain and sense of intense pressure in the lower abdomen. Dizziness may occur for several house. In this condition, you should live in presence of any family member or husband. In few cases nausea and vomiting feeling may also occur that are however nominal and correct on their own basis after some time.
The fully developed eggs are kept inside a nutritive liquid for rinsing. In the traditional IVF procedure, eggs which look healthy and fully developed are kept in contact of sperm for the whole night to produce embryos. Although, all eggs may not be completely fertilized. In case of sperm issues in men, an impenetrable infertility, we follow ICSI treatment under which an individual sperm is selected by a microneedle and inserted into egg to perform the fertilization.
An embryo implant is however performed inside the clinic and is done within 2 to 6 days subsequent to collecting eggs, which is overall a painless process. But a patient may experience nominal pains. A pain relieving medication can be given if you feel anxious. The clinic staff will introduce a lengthy, thin and flexible tube that is known as catheter tube in your that goes through cervix and kept in the uterus. A needle containing multiple embryos kept in a fluid is connected to catheter end and then sent through the tube inside the uterus.
Once the embryo is implanted, patient can restart normal routine activities. Although extension in ovaries may be continued. You should any extreme activity that causes tiredness and discomfort. The common side effects associated may be :
1. Moving a slight magnitude of clean or bloody fluid subsequent to the treatment because of cleaning of cervix prior to performing the embryo implantation.
2. Breast softness because of increase of increase in estrogen levels
3. Nominal bloating
4. Nominal pains
If you create slight or intense pain subsequent to embryo implant, you should visit your specialist. He will determine the factors including inflection, bending of an ovary and intense ovarian hyperstimulation syndrome to determine the reason of pain and will prescribe its cure.