In-Vitro Fertilization (IVF) in India

In Vitro-Fertilization, commonly known as IVF, encompasses a complex series of procedures designed to facilitate pregnancy. In cases where multiple embryos are implanted in the uterus, there is a potential for a multiple pregnancy, resulting in the birth of more than one baby.

It serves as a remedy for infertility, a condition that typically manifests when couples are unable to achieve pregnancy after a year of concerted efforts. In-Vitro Fertilization (IVF) can also be employed to prevent the transmission of genetic disorders to offspring. The likelihood of a successful, healthy pregnancy through IVF hinges on various factors, including age and the underlying cause of infertility. Moreover, it's important to note that In-Vitro Fertilization (IVF) entails a series of procedures that can be time-consuming, financially demanding, and invasive.

Before embarking on an In-Vitro Fertilization (IVF) cycle, you and your partner will likely undergo a series of screening tests. These tests encompass:

• Medical History: Your doctor will take a detailed medical history, including information about your menstrual cycles, previous pregnancies, surgeries, and any underlying medical conditions.
• Physical Examination: It is performed to assess your overall health and identify any physical factors that could affect fertility.
• Ovarian Reserve Assessment: This entails blood tests to gauge the quantity of eggs available in your body, also known as your egg supply. These results, often complemented by an ovarian ultrasound, help to predict how your ovaries will respond to fertility medications.
• Hormone Testing: Blood tests may be conducted to measure hormone levels, including follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, and anti-Müllerian hormone (AMH). These tests provide insights into ovarian function and egg reserve.
• Semen Analysis: Semen, the fluid housing sperm, undergoes evaluation to assess sperm count, morphology (shape), and motility (movement). This assessment may form part of the initial fertility evaluation or may be conducted shortly before commencing an IVF cycle.
• Infectious Disease Screening: Both you and your partner will undergo screening for infectious diseases like HIV.
• Mock Embryo Transfer: This procedure does not involve the insertion of a real embryo into the uterus but serves to determine the depth of your uterus. It also aids in identifying the most suitable technique for when one or more actual embryos are later inserted.
• Uterine Examination: A thorough examination of the uterine lining is conducted before commencing in-vitro fertilization (IVF). This examination may involve sonohysterography, where fluid is introduced into the uterus via a slender tube through the cervix to enhance ultrasound imaging, or hysteroscopy, which employs a slender, flexible, illuminated telescope inserted through the vagina and cervix to visualize the uterine interior.
• Genetic Testing: Depending on family history and ethnicity, genetic testing may be recommended to assess the risk of inherited genetic disorders.

Typically, in a woman's body, an egg and sperm join together, and if the fertilized egg attaches to the uterine lining and develops, a baby is born approximately nine months later. This natural process is referred to as unassisted or natural conception.

In Vitro-Fertilization (IVF) is a type of assisted reproductive technology (ART) that employs specialized medical methods to aid a woman in achieving pregnancy. It is commonly considered when other, more cost-effective fertility treatments have been unsuccessful.
In-Vitro Fertilization (IVF) involves five primary stages:

1. Stimulation (also known as Super Ovulation):

• Fertility medications, referred to as fertility drugs, are administered to stimulate egg production in the woman
• Normally, a woman produces one egg per month, but fertility drugs encourage the ovaries to produce multiple eggs
• Throughout this phase, the woman undergoes regular transvaginal ultrasounds to assess ovarian activity and hormone level monitoring through blood tests

2. Egg Retrieval:

• A minor surgical procedure called follicular aspiration is conducted to extract the eggs from the woman's body
• This procedure typically takes place in a doctor's office and involves providing pain-relieving medications to ensure the woman's comfort
• Using ultrasound guidance, a thin needle is inserted through the vagina into the ovaries and follicles containing the eggs. The eggs and surrounding fluid are gently aspirated
• The procedure is repeated for the other ovary if necessary. In rare cases, pelvic laparoscopy may be employed to retrieve eggs. If a woman cannot produce eggs, donated eggs may be an option

3. Insemination and Fertilization:

• The male partner's sperm is combined with the highest quality eggs in a process called insemination
• The resulting embryos are incubated in a controlled environment. Typically, fertilization occurs within a few hours after insemination
• In cases where fertilization is expected to be challenging, a technique called intracytoplasmic sperm injection (ICSI) may be used, where a sperm is directly injected into the egg

4. Embryo Culture:

• As the fertilized egg divides, it transforms into an embryo. Laboratory personnel regularly monitor the embryo's growth
• Around five days after fertilization, a typical embryo consists of several actively dividing cells
• Couples at risk of passing on genetic disorders to their child may consider pre-implantation genetic diagnosis (PGD), which involves screening a single cell or cells from each embryo for specific genetic conditions.

5. Embryo Ransfer:

• Embryos are placed into the woman's uterus 3 to 5 days after egg retrieval and fertilization
• This procedure occurs in a doctor's office, and the woman remains awake. A catheter containing the embryos is gently inserted into the vagina, through the cervix, and into the uterus
• Successful implantation of an embryo into the uterine lining can result in pregnancy
• Multiple embryos may be transferred at once, potentially leading to twins, triplets, or more, with the number of embryos transferred being influenced by various factors, including the woman's age
• Unused embryos can be frozen for future use, either for implantation in the woman or for donation.

Following are certain complications linked to In-Vitro Fertilization (IVF):

• Emotional & financial set back: In-Vitro Fertilization (IVF) demands significant physical and emotional resources, as well as a substantial investment in terms of time and finances. Many couples grappling with infertility experience stress and depression as a result.
• Fertility Medication side effects: Women undergoing fertility medication treatments may encounter side effects such as bloating, abdominal discomfort, mood swings, headaches, and other adverse reactions. Repeated injections associated with IVF can lead to bruising.
• Ovarian Hyperstimulation Syndrome (OHSS): In rare instances, the use of fertility drugs may lead to a condition known as ovarian hyperstimulation syndrome (OHSS). This condition results in an accumulation of fluid in the abdomen and chest, accompanied by symptoms like abdominal pain, bloating, rapid weight gain (typically 10 pounds or 4.5 kilograms within 3 to 5 days), reduced urination despite adequate fluid intake, nausea, vomiting, and breathlessness. Mild cases may be managed with bed rest, while more severe instances necessitate fluid drainage using a needle and potentially require hospitalization.
• Reactions to Egg Retrieval: Potential risks associated with egg retrieval encompass reactions to anesthesia, bleeding, infection, and harm to nearby structures, including the bowel and bladder.
• Multiple Pregnancies: The placement of more than one embryo in the uterus carries the risk of multiple pregnancies, which can heighten the chances of premature birth and low birth weight. However, the impact of IVF on the likelihood of birth defects remains uncertain.

Following the Embryo Transfer, the woman may be advised to take it easy for the rest of the day. Full bed rest is generally unnecessary unless there's an elevated risk of OHSS. For most women, they can resume their usual activities as early as the next day.

Women undergoing IVF are required to receive daily injections or take oral progesterone supplements for a period of 8 to 10 weeks after the embryo transfer. Progesterone is a hormone naturally produced by the ovaries, which prepares the uterine lining to facilitate embryo attachment. It also supports the growth and establishment of an implanted embryo in the uterus. In some cases, a woman may continue taking progesterone for 8 to 12 weeks after confirming pregnancy. Inadequate progesterone levels during the initial stages of pregnancy could increase the risk of miscarriage. Around 12 to 14 days following the embryo transfer, the woman will revisit the clinic for a pregnancy test.

If you have undergone IVF and experience any of the following symptoms, it's crucial to promptly contact your healthcare provider:

• High fever
• Pelvic discomfort or pain
• Significant vaginal bleeding
• Presence of blood in the urine

Couples who underwent IVF experienced a significant rise in their overall life contentment levels 6 and 12 months following the birth of their child, along with a reduction in stress and anxiety. However, life after in-vitro fertilization (IVF) can vary widely depending on the outcome of the treatment. If the IVF treatment is successful and you become pregnant, your life will soon be filled with the joys and challenges of pregnancy, childbirth, and parenthood. This includes prenatal care and preparing for the arrival of the baby. Once you become parent, you have to adjust to the responsibilities of being a parent including adapting to sleepless nights, feeding schedules, and the overall demands of raising a child. Parenting is a lifelong journey, and it's essential to be ready for the challenges and joys it brings.

The success rates of IVF are contingent on various factors, such as the cause of infertility, the location of the procedure, whether eggs are fresh or frozen, whether you are using donated eggs or your own, and your age. In the United States, data is typically reported based on the number of live births per egg retrieval, not per treatment cycle. In 2019, the average live birth rates per egg retrieval were as follows:

• Age below 35: 46.7%
• Age between 35 to 37: 34.2%
• Ages between 38 to 40: 21.6%
• Ages between 41 to 42: 10.6%
• Ages 43 and above: 3.2%

If you or a loved one is facing the difficult journey of overcoming infertility, its reassuring to know that the costs related to In-Vitro Fertilization (IVF) in India are remarkably affordable, all while maintaining a high standard of healthcare that meets global excellence.

Here are the factors that influence the cost of IVF in India:

• Complexity of the Case: If the couple has experienced multiple IVF failures, the cost of IVF may increase based on the complexity of their case
• Embryo Freezing Expenses: Many couples opt to freeze their embryos for future use. Thawing and transferring these frozen embryos to the woman's uterus when needed can add to the overall treatment cost.
• Patient's Age: The age of the patient plays a significant role in IVF success rates. Older patients may require multiple cycles to achieve a positive outcome, while younger women have higher chances of successful IVF within the initial cycles due to a larger pool of viable eggs.
• Donor Sperm or Egg: Couples dealing with infertility may need to consider using donor eggs or sperm, depending on their specific requirements, which can affect the overall cost.
• Doctor's Expertise: The cost of consultation and follow-up treatment may vary based on the expertise of the infertility specialist. Highly experienced doctors who have a successful track record may charge more than others.
• Donor Embryos: Some couples with severe health conditions or infertility problems opt for donor embryos, typically provided by couples who have successfully completed their own IVF cycles and no longer need their excess embryos.
• Overall Health: Unhealthy habits and the patient's medical history can impact the treatment cost, as these factors may require additional medical attention and care.
• Semen Quality: Poor semen quality can reduce the chances of successful IVF, as low-quality sperm may struggle to fertilize the egg. This can influence both the cost and the outcome of the treatment.

The cost of In-Vitro Fertilization (IVF) diagnostics are:

MedFlick, your trusted healthcare companion, is dedicated to ensuring that your medical journey goes as smoothly and successfully as possible.

• Individualized Guidance: Personalized guidance throughout your medical journey.
• Access to a broad network of prominent hospitals, top doctors, and skilled surgeons.
• Transparent and Competitive Pricing: A full breakdown of treatment costs that eliminates surprises and offers you cost-effective solutions.
• MedFlick provides everything from travel arrangements to hotel and visa help to lodging.
• Multilingual Support: Breaking down language barriers to allow patients and medical professionals to communicate more effectively.
• The road to a successful in-vitro fertilization (IVF) treatment procedure is long and winding, full of hope, resilience, and the promise of a brighter future. With MedFlick as your guide, navigating this life-changing adventure becomes simple and liberating.