In Vitro Fertilization: Definition, Types and Procedures
The Ultimate Method to Conceive a Child
In Vitro Fertilization (Test Tube Babies)
The colloquial term for babies conceived as the result of IVF is “test tube babies.” The IVF process involves the removal of the egg and sperm from the parents, fertilized and cultured for 3-5 days in Petri dishes before being transplanted into the mother’s womb. The success rate of IVF is around 30%, and chances are higher for repeated implantation.
What is In Vitro Fertilization (IVF)?
Artificial insemination takes place between a matured egg retrieved from the mother’s ovary, and sperm that is retrieved from the father’s semen. After fertilization, the fertilized egg is cultured for another 3-5 days in a Petri dish before being transplanted into the mother’s womb.
In the situation where the man is suffering from azoospermia, sperm may be retrieved via surgery. Depending on the man’s age and a variety of reason, there are many other ways to perform sperm retrieval.
IVF treatment is recommended for infertility reasons such as tubal blockage, low sperm mobility, anti-sperm antibodies, endometriosis, uterine malformations or uterine fusion, early menopause, or unexplained infertility. It is commonly assumed that there are differences between IVF babies and naturally conceived babies, along with increased chances of miscarriage and abnormalities for IVF babies. However, there is no significant difference between IVF babies and naturally conceived babies. Based on statistics, the miscarriage rate is around 12-15% in natural pregnancy and 20% in IVF pregnancy. As for deformations and other abnormalities, the percentage of both IVF and natural pregnancies are similar.
The success rates for IVF treatments are around 30-40%, and expenses are relatively high due to the need for repeated procedures.
The Procedures of IVF Treatments
Eggs fertilized via IVF are cultured for 3-5 days before being transplanted into the uterus for implantation. If there is no menstruation 16 days after IVF and the pregnancy hormone HCG is detected, it means that the IVF treatment has been successful.
1 - Undergo Infertility Tests before IVF
Before attempting IVF, you need to determine whether the uterus, ovulation and egg’s acceptance of the sperm are all normal and functioning. Also, general liver and kidney functionality tests and urine examination are also necessary.
In the natural course of ovulation, one egg will be matured and produced by the ovary every month, and it may be hard to determine the ovulation day for fertilization. However, the usage of ovulation-inducing agents will allow more eggs to be matured simultaneously and hence, increasing the chances of a successful pregnancy. There are two options for ovulation drug therapy: Oral or Injection.
3- The Timing for Egg Entropy
For IVF to be successful, it is crucial to harvest the egg at the appropriate time.
It is recommended that the ovulation-inducing agents are applied for 7-10 days within the first three days from the start of menstruation. To determine the maturation of the ovarian follicles and set a day for egg harvesting, ultrasound and blood tests are required. Once a date has been established for the harvesting of the egg, the man is required to practice abstinence to conserve semen for sperm harvest.
4 - Retrieval of Sperm and Eggs
The egg may be harvested once the ovarian follicle has matured. There are two types of egg harvesting methods: Vaginal Ultrasound and Laparoscopic Surgery.
For vaginal ultrasound, the woman is placed under anaesthesia and a guided needle is used to retrieve the egg. If the follicle is too deep for the guided needle to reach, a Laparoscopic surgery will then be necessary to retrieve it. Semen is collected around 2-3 hours after the egg has been harvested. However, only the strongest sperms will be utilized for the fertilization.
5 - In Vitro Fertilization and Culture
During a natural pregnancy, the egg only enters the fallopian tube when it is fully matured. However, the egg is harvested directly from the follicle before ovulation during IVF, so it will need to complete maturation via artificial methods. Hence, the egg is allowed to mature for around 30 hours in its medium after it has been retrieved. Once the egg is fully developed, the harvested sperm will then be allowed to fertilize the egg. According to statistics, the fertilization rate for a fully matured egg is increased by 70-80%.
6 - Embryo to Uterus Transplantation
The fertilized egg is then allowed to be cultured into the 8-cell stage or for 5 days before its transplantation into the uterus. It is common to encounter cervical obstruction during transplantation, so ultrasound may be used to help the needle insert directly into the uterine cavity for embryo transfer and complete the migration.
7 - Wait for Implantation
Once the IVF procedures are complete, leave the embryo to complete the migration naturally. If you do not get your menstruation around 16 days after the egg has been harvested, a blood sample is sent to the HCG for examination of HCG.
Types of IVF Treatments
Tubal Transplantation (GIFT method)
After the extraction of the egg and the sperm, they are placed together at the opening of the fallopian tube to be fertilized naturally. This approach may also be applied even if there is only one fallopian tube.
This technique is suitable for women with ovulation abnormalities but well-functioning fallopian tubes. Tubal Transplantation is a shorter process than IVF and results in approximately 30% success rate.
Zygote Intrafallopian Transfer Technique (ZIFT method)
In this approach, the extracted sperm and egg are in vitro fertilized. After which, the resulting zygote is placed into the fallopian tube by the use of laparoscopy. The success rate of pregnancy using this technique is around 30-40%.
This process involves preserving an embryo at -196 degree Celsius, generally at an embryogenesis stage corresponding to pre-implantation, that is, from fertilization to the blastocyst stage. This technique is useful for leftover embryos after a cycle of in vitro fertilization, as patients who fail to conceive may become pregnant using such embryos without having to go through a full IVF cycle. Hence, embryo cryopreservation is both time and cost-effective.
For men with low sperm count or reduced sperm mobility, natural fertilization might pose a challenge, which requires micromanipulation techniques to aid with fertilization. This process involves the sophisticated technique of microinjection of the spermatozoa directly into the cytoplasm of the egg, which normally result in 30% successful pregnancy rate.
Artificial Insemination via Donated Sperm
In the situation where the man is suffering from azoospermia or low sperm mobility, donated sperm may be used for the artificial insemination instead. The success rate for such artificial insemination is about 15% and even if the procedure fails, further implementation may be continued.
There will be insufficient secretion of cervical mucus during artificial insemination and sperm will not be able to enter the uterus naturally. Hence, for artificial insemination, a syringe pre-filled with semen will be injected directly into the bottom of the uterus during ovulation day.
In general, IVF is another method in having a child but if a couple is really persistent in undergoing this method; they should prepare a huge amount of money since this procedure is costly.