Once
the eggs are fertilized (at this stage known as embryo), one or more embryos
are placed into the woman's womb through the cervix. The aim is to produce
multiple mature follicles to enhance the chance of fertilization and
pregnancy.
After IVF infertility treatment further injections or peccaries may be needed to support the
lining of the womb. Patient can do a pregnancy test about two weeks after
egg collection in their home country. If positive, a scan will be performed
in five weeks after eggs collection to confirm that is a good pregnancy and
make sure a baby is growing. Miscarriages can occur in any pregnancy but
there is also no increased or decreased risk after IVF. There is a small
chance about seven percent that the pregnancy may stick in the tube (entopic
pregnancy). If this occurs an operation is required to remove the pregnancy
and possibly the tube as well.
Intra Uterine Insemination (IUI): This is the method by which processed
semen is placed directly in the uterus with the help of a catheter. IUI can
be done in a natural cycle, however to get better results, it is usually
preceded by ovulation induction / Ovarian stimulation using approprite
fertility enhancing drugs.
Intra Cytoplasmic Sperm Injection (ICSI): ICSI is the technological
breakthrough in the field of IVF, which is used to overcome the inability of
sperm to fertilize an egg. In this technique a sperm is directly injected
into the cytoplasm of an egg in order to achieve fertilization. The steps
involved in ICSI procedure are exactly the same as for IVF, except that
fertilization is achieved with the help of a micromanipulator. In some cases
where there is a complete absence of sperm in the ejaculate, sperm can be
retrieved from the testis / epididymis and used for ICSI. The testicular /
epididymal sperm retrieval techniques are: PESA (Percutaneous Epididymal
Sperm Aspiration), MESA (Microsurgical Epididymal Sperm Aspiration), TESA
(Testicular Sperm Aspiration), TESE ((Testicular Sperm Extraction)
IVF using Donor Oocyte (Eggs): Women who are unable to produce their
own eggs or whose eggs fail to fertilize during an IVF cycle due to poor
Oocyte quality, can be helped by using other women's eggs (Donor Oocyte).
Replacement of donor embryos and surrogacy are other options available to
the infertile couple.
Assisted Hatching: The procedure is based on the fact that an
alternation in the zona pellucida (outer covering of the egg) either by
drilling a hole through it or by thinning it, will promote hatching or
implantation of embryos that are otherwise unable to escape intact from the
zona pellucida.
Cryo Preservation of Embryos: Excess (Surplus) Embryos can be
cryo-preserved at ultra low temperatures for many years. These frozen
embryos can be used subsequently without the need for ovarian stimulation
and egg retrieval. However the pregnancy rate following transfer of frozen
embryos is lower than that with fresh embryos.
Semen / Sperm Freezing: Semen/ Sperm or testicular biopsies can be
stored frozen at ultra low temperatures for a long duration for future use
or analysis.
Semen Bank: The Apollo hospital has its own semen bank. The bank
contains frozen sperm from voluntary donors, with various backgrounds and
physical characteristics to match individual needs. Donors are screened
thoroughly to rule out any transmission of infectious or genetic diseases.
Risks Involved
1. Multiple pregnancy
2. Ovarian Hyperstimulation Syndrome (OHSS)
3. Failure at different steps of IVF Surrogacy Treatment
4. Ectopic pregnancy
5. The incidence of congenital malformation in IVF babies is no more than
in the general population.
Success Rate
Apart from the expertise of the individual fertility clinic there are other
factors, which affect the ART outcome, such as patient's age and the variety
of abnormalities, causing infertility. Some of these abnormalities respond
well to IVF while others do not. This means that some patient will have a
good chance of pregnancy while others will have a poor chance. At present
the Apollo Hospital has a 30 - 40 % pregnancy rate per attempt.
Treatment Options Available
1. Ovulation induction / controlled ovarian stimulation
2. Intrauterine Insemination (IUI) Husband / Donor
3. In Vitro Fertilization (IVF) and Embryo Transfer
4. Intra Uterine Cytoplasmic Injection (ICSI)
5. Gamete Intra Fallopian Transfer
6. Sperm Retrieval techniques - TESA (Testicular Sperm Aspiration), TESE
((Testicular Sperm Extraction), MESA (Microsurgical Epididymal Sperm
Aspiration), PESA (Percutaneous Epididymal Sperm Aspiration)
7. Sperm Bank
8. Donor Oocyte Program
9. Donor Embryo Program (genetic surrogacy)
10. Blastocyst Culture
11. Assisted Hatching
