What is In Vitro Fertilization?
Infertility is a disease or dysfunction of the reproductive system defined by the failure of regular unprotected intercourse. Infertility does not claim an individual’s life, it inflicts devastating emotional trauma on the couple.
Infertility was once considered as women’s problem, but the modern concept of the etiology of infertility connotes equal responsibilities to both partners. The causes of infertility hence are complex and multiple. The investigation of the infertile couples must begin with adequate history taking and physical examination of both partners.
Clinical evaluation of infertile couples may be grouped into
- Clinical evaluation
- Semen analysis
- Ovulation monitoring
- Assessment of tubal patency
- Tubal peritoneal defects
Based on the findings of these four basic investigations, all infertile couples can be broadly categorized into three groups
- Single defect in one of the partners.
- Multiple defects in one or more partners.
- Apparently no defects in ether partner (unexplained infertility).
ART provides a valuable treatment option for selected couples with a low probability of natural conception.
- Ovarian reserve testing. To determine the quantity and quality of your eggs, your doctor might test the concentration of follicle-stimulating hormone (FSH), estradiol (estrogen), and anti-mullerian hormone in your blood during the first few days of your menstrual cycle. Test results often used together with an ultrasound of your ovaries, can help predict how your ovaries will respond to fertility medication.
- Semen analysis. If not done as part of your initial fertility evaluation, your doctor will conduct a semen analysis shortly before the start of an IVF treatment cycle.
- Infectious disease screening. You and your partner will both be screened for infectious diseases, including HIV.
- Practice (mock) embryo transfer. Your doctor might conduct a mock embryo transfer to determine the depth of your uterine cavity and the technique most likely to successfully place the embryos into your uterus.
- Uterine exam. Your doctor will examine the inside lining of the uterus before you start IVF. This might involve a sonohysterography — in which fluid is injected through the cervix into your uterus — and an ultrasound to create images of your uterine cavity. Or it might include a hysteroscopy — in which a thin, flexible, lighted telescope (hysteroscope) is inserted through your vagina and cervix into your uterus.
IVF involves several steps — ovarian stimulation, egg retrieval, sperm retrieval, fertilization and embryo transfer. One cycle of IVF can take about two to three weeks, and more than one cycle may be required.
The treatment will begin with synthetic hormones to stimulate your ovaries to produce multiple eggs — rather than the single egg that normally develops each month. Multiple eggs are needed because some eggs won’t fertilize or develop normally after fertilization.
There are five basic steps to IVF:
Step 1: Stimulation, also called super ovulation which is already discussed in detail.
Step 2: Egg retrieval and semen preparation:
Step 3: Insemination and Fertilization
Step 4: Embryo culture
Step 5: Embryo transfer
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