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Test Tube Baby Technique (IVF / ICSI)
This is an assisted reproductive technique where eggs collected from female’s ovaries are fertilized outside in glass dishes( in laboratory)with male sperms, when embryos(cell stage of a baby) are formed they are transferred back into female’s uterus(womb) for pregnancy to happen.
Blocked fallopian tubes
Severe abnormalities in sperm counts and motility
Unexplained infertility
Repeated failed IUIs
Women with advanced age and declining ovarian reserves( may need donor eggs)
Genetic problems in husband or wife, causing repeated pregnancy losses
STEP 1: CYCLE DOWNREGULATION AND STIMULATION
Basically we want to collect good number of eggs from the wife’s ovaries( normally only one egg is released in one menstrual cycle),this is done by taking control over the menstrual cycle by giving drugs to suppress the natural responses(GnRH analoges) and stimulating the ovaries by hormonal injections (GONADOTROPINS) till a desired response is achieved, this response is monitored by hormonal tests and sonography.
STEP 2: EGGS PICK UP( OOCYTE RETREIVAL)
Developing eggs in the growing follicles of both ovaries needs to be taken out for invitro fertilisation. An injection is given(hCG) for final maturation of the eggs and 36 hrs later they are collected.This procedure is done under anaesthesia under ultrasound guidance through vaginal route .After few hours of rest, patient can go backhome.
STEP 3: FERTILISATION IN LAB AND EMBRYO FORMATION
The eggs collected are allowed to fertilise/fusion by sperms under special laboratory conditions( recreation of inside body like environment) .At this step, in case of ICSI(Intracytoplasmic Sperm Injection) each egg is fertilised by single motile sperm by direct injection into ovum under special microscope. After fusion of egg and sperm, the zygote is allowed to grow further till embryos( 4cell, 8 cell, Blastoysts) are formed.
STEP 4: EMBRYO TRANSFER
This a straightforward procedure not requiring anesthesia, done between 2nd to 5th day of egg pickup.The embryos are gently placed inside uterine cavity using a fine cannula introduced through vagina and cervix.
STEP 5: IMPLANTATION AND OCCURENCE OF PREGNANCY
After embryos are transferred, they follow the natural event of implantation by invading and burrowing into the endometrium(lining of uterus) and develops into a fetus.When this happens it secretes a hormone called hCG which can be detected at day 14 of the Embryo transfer in blood test.To support the pregnancy Progestorone hormone is given by injections/vaginally till 12th week of pregnancy.