IVF Treatment Clinic India

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• Dr. Rita Bakshi
• MBBS, DGO, MD (OBS Gynae)
• Diploma ART (KKIVF Hospital, Singapore)
• WHO fellowship Gynae Oncology (AIIMS, Delhi)
• Diploma Endoscopy (Kiel, Germany)
• Senior Infertility Specialist Endoscopy Surgeon
• Chairperson International Fertility Centre Delhi
• Paropkar Prasuti Gruh, Govt. Hospital, Kathmandu,
  Nepal
• Grande International Fertility Centre, Kathmandu,
  Nepal
• Apex Mansarovar Hospital, Jaipur

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In Vitro Fertilization
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WHAT IS IVF?
In vitro fertilization (IVF) is a process by
which egg cells are manually fertilized by sperm
outside of the womb. IVF is a major treatment in
infertility when other methods of assisted
reproductive technology (ART) have failed. With
IVF, you can use any combination of your own eggs
and sperm and donor eggs and sperm. The first
test tube baby, Louise Brown, was born in 1978.
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Why It Is Done

• In vitro fertilization may be a treatment option
  if
• A woman's fallopian tubes are missing or
  blocked.
• A man has low sperm counts.
• Unexplained infertility has continued for a long
  time.
• A couple wants to test for inherited disorders
  before embryos are transferred.

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What is involved with in vitro fertilization?

• There are 5 basic steps in the IVF and embryo
  transfer process which include the following
• Monitor and stimulate the development of healthy
  egg(s) in the ovaries.
• Collect the eggs.
• Secure the sperm.
• Combine the eggs and sperm together in the
  laboratory and provide the appropriate
  environment for fertilization and early embryo
  growth.
• Transfer embryos into the uterus.

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Basic Principle of IVF
Hormonal treatment
Female
Harvest the ovum
Mature Ova
Keep to develop embryo
Mix in a test tube
Motile sperms
Collect semen
Transfer to mother
Male
Natural ejaculation
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STEP 1

• Step 1 Fertility medications are used to control
  the timing of the egg ripening and to increase
  the chance of collecting multiple eggs during one
  of the woman's cycles (referred to as ovulation
  induction). Multiple eggs are collected because
  some eggs mightn't be developed or are unable to
  fertilize. Egg development and hormone levels are
  monitored using ultrasounds and blood tests.

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STEP 2

• Step 2 Through a minor surgical procedure using
  ultrasound, a hollow needle is guided through the
  pelvic cavity to retrieve the eggs. Sedation and
  local anesthesia are provided to remove any
  discomfort during the experience. The eggs are
  removed from the ovaries using the hollow needle,
  which is called follicular aspiration.

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STEPS 3 4

• Step 3 Sperms, usually obtained by ejaculation
  are prepared to be combined with the eggs.
• Step 4 The sperm and eggs are placed in
  laboratory incubators which enable fertilization
  to occur. This process is called insemination. In
  cases where fertilization is suspected to be low,
  intracytoplasmic sperm injection (ICSI) may be
  used. In this procedure, a single sperm is
  injected directly into the egg in an attempt to
  achieve fertilization. Once fertilization and
  cell division occurs, the fertilized eggs are
  considered embryos.

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STEP 5

• Step 5 The embryos are transferred into the
  woman's uterus anywhere from one to six days
  later (usually 2-3 days following egg retrieval).
  At this point, the fertilized egg has divided to
  become a two-to-four cell embryo. The transfer
  process involves a speculum which is inserted
  into the vagina to expose the cervix. A number
  of embryos are suspended in fluid and placed
  through a catheter into the womb. This process is
  often guided by ultrasound.

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Oocytes with granulosa cells
"Naked" Oocyte
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8-cell embryo for transfer
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Blastocyst for transfer
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Viable Fetus
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Are there variations of in vitro fertilization?

• Gamete intrafallopian transfer (GIFT) GIFT
  is similar to IVF. It is used when a woman has at
  least one normal fallopian tube. Eggs are placed
  in this tube along with a mans sperm to
  fertilize there.
• Zygote intrafallopian transfer (ZIFT) ZIFT is
  tubal embryo transfer in which a womans eggs are
  taken from her ovaries, fertilized in the
  laboratory, and put back in the fallopian tubes
  rather than the uterus.
• Assisted fertilization techniques when not enough
  sperm are available or sperm quality is not
  sufficient to fertilize include the following
• Partial zona dissection
• Subzonal sperm injection
• Intracytoplasmic sperm injection
• Embryo cryopreservation (frozen fertilized egg
  and sperm)

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ICSI Stands for intracytoplasmic sperm
injection. This process is used to inject a
single sperm into each egg before the fertilized
eggs are put back into the woman's body. The
procedure may be used if the male has a low sperm
count.
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Female Reproductive System
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Male Reproductive System
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How successful is in vitro fertilization?

• The success rate of IVF clinics depends on a
  number of factors including patient
  characteristics and treatment approaches. In the
  United States, the live birth rate for each IVF
  cycle started is approximately
• 40 to 45 for women under age 35
• 35 for women ages 35 to 37
• 25 to 35 for women ages 38 to 40
• 15 to 25 for women ages over 40
• NOTE that pregnancy rates do not equate to
  live birth rates.

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Video Explaining IVF