IVF

IVF Treatment In Hyderabad

In vitro fertilisation (IVF) is a form of assisted reproductive technology, which involves a series of procedures to help with fertility. During IVF, mature eggs are extracted (retrieved) from the ovaries and fertilised in a laboratory with sperm. A whole IVF cycle takes roughly three weeks. The treatment can be performed with the couple's own eggs and sperm. A gestational carrier, or someone who has an embryo implanted in their uterus, may be used in some cases.

IVF can result in a pregnancy with more than one foetus if more than one embryo is implanted into the uterus (multiple pregnancies). 
Your doctor can explain how IVF works, the risks involved, and if this procedure is suitable for you.

Why is it done?

If IVF is used to treat infertility, you and your spouse may be able to try less intrusive treatment options first, such as fertility medicines to enhance egg production or intrauterine insemination – a process in which sperm are inserted directly into the uterus near the time of ovulation.

If you have specific medical issues, IVF can also be performed. 

• Damage to or obstruction of the fallopian tubes - Damage or obstruction of the fallopian tubes makes it difficult for an egg to be fertilised or an embryo to move to the uterus.
• Ovulation problems - When ovulation is rare or non-existent, there are fewer eggs accessible for fertilisation.
• Fibroids in the uterus - Fibroids are uterine tumours that are not cancerous. Fibroids can obstruct the implantation of a fertilised egg.
• Previous tubal sterilisation or removal - Tubal ligation is a method of sterilisation in which the fallopian tubes are cut or closed to prevent conception indefinitely. 
• Sperm production or function is impaired - Below-average sperm concentration, sluggish sperm movement (poor mobility), or sperm size and shape abnormalities can all make it difficult for sperm to fertilise an egg. If abnormalities in the sperm are discovered, a visit to an infertility expert may be required to determine whether there are any correctable issues or underlying health concerns.
• Unexplained infertility 
• A genetic condition - If you or your spouse are at risk of passing on a genetic condition to your kid, you may be a candidate for IVF-based preimplantation genetic testing. After the eggs have been retrieved and fertilised, they are checked for genetic issues, albeit not all genetic disorders can be detected. 
• If you're going to begin cancer treatment that might affect your fertility, such as radiation or chemotherapy, IVF for fertility preservation may be a possibility. Women can have their eggs extracted from their ovaries and preserved in an unfertilised form for future use. Alternatively, the eggs might be fertilised and saved as embryos for later use.

Women who do not have a functioning uterus or for whom pregnancy offers a significant health risk may choose IVF with another person to carry the foetus (gestational carrier or surrogate). The woman's eggs are fertilised with sperm in this situation, but the resultant embryos are implanted in the gestational carrier's uterus.

Risks of IVF

Risks or complications of IVF include:

• Births in multiples - If more than one embryo is transplanted to your uterus during IVF, the possibility of multiple births increases. Pregnancy with multiple foetuses is associated with a greater risk of premature labour and low birth weight than pregnancy with a single foetus.
• Premature birth with low birth weight.
• Ovarian hyperstimulation syndrome - Injectable fertility medicines, such as human chorionic gonadotropin (HCG), can cause ovarian hyperstimulation syndrome, which causes your ovaries to become enlarged and uncomfortable.
• Mild stomach discomfort, bloating, nausea, vomiting, and diarrhoea are common symptoms that last about a week. However, if you get pregnant, your symptoms may linger for several weeks. Rarely, a more severe type of ovarian hyperstimulation syndrome can occur, causing rapid weight gain and shortness of breath.
• Miscarriage - Miscarriage rates for women who use IVF with fresh embryos when compared to those for women who conceive naturally are approximately 15% to 25%, but the incidence rises with maternal age.
• Complications with the egg-retrieval technique - The use of an aspirating needle to harvest eggs may result in haemorrhage, infection, or injury to the intestine, bladder, or a blood vessel. Sedation and general anaesthesia, if utilised, pose additional risks.
• Ectopic pregnancy - An ectopic pregnancy occurs in around 2 to 5% of women who undergo IVF and occurs when the fertilised egg implants outside the uterus, generally in a fallopian tube. The fertilised egg cannot survive outside of the uterus; thus, the pregnancy cannot be continued.
• Defects in birth - Regardless of how the kid is conceived, the mother's age is the greatest risk factor in the development of birth abnormalities. 
• Cancer - Although early research revealed a relationship between some drugs used to increase egg formation and the development of a certain kind of ovarian tumour, more current research contradicts these findings. 
• Stress

How do you prepare?

Before commencing an IVF cycle, you and your spouse will most likely need a variety of testing, including:

• Ovarian reserve evaluation - Your doctor may test the concentrations of follicle-stimulating hormone (FSH), oestradiol (oestrogen), and anti-Mullerian hormone in your blood during the first few days of your menstrual cycle to evaluate the amount and quality of your eggs. The findings of the tests, which are frequently combined with an ultrasound of your ovaries, can help anticipate how your ovaries will respond to reproductive medicine.
• Analyze the sperm. 
• Screening for infectious diseases. 
• Experiment with (mock) embryo transfer - A mock embryo transfer may be performed by your doctor to establish the depth of your uterine cavity and the procedure most likely to effectively insert the embryos into your uterus.
• Examine the uterus - Before you begin IVF, your doctor will inspect the uterine lining. A sono-hysterogram might also entail a hysteroscopy, which involves inserting a thin, flexible, lighted telescope (hysteroscope) through your vagina and cervix into your uterus.

Consider the following key questions before commencing an IVF cycle:

• How many embryos will be implanted? The number of embryos transplanted is usually determined by the age of the patient and the number of eggs recovered. Because older women have a lower implantation rate, more embryos are normally transplanted — unless they use donor eggs or genetically verified embryos.
• Most physicians adhere to strict rules in order to avoid higher-order multiple pregnancies, such as triplets or more. 
• What are you going to do with any surplus embryos? These can be frozen and preserved as future-use material for several years.
• Alternatively, you may be able to donate any remaining frozen embryos to another couple or a research centre. 
• How will you deal with several pregnancies? IVF can result in multiple pregnancies if more than one embryo is transplanted into your uterus, which poses health concerns to both you and your infants. The foetal reduction can be utilised in some situations to help a woman birth fewer infants with fewer health hazards. However, pursuing foetal reduction is a serious decision with ethical, emotional, and psychological ramifications.
• Have you considered the risks of utilising donated eggs, sperm, or embryos, as well as a gestational carrier? A skilled counsellor with knowledge of donor problems can assist you in understanding the concerns, including the donor's legal rights. 

Induction of ovulation

An IVF cycle begins with the use of synthetic hormones to encourage the ovaries to create several eggs rather than the single egg that naturally matures each month. Because some eggs will not fertilise or develop normally the following fertilisation, many eggs are required.
Several drugs may be utilised, including:

• Medications are used to stimulate the ovaries - You may be given an injectable medicine containing follicle-stimulating hormone (FSH), luteinizing hormone (LH), or a combination of the two to activate your ovaries. 
• Oocyte maturation medications - When the follicles are mature enough for egg extraction, which usually takes eight to fourteen days, you will be given human chorionic gonadotropin (HCG) or other drugs to assist the mature eggs.
• Preventing early ovulation using medications - These drugs prevent your body from releasing developing eggs early.
• Medications that prepare your uterine lining - Your doctor may advise you to start taking progesterone supplements on the day of egg retrieval or on the day of embryo transfer to make the lining of your uterus more receptive to implantation.

Options for determining when a collection of the eggs is due:

• Vaginal ultrasound is an imaging check of your ovaries used to track the growth of follicles, which are fluid-filled ovarian sacs where eggs mature.
• Blood tests will be performed to assess your response to ovarian stimulation medicines.

Sometimes IVF rounds must be discontinued prior to egg harvesting for one of the following reasons:

• Inadequate quantity of growing follicles
• Ovulation occurs prematurely
• There are too many follicles forming, which increases the risk of ovarian hyperstimulation syndrome.
• Other medical concerns
• If your cycle is cancelled, your doctor may advise you to change drugs or their dosages in order to get a better response during future IVF cycles. You can also be told that you require an egg donor.

Egg extraction

Egg retrieval at your respective doctor's office takes 34 to 36 hours after the final injection and prior to ovulation.

• In transvaginal ultrasound aspiration - the eggs are then extracted by inserting a small needle into an ultrasound guide and passing it through the vagina and into the follicles.
• If your ovaries cannot be reached through transvaginal ultrasound, an abdominal ultrasound may be utilised to guide the needle. The eggs are extracted from the follicles using a needle attached to suction equipment. In around 20 minutes, many eggs can be extracted.

However, not all eggs will be fertilised successfully.

Sperm extraction

If you're utilising your partner's sperm, you must deliver a sperm sample to your doctor's office or clinic on the morning of egg retrieval. Other treatments, such as testicular aspiration (the use of a needle or surgical procedure to harvest sperm straight from the testicle), are occasionally necessary. Donor sperm can also be used. 

Fertilisation

Insemination using traditional methods. 

• Intracytoplasmic sperm injection (ICSI) - ICSI is frequently used when sperm quality or quantity is an issue, or when fertilisation efforts during previous IVF cycles have failed.
• In some cases, your doctor may advise you to undergo further treatments prior to embryo transfer.
• Hatching with assistance - If you are an older woman or have had several unsuccessful IVF efforts, your doctor may consider assisted hatching, which is a method in which a hole is cut in the zona pellucida right before transfer to help the embryo hatch and implant. Because the technique can thicken the zona pellucida, assisted hatching is especially beneficial for previously frozen eggs or embryos.
• Genetic testing before implantation - After five to six days of growth, embryos are placed in an incubator and left to develop until a tiny sample can be taken and examined for certain genetic illnesses or the proper number of chromosomes. While preimplantation genetic testing can minimise the possibility of a parent passing on a genetic issue, it cannot completely remove the danger. Prenatal testing may still be advised.

Transfer of embryos

Embryo transfer is normally done at your doctor's office or a clinic two to five days after egg retrieval.

• The doctor will put a catheter, which is a long, thin, flexible tube, into your vagina, through your cervix, and into your uterus.
• A syringe with one or more embryos suspended in a little quantity of fluid is linked to the catheter's end.
• If all goes well, an embryo will implant in the lining of your uterus after six to ten days following the egg extraction.

Following the process

Your ovaries, however, may still be swollen. Avoiding strenuous activities, which may cause discomfort, is a good idea.

The following are common side effects:

• Passing a tiny quantity of clear or bloody fluid quickly after the operation — as a result of the cervix swabbing prior to embryo transfer
• Breast discomfort as a result of excessive oestrogen levels
• Bloating
• Mild cramping 
• Constipation

The doctor will also assess you for issues such as infection, ovarian torsion, and severe ovarian hyperstimulation syndrome.

Results

• Your doctor will analyse a sample of your blood 12 days to two weeks following egg retrieval to see if you're pregnant.
• If you are pregnant, your doctor will recommend you to a gynaecologist or other pregnancy expert for prenatal care.
• If you want to try another cycle of in vitro fertilisation (IVF), your doctor may recommend measures you may take to increase your chances of getting pregnant through IVF.

The likelihood of having a healthy baby after utilising IVF is determined by a number of factors, including:

• Age of the mother - Women over the age of 41 are frequently advised to consider utilising donated eggs during IVF to boost their chances of success.
• Embryo stage - Transferring more mature embryos is related to greater pregnancy rates than transferring less developed embryos (day two or three). Not all embryos, however, survive the growth process. 
• History of reproduction - Women who have previously given birth are more likely than women who have never given birth to become pregnant with IVF. Women who have previously done IVF numerous times but did not become pregnant have decreased success rates.
• The reason behind infertility - Having normal egg production boosts your chances of becoming pregnant with IVF. Women with severe endometriosis are less likely than women with unexplained infertility to be able to conceive via IVF.
• Aspects of one's lifestyle - Women who smoke have fewer eggs to recover during IVF and are more likely to miscarry.