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IN Vitro Fertilization

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Intrauterine Insemination (IUI) is a type of fertility treatment where specially prepared sperm is placed directly into a woman’s uterus using a thin catheter.
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IN Vitro Fertilization

What is in Vitro Fertilization (IVF) ?

In Vitro Fertilization (IVF) is a type of assisted reproductive technology (ART) where an egg is removed from a woman’s ovary, fertilized with sperm outside the body in a laboratory (literally “in glass”), and the resulting embryo is transferred back into the uterus to establish a pregnancy.
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When to Consider IVF

IVF is usually done when simpler treatments (like medicines or IUI) don’t work. You may need IVF if:

  • Blocked / Damaged Fallopian Tubes – eggs and sperm can’t meet naturally.
  • Severe Male Infertility – very low sperm count or poor sperm quality.
  • Endometriosis – moderate to severe cases affecting fertility.
  • Ovulation Problems – when medicines don’t help you release eggs.
  • Unexplained Infertility – when no cause is found after years of trying.
  • Genetic Conditions – to test embryos and prevent passing on diseases.
  • Age Factor – women over 35 or with low egg reserve.
  • Failed Other Treatments – if IUI or medications haven’t worked.
In short: IVF is considered when natural conception isn’t possible or other fertility treatments fail.

Types of IVF Treatment

Conventional (Stimulated) IVF

  • Ovaries are stimulated with medication to produce multiple eggs for retrieval.

Natural Cycle IVF

  • No stimulation drugs; uses the naturally selected egg.

Mild or Modified IVF

  • Uses lower doses of stimulation drugs to retrieve fewer eggs, aiming for safer, more cost-effective treatment.

Advanced Variants and Add-ons

  • Intracytoplasmic Sperm Injection (ICSI) : A single sperm is injected into the egg, especially useful in male-factor infertility.
  • Intracytoplasmic Morphologically Selected Sperm Injection (IMSI) : High-magnification selection of optimal sperm for injection.
  • Cryopreservation : Freezing embryos (or eggs/sperm) for later use.
  • Pre-implantation Genetic Diagnosis (PGD)/Screening (PGS) : Screens embryos for genetic disorders before transfer.

Step Process

IVF Procedure Explained

Step 1 : Ovarian Stimulation
  • Normally, a woman releases just one egg per month.
  • In IVF, the goal is to have multiple eggs so there are more chances of success.
  • The woman is given hormonal injections (FSH/LH-like medicines) for 8–14 days to help the ovaries grow several follicles (fluid-filled sacs containing eggs).
  • Monitoring is done with ultrasounds and blood tests to check follicle growth.
  • When the follicles are mature (about 18–20 mm), an injection of hCG (trigger shot) is given to finalize egg development.
  • 36 hours later, the eggs are collected.
  • The doctor uses a thin needle under ultrasound guidance, inserted through the vagina into the ovary to gently suction out the eggs.
  • This is done under light sedation or anesthesia — not painful, but some mild cramping may occur after.
  • On the same day, a semen sample is collected from the male partner.
  • If needed, sperm can be obtained through surgical techniques (TESA, PESA) or donor sperm can be used.
  • The sperm is then washed and prepared in the lab so only the healthiest ones are selected.

There are two main ways to fertilize the eggs in the lab:

  • Conventional IVF – The eggs and sperm are placed together in a dish, and fertilization happens naturally.
  • ICSI (Intracytoplasmic Sperm Injection) – A single, healthy sperm is directly injected into each egg (used in cases of male infertility or poor sperm quality).
  • After fertilization, the eggs become embryos.
  • The embryos are grown in the lab for 3–5 days.
  • Embryologists monitor them daily to check their development.
  • The best quality embryo(s) are chosen for transfer. Extra embryos can be frozen (cryopreserved) for future use.
  • A thin catheter (tube) is gently passed through the cervix into the uterus.
  • One or two embryos are carefully placed inside the uterine cavity.
  • This is a simple, painless procedure, similar to a Pap smear — no anesthesia needed.
  • After transfer, the woman takes progesterone supplements (pills, injections, or vaginal gels) to help the uterine lining support implantation.
  • This phase lasts about two weeks.
  • About 10–14 days after embryo transfer, a blood test (β-hCG) is done to check if pregnancy has occurred.
  • If positive → an early ultrasound is scheduled.
  • If negative → the couple may try again using frozen embryos or another stimulation cycle.

Results of IVF

  • Global Impact: By 2023, IVF and similar ART methods have resulted in over 12 million births worldwide.
  • Success Factors: Success varies based on age, embryo quality, and treatment protocols.
  • Add-on Treatments: Techniques like PGD, growth hormone, or supplements haven’t yet proven reliably effective and should be used cautiously.