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An overview of In Vitro Fertilization
An overview of In Vitro Fertilization
In vitro fertilization or IVF is a medical technique, which is highly beneficial for the couples not able to conceive even after undergoing infertility treatment. The IVF procedure is also called as assisted reproductive technology or test-tube baby procedure. The IVF procedure involves union of the egg and sperm under artificial conditions in the laboratory. The egg and sperm taken from the couple are made to fertilize outside the human body and the resulting embryo will be placed in the uterus of the female partner.
Natural process of fertilization
In the usual process of fertilization, the sperm enters the uterus and reaches the egg to fertilize it inside the fallopian tube of the female reproductive system. The fertilized egg moves through the fallopian tubes into the uterus and gets embedded there. The implanted zygote in the womb starts dividing and develops into the embryo. The embryo further divides and develops into a baby in nine months period. This is the actual process that happens in the natural conception or unassisted conception. Here, the woman becomes pregnant naturally.
Artificial or modified process of fertilization
In the case of assisted reproductive method or IVF, the woman is made to become pregnant using an artificial medical procedure. The IVF has been in use since the year 1978 and has successfully resulted in allowing several couples to conceive. The IVF is followed when all other fertility treatments are not working anymore.
IVF is basically performed for treating few causes of infertility such as advanced age of the woman, fallopian tube blockage, reduced sperm count, endometriosis and infertility due to some unknown reasons. The above causes are overcome by the IVF procedure and it can make the woman becoming pregnant.
The sequential steps involved in the IVF procedure are:
- Super ovulation: The woman is administered with fertility drugs, which enhances the production of eggs in the ovarian follicles. Usually, it is observed that one mature egg is released per month in every woman. The ovulating drugs help in the production of more than one egg in the ovaries. Transvaginal ultrasound is carried out regularly during the period to monitor the ovaries and relevant blood tests are done to observe the hormone levels.
- Egg retrieval: The eggs are collected from the follicles in the ovary through a procedure called follicular aspiration. Follicular aspiration is a small surgery, where the eggs are sucked into a needle sent via the vagina and into the ovarian follicles with the ultrasound guidance. The woman will be unconscious during the egg retrieval and might experience mild cramps after the surgery. If there are no eggs produced by the woman, donated gametes are used.
- Insemination and Fertilization: The sperm and egg that are collected from the couple are made to fertilize by injecting a best sperm into the best egg under controlled laboratory conditions. This process is called as intra-cytoplasmic sperm injection or ICSI. Sometimes, it might happen that the sperm and egg stored together in the controlled chamber can get fertilized without manual intervention (injection) to unite them.
- Embryo culture: The egg after fertilization starts dividing to form the embryo. In a period of five days, the embryo will be actively dividing and can be used for implanting it in the womb of the woman. The couples who feel that they might transfer a genetic disorder will have the chance of selecting embryos, which have the lesser risk of transmitting their disorder to the child. The selection is done following a procedure called pre-implantation genetic diagnosis.
- Embryo transfer: The artificially cultured zygote transforms into the embryo in three to five days. The five-day-old embryo will be placed in the womb of the woman with the help of a catheter. The embryo will stick to the uterus wall and grows, resulting in pregnancy. Depending on the number of successfully implanted embryos, the woman gives birth to that many babies.
Genetic test to improve IVF outcomes
Recently, Queensland fertlity group and IVF Australia introduced a genetic test called karyomapping that improves treatment access and enhances the chances of live birth of the child for the couples who wish to avoid the transmission of genetic disorders to the children. The couple undergoing IVF and already suffering from serious genetci disorders like hemophilia and cystic fibrosis, can have their embryos tested with karyomapping for the preimplantation genetic diagnosis.