This is the stimulation phase, which begins on Day 1 or Day 2 of menstrual cycle. In a normal menstrual cycle, the ovaries (egg bags) produce only one egg per month. But during IVF cycle, we aim to get more egg in order to enhance the chances of pregnancy. During this stimulation phase we give gonadotrophin (FSH and LH) injection for follicular growth (egg development) via subcutaneous injections. These injections need to be given for 8- 10 days depending on the patient’s response.
This is the monitoring phase during which we observe how follicles are developing via ultrasounds and blood tests. Based on these tests, the dose of injections if decided. We plan the trigger injection for final maturation of the egg once 3 or more follicles have reached 18mm size. The egg collection is then planned 36 hours following the trigger as we plan to collect the eggs before ovulation happens.
Egg retrieval or ovum pick up is a procedure where the eggs are collected from the ovaries. It is done under light general anesthesia in OT. It takes approximately 15-20 minutes for the procedure. The patient is discharged on the same day, about 4-6 hours after the procedure. It is done transvaginally, under ultrasound guidance, wherein the fluid from all the developing follicles in the ovary is aspirated and handed over to the embryologist to find the eggs.
On the day of egg collection, the husband is asked to produce the semen sample in a container supplied by the lab. If the husband cannot be present at the scheduled time or has a difficulty in producing the sample, we collect the semen sample in advance and the semen is frozen for use during the IVF treatment. The semen sample is processed to obtain highly motile sperm, which can then be used to inseminate the eggs.
Fertilization About 3- 6 hours following egg collection, a measured volume of sperm is added to the dish containing the eggs. The dish is placed inside the incubator to maintain the temperature and Ph for ideal conditions for culture of the embryos. The embryos are checked the next day for evidence of fertilization.
Embryo development The embryologist monitors the development of the embryos over a period of 2-5 days and keeps the couple updated about the fertilization, embryo development and quality of the embryos.
Embryo transfer Embryo transfer is done any day between 2nd day and 5th day, following egg retrieval. It is a simple procedure, does not require sedation and is done under aseptic conditions. The embryos are gently placed into uterine cavity via a fine catheter. The patient is allowed to go home the same day. At our center, we give progesterone supplementation in order to enhance the chances of implantation.
Blood test Following two weeks of embryo transfer, we will do a blood test to check the HCG hormone levels i.e. evidence of pregnancy.