FAQ's IVF and ICSI

1. What is in vitro fertilization (IVF)?
What is ICSI?

IVF ICSI Procedure – Important things you need to know

Let’s talk about assisted reproduction procedures. IVF and ICSI come under Assisted Reproductive Technologies. IVF means in vitro fertilization in which the union of egg and sperm happens outside the human body in an IVF lab under appropriate conditions. Eggs are often fertilized in vitro by culturing eggs with many motile sperm.

ICSI is an advanced IVF technique in which sperm is injected into the egg manually using a thin glass pipette with higher technology and skills. This technique was developed to facilitate fertilization in cases of male-factor infertility but is now used in most IVF cycles. Selected Embryos are then transferred into the mother’s womb to achieve pregnancy.

2. Do I need to get admitted during IVF Procedure?

Hospital admission is not required for IVF treatment at Krishna IVF Clinic.

In IVF or ICSI, the ovaries are stimulated by daily injections of gonadotropins for follicular development, which is monitored utilizing transvaginal ultrasonography.

For this, the lady must visit the clinic daily at 8.30 am / 9 am for 10-12 days. The male visit is required only on the day of egg pick-up to give a fresh semen sample. Lady can come alone after 3-5 days for scheduled embryo transfer.

3. How to Prepare for an IVF Cycle at KrishnaIVF?

IVF treatment protocols are customized according to the couple’s needs and the severity of factors. Since we get a lot of poor responders after repeated failures, a long agonist protocol is followed at Krishna IVF. This is done in two phases- The preparatory phase and the proper treatment phase. Consider the first day of the bleeding as day one and make an appointment for a basal scan between the 18th to 24th day. The couple must plan 2 days visit for the preparatory phase. Lady basal scan is done, and after a couple of blood tests, the semen backup sample is frozen. Downregulation injection is the first injection given to the lady after taking a couple’s consent for ICSI.

The clinic will provide an appointment date after 3 weeks to start the 2nd phase of treatment. This proper treatment phase includes pre – IVF hysteroscopy on the first day followed by daily injections and alternate day scans for 10-12 days. Towards the end of stimulation, the last trigger injection is given at 7 pm. The male visit is required only on the day of egg pick-up to provide a fresh semen sample. 3-5 days later, the lady can come alone for embryo transfer. Serum beta hCG pregnancy test will be done 2 weeks later. Antagonist protocol is suggested in certain conditions, and stimulation begins on day 2 or 3 of the menstrual cycle.

4. What are the IVF side effects and risks of IVF Treatment?

The side effects would be ovarian hyperstimulation syndrome or OHSS during stimulation and twin pregnancy after treatment. OHSS cases may need hospitalization sometimes, but we take adequate precautions to prevent these complications by altering the dose of injections and transferring fewer embryos. The second side effect is multiple pregnancies which can be prevented by reducing the number of embryos.

5. What are the chances of getting pregnant with IVF?

The chances of getting pregnant are around 35% for couples less than 35 yrs. And 25% for more than 35 yrs. of age. In any IVF cycle, the possibility of getting pregnant is approximately 35%. IVF treatment is designed for multiple processes and never for a single cycle. Success depends on many variables, of which age and ovarian reserve are number egg reserve is an essential factors. The couple’s health also contributes to the outcome and other infertility factors. Realistic chances of getting pregnant in one or subsequent cycle are based on the severity of factors. In an individual couple, IVF success is the carry-home baby rate and not just pregnancy-positive results.

6. Doctor, Could my IVF cycle get cancelled?

On day 4 and day 6 of hormonal stimulation, if the follicle growth is less or E2 levels are not adequate, the cycle will be stopped. Sometimes, the response of the lady’s ovary to the stimulation injections is poor or excessive. In such situations, the process is cancelled for safety and to avoid further wastage of the couple’s money. One should not take these things wrongly when the chances are negligible despite best efforts. The clinic tries to balance the financials to outcome in the poor circumstances of the couple. Still, people misunderstand when we say chances are low in the middle of the treatment. They feel that this information is not adequately told in the beginning. A couple must try to understand the technical issues when such situations arise.

7. Is egg retrieval painful?

Doctor, Is oocyte retrieval painful? Do you give general anesthesia? Can I go home after oocyte retrieval and attend to my regular work?

Egg retrieval is the main procedure in IVF treatment. Therefore, 6-8 hours of fasting before the process are mandatory. The patient will not feel any pain because she is kept asleep under the care of an anesthetist during this procedure which lasts for just 10-15 minutes.

After this procedure, they can go home the same day and attend regular work the next day.

8. Precautions After Embryo Transfer?

Doctor, what are the precautions I must take after the embryo transfer? Is complete bed rest required after the embryo transfer? When should I come for confirmation of pregnancy?

Rest and abstinence are advised. Complete bed rest is not required. However, we recommend restricted work and movement activities to avoid any infection, fever, cough, or gastroenteritis in those cycles when the chances of pregnancy are there. By restricting activity, we limit the risk of getting a fever or using unwanted medications. That is the primary rationale behind the restricted movement. Many couples who undergo IVF think that if they sleep continuously or stay in bed always after embryo transfer, it will improve the chance of pregnancy.

The answer is a frank no because bed rest will not improve the embryo’s implantation process. Therefore, there is no need for bed rest after embryo transfer. No other medication should be taken without informing your doctor. You should come for a pregnancy test on the 14th day after embryo transfer.

9. Do’s & Don’ts during IVF treatment?

Doctor, what precautions must I take regarding food, work, sex, and medicines during IVF treatment?

There are no food restrictions during or after IVF treatment. A regular diet can be continued. . You can have breakfast and come for IVF scans and injections. Fasting for 6-8 hours is mandatory only before pre-IVF hysteroscopy and oocyte retrieval procedures. After embryo transfer, abstinence for 6 weeks is essential. You can take any medication only after consulting a doctor.

10. Male Infertility and TESE Surgery?

Doctor, What is TESE? Is there any medication to increase sperm count?

The maturation of Spermatozoa takes approximately 72 days. In human beings, sperm count will be in varying degrees. Hence repeated testing of at least two samples is required to confirm the diagnosis of male factor infertility. There are no medications to improve sperm counts. If motility and count are less, ICSI (Intra Cytoplasmic Sperm Injection) is performed through an instrument called a micro-manipulator. Suppose there is Obstructive Azoospermia due to obstruction in the passage of sperms. In that case, sperm retrieval is done by TESE – Testicular Sperm Extraction, and ICSI can be done by freezing the sample.