In vitro fertilization (IVF) also called Test tube baby is an assisted reproductive technology where in an egg is fused with the sperm outside the body (In Vitro). during this process the ladies ‘s ovaries are stimulated using daily hormonal injections of highly pure HMG or recombinant FSH ranging from Day 2 of the cycle for 9 to 11 days. When the leading follicle is > 14 mm, a daily dose of GnRh antagonist is additionally given to the patients. When two leading follicles are > 17 mm in diameter the patient is given an Injection of urinary HCG 5000/10000 units or recombinant HCG 250/500 units and therefore the eggs are retrieved after 35 to 36 hours. If there are too many follicles, then rather than HCG a dose of Gnrh agonist is given to stop overstimulation of the ovaries. The egg retrieval is completed under short general anesthesia or local anesthesia, by employing a very thin needle. This needle is skilled the vagina under ultrasound guidance. The egg retrieval takes about 10 to twenty minutes & the patients can head home in 4 to six hours. Once the eggs are isolated within the lab, the husband is asked to supply sperms by masturbation. The sperms are processed using various techniques like swim up, density gradient, microfluidics or Magnetic Assisted Cell Sorting MACS. Following the processing of the semen, about 1,00,000 healthy forwardly motile sperms are mixed with the wife’s egg during a Petri dish within the embryology lab. The fertilized eggs are called the embryos (baby’s eggs) which are cultured and on day 3( 8 cell cleavage stage embryo ) or day 5 (150 cells blastocyst) is released back to the wife’s womb with the assistance of a procedure called Embryo Transfer Sometimes on the day of IVF the Husband may fail to supply semen by masturbation , thanks to psychological pressure . Hence our unit always request the husband to supply another semen sample, a couple of days before the egg devour and freeze that semen sample as a copy.

IVF is performed to treat infertility, after trying less invasive treatment options, including fertility drugs for the formation of egg or IUI (Intrauterine Insemination – when sperm are placed directly in the uterus near the time of ovulation.)

Often, IVF is used as a primary treatment for infertility in women over 40.

IVF may also be done in cases where there is:

• Fallopian tube damage or blockage: Blocked or damaged Fallopian tubes make it difficult for an egg to be fertilized or for an embryo to travel to the uterus.
• Ovulation disorders: In cases where ovulation is infrequent or absent and as a result, fewer eggs are available for fertilisation.
• Premature ovarian failure: The loss of normal ovarian function before age 40. This means that the ovaries don’t produce normal amounts of the hormone oestrogen, or that no eggs are released regularly.
• Endometriosis: Endometriosis occurs when the uterine tissue implants and grows outside of the uterus, often affecting the function of the ovaries, uterus and Fallopian tubes.
• Uterine fibroid: Common in women in their 30s and 40s, fibroids are benign tumors in the wall of the uterus that can interfere with implantation of the fertilized egg.
• Previous tubal sterilization or removal: In cases where a patient’s fallopian tubes are cut or blocked to permanently prevent pregnancy, IVF may be a good option.
• Impaired sperm production or function: Poor mobility – low sperm concentration, weak movement of sperm or poor morphology – abnormalities in sperm size and shape often make it difficult for sperm to fertilize an egg.
• Unexplained infertility: When no cause of infertility has been found despite evaluation.
• A genetic disorder: If the patient or her partner are at risk of passing on a genetic disorder to the child, pre-implantation genetic diagnosis, a procedure that involves IVF, may be used. After the eggs are harvested and fertilised, they can be screened for some genetic problems. Only embryos without the identified problems are transferred to the uterus.
• Fertility preservation for cancer or other health conditions: If a patient is about to begin cancer treatment that could harm fertility, IVF is an option for fertility preservation. Eggs can be harvested from the patient’s ovaries and frozen for later use. Eggs can also be fertilized and frozen as embryos for use later.
• Lack of a functional uterus and high-risk pregnancies: Patients who do not have a functional uterus or those for whom pregnancy poses high health risks may choose IVF. In this case another person or a surrogate appointed by the couple is used to carry the baby to term. In this case, the patient’s eggs are fertilised with sperm and the resulting embryos are placed in the surrogate’s uterus.

Tests for men

Male fertility requires that the testicles produce enough healthy sperm, which the sperm is ejaculated effectively into the vagina and travels to the egg. Tests for male infertility plan to determine whether any of those processes are impaired.

You may have a general physical exam, including examination of your genitals. Specific fertility tests may include:

Semen analysis: Your doctor may invite one or more semen specimens. Semen is usually obtained by masturbating or by interrupting intercourse and ejaculating your semen into a clean container. A lab analyzes your semen specimen. In some cases, urine could also be tested for the presence of sperm.
Hormone testing : you’ll have a biopsy to work out your level of testosterone and other male hormones.
Genetic testing: Genetic testing could also be done to work out whether there is a genetic disease causing infertility.
Testicular biopsy: In select cases, a testicular biopsy could also be performed to spot abnormalities contributing to infertility or to retrieve sperm for assisted reproductive techniques, like IVF. Imaging. In certain situations, imaging studies like a brain MRI, transrectal or scrotal ultrasound, or a test of the ductus deferens (vasography) could also be performed. Other specialty testing. In rare cases, other tests to guage the standard of the sperm could also be performed, like evaluating a semen specimen for DNA abnormalities.

Test for Women

Ovulation testing: A biopsy measures hormone levels to work out whether you’re ovulating.
Hysterosalpingography: Hysterosalpingography (his-tur-o-sal-ping-GOG-ruh-fee) evaluates the condition of your uterus and fallopian tubes and appears for blockages or other problems. X-ray contrast is injected into your uterus, and an X-ray is taken to work out if the cavity is normal and to ascertain if the fluid spills out of your fallopian tubes.
Ovarian reserve testing: This testing helps determine the number of the eggs available for ovulation. This approach often begins with hormone testing early within the cycle.
Other hormone testing: Other hormone tests check levels of ovulatory hormones, also as pituitary hormones that control reproductive processes.
Imaging tests. Pelvic ultrasound looks for uterine or ovarian disease. Sometimes a sonohysterogram, also called a saline infusion sonogram, is employed to ascertain details inside the uterus that aren’t seen on a daily ultrasound.

Depending on your situation, rarely your testing may include:

Hysteroscopy : counting on your symptoms, your doctor may request a hysteroscopy to seem for uterine disease. During the procedure, your doctor inserts a skinny, lighted device through your cervix into your uterus to look at any potential abnormalities.
Laparoscopy: This minimally invasive surgery involves making alittle incision beneath your navel and inserting a skinny viewing device to look at your fallopian tubes, ovaries and uterus. A laparoscopy may identify endometriosis, scarring, blockages or irregularities of the fallopian tubes, and problems with the ovaries and uterus.