Dr Lukic talks IVF procedures, in simple terms
24/02/2009 23:26

In Vitro Fertilization

 The first test tube baby was born in 1978.  Since then IVF pregnancy rates have improved dramatically.  The technique was initially used for women with irreparable fallopian tube damage but it is now shown to be successful for other types of infertility too.  Common reasons for IVF are:

• 1. Blocked fallopian tubes
• 2. Endometriosis
• 3. Sperm problems
• 4. Ovulatory problems
• 5. Unexplained infertility

 The IVF procedure involves:

1 Pituitary suppression.

Drugs are used in the form of nasal sprays or injections to suppress your body's natural tendency to ovulate.  In a normal menstrual cycle only one egg is produced each month but with IVF it is preferable to try and stimulate more follicle development.  A follicle is a fluid filled sac in which eggs grow to maturity.  Between 5 and 10 follicles is ideal as any more starts to compromise quality and the risk of ovarian hyperstimulation increases. 

 2. Follicle Stimulation

Ovarian stimulation involves the use of Follicle Stimulating Hormone.  This is administered in an injectable form and patients are taught how to do this themselves.  It is given as a daily injection just under the skin for about 10 to 12 days. 

 3.  Ultrasound and Blood Tests

Serial ultrasounds are performed to monitor follicle growth and endometrial response and blood oestradiol measurements are taken.  The scan shows the number and site of developing follicles and each follicle has a potential to produce an egg.  Once follicle reach a diameter of 17 to 24 mm the egg are deemed mature and ready for ovulation.

 4  Ovualtion trigger.

HCG is used to trigger ovulation.  The timing of HCG administration is critical and egg collection is scheduled 35 hours later

 5. Egg Collection

Egg collection is performed using an ultrasound guided technique through the vagina.  The procedure can be performed with sedation or under general aneasthetic.  It is important to note that there is not always an egg in each follicle.  The ultrasound guided technique allows for more accurate aspiration of the egg as the doctor can guide the needle into each follicle and withdraw its contents. 

6. Fertilization

At the same time or just prior to egg collection a sperm sample is obtained from the male partner and prepared in culture medium.  The process is called sperm washing and the goal is to obtain the strongest and most active sperm from the ejaculate.  If IVF is chosen the sperm and eggs are placed together and incubated at body temperature.  Fertilization is assessed twenty four hours later.  ICSI is reserved for moderate to severe male infertility and in this case a single sperm is injected directly into each mature egg. 

 Some great sites to look at regarding IVF and fertility are -:

The Conception Zone (Dr Julie Lukic)

About IVF