In Vitro Fertilisation (IVF)

IVF is the process of fertilizing eggs with sperm, outside the uterus, in a petri dish in an IVF Laboratory. The resulting embryo with high implantation potential, is transferred back into woman’s uterus for a successful pregnancy. There are 4 main IVF treatment options available, depending upon your situation.

• IVF using own eggs and partner’s sperm
• IVF using own eggs and donor sperm
• IVF with donor eggs and partner’s sperm
• IVF with donor eggs and donor sperm.

IVF is the most effective fertility treatment available today with high chances of success rates. IVF is recommended for women suffering from blocked fallopian tube, endometriosis, ovulation disorders, premature ovarian failure, fibroids, male infertility factors, same-sex couples, single women and other unexplained infertility factors

IVF Process – Step-by-Step

Step 1: Meet an IVF specialists

Your first step towards building a family begins with meeting our IVF specialist. In order to determine the best approach for your treatment, our IVF specialist will conduct your fertility investigation during the initial consultation. You may be asked to undergo blood tests and ultrasound to check hormonal levels and assess your uterus and ovarian function. We will request you to provide us with relevant medical records and laboratory results, if you have already undergone some tests and treatments previously. If the infertility is due to a male factor, a semen analysis will be conducted. Based on your medical history, physical exams and test results, we will prepare a personalised treatment plan for you.

Step 2: Ovarian Stimulation

The first step of your IVF treatment is to stimulate the growth of follicles in your ovaries to produce more eggs than usual. If there are more eggs, then there is a greater chance of obtaining embryos to help increase your chances of pregnancy. Injections are administered using follicle-stimulating hormone FSH (in some cases, Luteinising Hormone, LH) to stimulate the maturation of a larger number of follicles containing eggs. The FSH stimulation is done over a time period of approximately 10-12 days and during this time we monitor the follicular growth through ultrasound and blood tests until it reaches the correct number and size. Once you have optimum number of follicles ready, an HCG shot is triggered for final maturation of eggs. This is usually done 36-40 hours before the scheduled egg retrieval.

Step 3: Egg Retrieval & Sperm Collection

Egg retrieval is a day procedure done under sedation. Eggs are retrieved by inserting an ultrasound guided thin needle into the ovary and aspirating the follicular liquid which contains the eggs from the ovarian follicle. Once the follicular liquid is removed, it is immediately passed on to the laboratory to ascertain whether it contains eggs. The retrieved eggs will be stored in a culture dish while, the sperm is being prepared for fertilization.
The same day of your egg retrieval, your partner can provide the semen sample to our lab. The best motile sperm is selected to fertilise with the eggs.

Step 4: Embryo Transfer

Embryo transfer is comparatively a minor procedure, in most cases, sedation is not required. The eggs and sperm are combined for fertilization. Between day 3 and 5 after fertilization, the best embryo with a highest implantation potential is selected for transfer. At this stage, couples with higher chances of passing on any genetic diseases can consider genetic screening of the embryo Preimplantation Genetic Diagnosis (PGD). The highest quality embryo is inserted into a thin catheter and is transferred into the uterus through the cervix. Most women are able to continue with their routine activities the next day after the embryo transfer. Two weeks after the procedure, blood tests are conducted to confirm pregnancy.

Intracytoplasmic Sperm Injection (ICSI)

Intracytoplasmic Sperm Injection is an assisted reproduction technique in which a single motile sperm is selected, immobilized and is injected directly into an egg using a micromanipulator. ICSI is usually recommended when the basic semen analysis and sperm function tests demonstrate an evident male infertility or in cases of previous repeated fertilization failures. However based on your fertility evaluation our doctors will be able to determine the best treatment plan for you.

ICSI Procedure

Ovarian stimulation

ICSI treatment begins with stimulation of your ovaries by injecting FSH (Follicle Stimulating Hormone) or in some cases LH (Luteinising Hormone) on day 2 or 3 of your menstrual cycle. During this time follicular growth is monitored through ultrasound scan until the follicle reaches the correct size and number. As this point, the HCG shot is triggered to induce ovulation and release the egg.

Egg retrieval

Eggs are retrieved by inserting a thin ultrasound guided needle into an ovarian follicle and aspirating the fluid from the follicle. This procedure is done under sedation. The retrieved eggs are stored in a culture dish in an IVF lab.

Sperm collection and ICSI procedure

On the day of egg retrieval your partner can give the sperm sample to be prepared for fertilization with the egg. Eggs are denuded immediately after the retrieval, to facilitate the injection. Denudation means removing the cumulus cells surrounding the oocyte. During this time, a single highly motile sperm is prepared and immobilized for efficient fertilization. This single sperm is directly injected into the egg using a micromanipulator and the technique is done under an inverted microscope under high magnification.

Embryo transfer

The day after ICSI procedure we will be able to know how many eggs are fertilised and have reached embryo stage. In the next 2 or 3 days, the embryos with highest developmental potential are selected and implanted into the woman’s uterus through a thin catheter. The embryos that are not used are cryopreserved for any future IVF cycles.