IVF Process in Delhi
IVF Doctor and Specialist Gynaecologist in Delhi NCR
Over the last few decades, the global fertility rate has dropped to 2.5 per woman and 10-15% of the world population suffers from infertility due to various reasons. In this havoc, In Vitro Fertilization (IVF) has become a global phenomenon to aid with many male and female infertility factors in infertile couples.
Couples of reproductive age, who are constantly trying to conceive for more than a year are supposed to be suffering from infertility. In that case, primary fertility treatments i.e. reproductive medications are recommended to the couples. But, if medication is not an effective solution or if it doesn’t work out for them then assisted reproductive techniques such as IUI or IVF are more reliable. For a better understanding of the IVF process, let’s see what IVF treatment is.
What is IVF?
In vitro fertilization (IVF) is a process where an egg gets assisted fertilized by the sperm in a laboratory outside of the body. In the IVF process, we retrieve eggs from a woman’s uterus and fertilize them with quality sperm in a cultural dish.
When the fertilized egg develops up to the blastocyst embryo, we transfer it back to the womb for implantation. If the embryo successfully implants on the uterine lining, the pregnancy will be established within two weeks of embryo transfer. The rest of the pregnancy proceeds the same as in the case of natural conception. IVF and other ARTs have accounted for approximately 8 million live births worldwide to this day.
Who are Ideal candidates for IVF treatment?
Numerous male and female infertility factors can be overcome with the help of IVF. IVF is reportedly the most effective treatment for many infertility factors, such as:
- Blocked or damaged fallopian tube in women
- PCOS and Poor ovarian reserve in women
- Uterine fibroids
- Tubal ligation or permanent birth control
- Abnormal semen parameters in males
- Varicocele and vasectomy
- Genetic disorders
- IVF after cancer treatment
- Infertility related to age
- Donor gametes (eggs and sperm) or embryo or surrogacy
- Unknown cause of Infertility.
IVF treatment might be an effective solution for many infertile couples to achieve pregnancy. However, it’s not always a primary aid to infertility. Treatment such as fertility drugs and intrauterine insemination (IUI) is suggested prior to IVF, as IVF can be expensive for some people, and there’s the possibility of multiple pregnancies.
IVF Process - Step by Step
The IVF process follows a distinctive procedure. The treatment starts with finding the cause of infertility by some diagnosis protocol. The diagnosis can include the following:
- Bloodwork and urine tests: to check hormonal levels (FSH, LH, estrogens, anti-mullerian hormones, etc.), infectious diseases tests (HIV, AIDS),
- Transvaginal Ultrasound Scan: for ovarian reserve testing and checking fallopian tubes for blockages
- Uterine Examination: hysteroscopy or sonohysterography to check the uterine walls
- Complete semen analysis
- Mock embryo transfer: this is done to examine your uterus cavity and find the right spot for implantation during the IVF cycle.
Upon your medical evaluation, the next step is to construct an IVF program individualistic to you. Your doctor will create an effective IVF program based on your infertility factors and medical reports.
A standard IVF program includes 5-6 steps: superovulation or ovulation stimulation, egg aspiration, sperm collection, fertilization, and embryo transfer.
1. Superovulation or Ovaries stimulation - IVF Protocols
The first step of the IVF process is to stimulate your ovaries to produce more than one egg per month. More often than not, infertility in couples arises from women unable to produce enough healthy eggs for fertilization. If there are more eggs for fertilization, there are more chances for conception.
- Generally, the treatment starts on the first day of your menstrual cycle. You may be given birth control pills before the start of the IVF cycle to promote more egg production. Then the doctor will recommend you superovulation injectables containing FSH or LH for 8-14 days. During these days, your doctor will constantly examine your ovaries for follicular development via blood tests and ultrasound.
- Once the follicular size grows up to 16-18 mm, then the eggs are about to mature. Then your doctor will suggest you take a last ‘trigger shot’ of hCG (human chorionic gonadotropin) hormone exactly 36 hours before the egg retrieval. This is done to control the timing of your ovulation.
- You might also have to take an ‘antagonistic shot’ to prevent eggs from maturing too soon. These are different IVF protocols specific to the patients. Your doctor will decide what protocol you need, and you might not even need any medication called a natural IVF cycle. These medications are time-specific and self-administered. Moreover, they are pain-free. Your protocol may get cancelled if it doesn’t work for you, and you’ll have to follow a new protocol.
2. Follicular Egg Aspiration or Egg Pick-up (EPU)
After 34-36 hours of ‘trigger shot,’ the doctor will remove eggs from the follicles with the help of an ultrasound-guided needle. The procedure is performed at your doctor’s office during an outpatient appointment and won’t require hospitalization. You will be administered a local anaesthetic.
- The needle is inserted inside the uterus, and eggs are retrieved from the follicles with the help of a suction device attached to the needle. About 8-15 mature eggs are collected and placed in a nutritive cultural medium inside an incubator.
- It will only take 20-30 mins, and you will not feel any major pain, just minor cramping and fullness after the retrieval.
3. Sperm Collection
A fresh sperm sample is collected from your partner while your eggs are retrieved. If your partner can’t ejaculate properly, then PESA or TESA is performed for sperm aspiration from the testicle before the day of egg retrieval. Sometimes, pressure makes it hard for a male partner to provide a fresh sperm sample. For this reason, a sperm sample is collected in advance, and the sperm is frozen for future use.
The sperm sample is subjected to various tests and filtration in the laboratory to separate the healthiest sperm. The scientists use a defined microscope to hand-pick the best quality sperm.
4. In vitro Fertilization
Two methods can be used for fertilization in a lab:
- The sperm and eggs are placed in the same culture for fertilization. It can take 18-24 hours.
- Intracytoplasmic insemination (ICSI): The eggs are inseminated by a sperm by injecting it directly into the egg. This method is used when sperm quality is very poor for standard insemination.
The eggs and sperm samples are placed inside an incubator for embryo development.
5. Embryo Development
It can take 3-5 days for embryos to develop up to the stage where they might implant after transferring to the uterus. The embryos are monitored closely during the developing stage. Usually, the embryos are developed up to the blastocyst stage. A blastocyst has a better chance for implantation than 3-4 day embryos. The embryologists will pick healthy embryos by morphological and cytogenetic evaluation of embryos.
6. Embryo Transfer
Before the day of embryo transfer, the doctor runs some ultrasound screening to check whether your uterine wall is thick enough for implantation. They may recommend some medication to prepare your uterine lining for implantation on time.
- The embryo transfer procedure is performed at the doctor’s clinic under mild anesthesia.
- A long catheter tube is inserted into your vagina, through the cervix, and directly into the uterus. A syringe containing embryo(s) (dispersed in a fluid) is connected to the catheter.
- The doctor will carefully put the embryo(s) inside the uterus near the uterine walls with the help of the syringe.
An embryo can take 4-5 days for implantation after transfer and 6-10 after egg retrieval. There’ll be no pain after embryo transfer, but minor cramping and fullness are normal.
7. Pregnancy Test
It takes two weeks after embryo transfer to detect the clinical pregnancy. The doctor will do some bloodwork and ultrasound to confirm the pregnancy. After confirmation, your doctor will follow your pregnancy and prenatal care treatment.
If pregnancy doesn’t establish, your doctor will make a follow-up plan after considerable evaluation.
The chances for live birth are influenced by various factors such as maternal age, embryo quality, the lifestyle of the mother, the mother’s reproductive and overall health, cause of infertility. Talk to your doctor about how to increase your chances of live birth.
Complications of IVF Process
There is no major risk for IVF, but some complications are common for an IVF treatment:
- Multiple pregnancies: more than one embryo transfer can lead to multiple implantations and, eventually, multiple pregnancies or births.
- Mild cramping, spotting after embryo transfer, and egg retrieval.
- Recurrent IVF failure.
- Ovarian hyperstimulation syndrome.
Talk to your doctor about the concern of risk factors and how to lower them. Ask necessary questions before starting the IVF process.
IVF process in Delhi
We offer cost-effective IVF treatment with the highest success rate (50-58%) in Delhi. Our clinic is recognized as the best IVF center in Delhi, and we provide world-class IVF facilities. For more queries related to the IVF process in Delhi, and the IVF process in India, don’t hesitate to contact us or visit our clinic Risaa IVF, Green Park, New Delhi-110016.
The average cost of one IVF cycle in Delhi is 1.5-2 lakh (in INR) for IVF self cycle.
The average success rate of IVF treatment is 35-45% worldwide.
Yes, for the most part, IVF is fairly risk-free infertility treatment.
One IVF cycle can take between 4-6 weeks and more. But if one IVF cycle fails, then the treatment can take longer.
Yes, there are other infertility treatments like IUI as alternatives for IVF.