IVF Centre in Delhi (1)

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In Vitro Fertilization-I.V.F
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What do we mean by In Vitro Fertilization?
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Indications of In Vitro Fertilization - I.V.F
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There Are 7 Steps For I.V.F Procedure
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Blood Tests
Seminal fluid
Trans-Vaginal US
Fallopian Tube
US Scan - Uterus
Ovarian Follicles
First step Evaluation
US Scan - Ovaries
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Second step Ovulation Induction

• Producing many good follicles to be Fertilized.
• Short or Long protocols Is done by daily
  injections of gonadotropins.
• Regular monitoring by ultrasound scan is done.
• Following the follicular development and adjust
  the dose of the injections accordingly,
• After reaching certain size, the final maturation
  of those follicles is done by giving HCG.

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Third step Egg Retrieval (oocytes)

• Egg retrieval is done 34 to 37 hours post HCG
  injection.
• This procedure is considered as minor surgery.
• It is done under general anesthesia, using
  ultrasound guide.
• It takes 15 to 20 minutes. Not more than two
  hours are required for the patient to recover.
• Then, the patient can leave the hospital. A
  needle is used to aspirate all the follicles.
• The fluid is passed over to the embryologist, who
  identifies and separates the eggs.

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Fourth step Sperm and Egg Preparation

• The eggs are prepared and stripped from the
  surrounding cells.
• At the same time, sperm preparation is done using
  a special media.
• We need from 10,000-100,000 motile sperm to be
  put beside each egg in a special dish, this is
  called traditional I.V.F.
• It is different from intra-cytoplasmic sperm
  injection (ICSI, in which we need only one sperm
  to be injected in the cytoplasm of the egg)
• Which is indicated in cases where sperm is
  present in the testes but the semen fluid does
  not contain sperm.

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Fifth step Fertilization
After preparing the sperm, and the eggs are put
in the same dish, in cases of failed
fertilization we use ICSI procedure.
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Sixth step Blastocyst Day 5 Embryo

• After 16 to 18 hours after the eggs, called
  zygotes, are fertilized,
• They are cultured in special incubators to
  support division and development.
• In this step, if the couple has a history of
  certain genetic disease and the gene that is
  causing that problem is identified, we may do
  pre-implantation genetic diagnosis.
• Grading of the embryos is done using specific
  criteria.

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Seventh Step Embryo Transfer

• The Embryos are transferred into the uterus after
  2 to 5 days from the date of pick up.
• Depending on the quality and quantity of the
  embryos.
• Using a special embryo transfer catheter.
• The patient is given drugs to help support the
  implantation procedure.
• There is no need for a lengthy hospital stay
  after the embryo transfer procedure (usually one
  hour is sufficient).
• Residents of other countries can travel the next
  day if they wish.
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What are the percentages of success?
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Factors That Affects The Success Rate

• Regular cycle or not.
• Semen fluid analysis
• Sometimes AMH.
• Smoking.
• BMI (body mass index) and percent of fat in the
  body
• Health of the tubes.