“What are the stages of IVF”
In vitro fertilisation (IVF) is a complex set of procedures used to aid in the conception of a child or to help with fertility or to prevent genetic abnormalities. In vitro fertilisation (IVF) is a multi-stage process that bypasses the natural fertilisation mechanism within a woman's fallopian tubes. It aims to achieve sperm and oocyte fusion outside of the body, in a culture medium. IVF involves extracting mature eggs from the ovaries and fertilising them with sperm in a laboratory. The fertilised egg (embryo) or eggs (embryos) are then implanted to a uterus for further development. Extra embryos can be frozen in the hopes of having a baby in the future. IVF takes around three weeks to complete. When these stages are broken down into phases, the procedure might take longer.
IVF is a fairly successful procedure. The average live-birth rate for the first cycle was 29.5%, according to a survey of about 156,000 women. This is equivalent to natural cycle success rates in couples with healthy fertility. Repeated therapy cycles may provide the best chances for success. The cumulative live-birth rate after six IVF treatments was 65.3%, according to the same research. These six cycles generally spanned over two years.
For women, under 35 years of age, the success rate was 54%, and for the 35-37 age range the success rate was 40%. Women between the ages of 38 and 40 had a success rate of 26%, while women above the age of 40 had a success rate of 8%. (SART data, 2008). Pregnancy was obtained in an average of 27.3% of all cycles (greater or lower depending on the woman's age), while the proportion of cycles that ended in live births was 22.2% on average, according to the most current data from 2016.
The stages of IVF
The procedure of IVF might take up to two months to complete successfully. There are five main phases in the IVF procedure:
1.Ovulation Stimulation
Your doctor will give injectable hormones or other drugs to stimulate the ovaries to release several eggs instead of the one egg that usually matures each month, whether you are utilising your own eggs or those from an egg donor. This increases the odds of at least one viable embryo being available for use throughout the IVF treatment. Because some eggs will not fertilise or develop normally following fertilisation, several eggs are required. This is done by injecting FSH into the body on a daily basis for 9 to 14 days. In order to stimulate the development of numerous follicles, the FSH dose utilised is somewhat greater than what a woman generates normally. Regular ultrasounds and blood tests are used to track the ovaries' response. The different medications used are:
- Medications for ovarian stimulation (FSH, LH, or both)
- Medications for oocyte maturation (HCG)
- Medications to prevent premature ovulation
- Medications to prepare the lining of the uterus (progesterone supplements)
Egg retrieval can be done 34 to 36 hours after the final injection and before ovulation in your doctor's office or a facility. Waiting for more than 36 hours risks ovulation and the loss of some or all of the eggs. Intravenous sedation is given before a transvaginal ultrasound-guided needle aspiration is used to carefully remove the eggs from each follicle. An abdominal ultrasound may be utilised to guide the needle if your ovaries aren't accessible via transvaginal ultrasound. Multiple eggs are usually retrieved in around 20 minutes. After that, the eggs are placed in a culture medium, and later that same day, healthy, mature eggs will be combined with sperm in an attempt to create embryos. However, not all of the eggs will be fertilised. Women may experience cramping after the procedure, for which medication will be administered. The amount of eggs produced and removed depends on the patient's age, ovarian reserve, responsiveness to ovarian stimulation, and, in some cases, the capacity to access the ovaries with a needle.
If you're utilising your partner's sperm, he'll supply a semen sample through masturbation the morning of egg retrieval at your doctor's office or a clinic. Testicular aspiration, which involves extracting sperm straight from the testicle using a needle or surgical technique, is sometimes required. Sperm from donors can also be used. In the lab, sperm and semen fluid are separated. In certain circumstances, sperm can be collected and frozen ahead of time. Men's sperm can be harvested by a variety of methods, depending on their fertility and health. In some cases, surgical sperm harvesting may be required.
In this stage, the oocytes and sperms are combined in a specific medium and left alone to fertilise. The kind of sperm utilised determines the manner of fertilisation. Experts check eggs after they arrive at the lab to assess their maturity and quality. Mature eggs are placed in a specific culture medium, placed in an incubator, and fertilised with sperm within a few hours following egg harvesting. Fertilization can be done in two ways:
Conventional insemination: Healthy sperm and mature eggs are combined and incubated overnight during conventional insemination. 50,000 to 100,000 motile sperm are put into the dish containing the oocytes if normal sperm is available from the partner. Healthy sperm and eggs are mixed in a laboratory petri dish and left to incubate for natural fertilisation overnight.
Intracytoplasmic sperm injection (ICSI): The intracytoplasmic sperm injection (ICSI) method is preferable if normal motile sperm are not available. Under a high-powered microscope, single sperm are selected out with microneedles and directly injected into the cytoplasm of the egg. When the quality or quantity of sperm is a concern, or fertilisation efforts during previous IVF cycles have failed, ICSI is usually applied.
The medical team will wait up to 20 hours after the sperm and egg have been combined to see if fertilisation has occurred. Before going on to step five, the fertilised eggs may be left to develop in the lab for up to six days. Other procedures that your doctor may prescribe before moving on to step five include:
In certain cases, assisted "hatching" is performed to make a tiny incision into the embryo's shell just before transfer to improve implantation.
Preimplantation genetic testing (PGT) enables for pre-transfer genetic testing of embryos to identify if they are chromosomally normal and/or to screen for particular genetic disorders based on your genetic screening. The embryos are frozen after PGT, which happens on embryo development day five or six, to await the findings of the analysis.
Embryo transfer is generally done two to five days following egg retrieval, either at the doctor's office or a facility. Under ultrasound guidance, the doctor will insert a soft, flexible tube (catheter) into the uterus via the cervix. The embryos (or embryos) are then inserted into the uterus with caution. If there are any remaining viable embryos, they may be frozen for future pregnancy attempts. You may typically continue all normal activities after the embryo transfer surgery, including exercise, but it's best to avoid intercourse until the pregnancy test. You may have minor bloating or breast discomfort. Cramping or passing a little amount of bloody fluid might indicate embryo implantation.
The doctor will do a blood test less than two weeks following the embryo transfer procedure to see if you are pregnant, and if you are, the test will be repeated in two days. A vaginal ultrasound is planned around three weeks later to evaluate the pregnancy's health if your blood hormone level (hCG) is rising appropriately.
IVF has helped women at various phases of their reproductive cycle become pregnant for more than four decades. And IVF has been found to be successful in several cases.
Sources:
https://www.news-medical.net/health/Stages-of-IVF.aspxhttps://myfertilitycare.com/what-are-the-5-stages-of-ivf/
https://www.cityfertility.com.au/understanding-the-steps-of-ivf/
https://www.arcfertility.com/how-is-ivf-done-step-by-step/
https://www.verywellfamily.com/understanding-ivf-treatment-step-by-step-1960200#ovarian-stimulation-and-monitoring