M M Medical Centre & Diagnostics (Bavishi Fertility Clinic)

Hello friends!

I am Dr. Riddhi Doshi. Today I am going to talk about the process of IVF. What is IVF? How does this process work? I am going to answer these questions in the most simple way possible. IVF actually means In-vitro fertilization that is a union of the male gamete which is the sperm and the female gamete which is the egg. That fertilization, when done outside the body, is called as IVF or In-vitro fertilization. Now sperms can be directly retrieved through the semen sample by the masturbation process. Eggs cannot be retrieved directly from the body of the women. For that purpose hormonal injections are given to the women for a period of 10-12 days to stimulate her ovaries to grow a number of follicles. Then that follicular fluid is aspirated through a sonography probe with the needle puncture method.

Through that follicular fluid, the eggs are isolated under a microscope. The eggs which are retrieved are graded as per their maturity and the mature eggs are selected for fertilization. The fertilization of the egg and the sperm can be done by two ways- one is the conventional IVF method in which the sperm and eggs are simply kept together in a petridish and allowed to fertilize. The second method which is now more commonly used is called as the ICSI that is Intra Cytoplasmic Sperm Injection. Here the sperm is individually selected and injected in the egg and that's how the fertilization is done. This process takes place in the laboratory under strict septic conditions and performed by an embryologist. Once the fertilization is done, the embryos start to grow and they have certain number of days through which they progress. The mature the good quality high grade embryos are then transported into the uterus through a very thin catheter.

This is an office procedure called as the embryo transfer and it is a painless simple procedure which is done. Once the embryos are transferred, the medications are given for two weeks which involves support medications of Oestrogen and Progesterone hormone. Thereafter the pregnancy test is done through a blood test where the hormone level of beta hCG is checked. If the beta hCG level is positive the pregnancy is confirmed. This is how the entire process of IVF works. It is a simple process and there is lot of misconception regarding it being very complicated or causing lot of hardship to the patient. I hope I was able to help with this process.

Thank you.

Hi,

I am Doctor Riddhi Doshi. Today I am here to address the common myths and misconceptions related to assisted reproductive treatment.

First and foremost I would like to touch upon the fact that many patients in our population they feel that IVF or ART is an artificial mode of reproduction that some artificial component of reproduction is done in this treatment and which keeps them away from it and they don't opt for this kind of treatment. So, first of all, it is not an artificial method. it is an assisted mode of reproduction. The natural conception is assisted with the help of technology.

The second point about the misconception is regarding the injections which are given in the ART process. These are hormonal injections which are thought to be having long term side effects and that huge amount of injections are to be taken by the patient, so these hormones are basically naturally produced in the body but we are supplementing them from outside so that we get better yield of eggs, these injections have a stipulated duration of action after which they are eliminated from the body. They do not stay in the body to cause any long term side effects. If there is an underlying medical condition then the patient may have some unwanted side-effects of these injections but people attribute weight gain and liver problems and obesity and other things to these injections which is not true.

The third misconception is that bed rest is a must or a compulsion in IVF treatments. This is not true there is no scientific base to it. These treatments do not require the patient to disturb their routine schedule. They can do their job, household work when the treatment is going on, even when the pregnancy is conceived they can do their routine activities unless and until there is some complication in the pregnancy they need not take bed rest at all.

The fourth misconception is regarding azoospermia, that is nil count in the semen report of the male partner. It comes as a great shock and traumatic experience for the couple when they see this report and most of them believe that this report means it's the end of the story and they will have to take donor sperm to get pregnant. So first and foremost, I would like to clarify that azoospermia is not defined by a single semen report. one has to do multiple semen reports to say that the patient has azoospermia. Even after the azoospermia is there on the semen report, we do certain hormonal profiles that testosterone, FSH hormone to try and find out the cause of azoospermia. If it is treatable then it is treated then the count definitely improves and unless and until the testicular biopsy report says that it is azoospermia the patient still has a chance of having the biological offspring.

The next misconception I would like to address is regarding multiple pregnancies. So most people and population feel that IVF treatment or ART treatment is done then the couple will and definitely have multiple pregnancies, twins and triplets so that is not entirely wrong, it is not entirely true too. In IVF we do transfer more than one embryo for better success rate but that doesn't mean that all patients will get twins or triplets, there is a certain percentage around 20% that the patients will have twins or triplets and if the couple wishes to avoid multiple pregnancy, there is always an option of blastocyst or single embryo transfer which gives good results as transferring more than one embryo, so it is not true that multiple pregnancy is a rule in IVF.

The other misconception is a serious one, regarding IVF and the incidence of Cancer which I people are correlating and they think multiple IVF cycles lead to cancer. So a lot of research has been carried out, many studies have been done but there is no direct correlation with the number of IVF cycles causing cancer, especially of the ovaries. The risk of cancer is comparable to the general population.

The last misconception which I would like to address which is a bit rare but it requires to be spoken about is the concept of secondary infertility. So there is a mindset in our general population and people they also feel that once the couple has had a baby that fertility remains the same throughout the lifespan and they will always remain fertile and when they plan a pregnancy, it should happen naturally. Unfortunately, that's not the rule even once the one pregnancy has happened if there is some other factor like a tubal infection, tubal blockage. Which has occurred in that period of time, the couple may not be able to conceive naturally.

Also if the age has advanced then the hormonal profile can vary, the ovarian reserve can become less. So still they can have infertility which is then called a second infertility that also requires treatment and they also have better chances when they approach the fertility specialist at the right stage. So this is something which people should think about and go to the doctor at the right time.

I hope I have been able to clear and clarify the myths related to IVF. So people can have a better knowledge about it and approach it in a scientific way.

Thank you.