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In vitro fertilization (IVF) – Intracytoplasmic Sperm Injection (ICSI)

IVF Treatment

In Vitro fertilization (IVF) is a method of assisted reproduction that involves combining an egg with sperm in laboratory dish. If the egg fertilized and begins cell division, the resulting embryo is transferred into the woman’s uterine lining and further develops. IVF by passes the fallopian tubes and its usually the treatment of choice for women who have tube damaged or absent tubes.  

The Process of IVF/ICSI – How is the IVF/ICSI done?

I. Basic Screening tests are performed on both partners.

In general, some testing of ovarian reserve should be done on the female prior to starting the injections. We use AMH as gold standard as well as D2-3 FSH, E2, P4 and antral follicle counts for this purpose. The results of these tests give us some information to predict her ovarian responses and also help us to administer to dose of injections.

II. Consents are signed by all parties

We use the consents form which is from The Royal Thai College of Obstetrician and Gynaecologists.

III. Controlled Ovarian Hyperstimulation

The woman is stimulated with injected medications to develop multiple follicles in the ovaries. Each follicle contains a microscopic egg. These injections continue to stimulate follicle and egg growth and development for about 8-10 days. Blood test for hormone and ultrasound scan is done 1-2 times to monitor the development of the follicles. After the follicles are in 16-18 mm. in diameter, injected medicine is used to trigger the final maturation. Then egg retrieval is performed 35-37 hours later.

IV. Egg Retrieval and fertilization

When a sufficient number of the woman’s follicles are mature, a transvaginal ultrasound-guided egg retrieval (egg aspiration) procedure is performed to remove the eggs from the follicles. At our IVF clinic, the average duration of the egg retrieval procedure is under 10 minutes, with a range of about 2-15 minutes. Powerful anesthesia medications are used so that the woman is “out” during this procedure and does not feel or remember anything. Pictures of In Vitro Fertilization Procedures

In Vitro Fertilization

In Vitro Fertilization

In Vitro Fertilization

In Vitro Fertilization

Around the time of egg retrieval, semen is collected. In case of a male partner is not available, frozen sperm may be used. The eggs are then fertilized in the laboratory with her partner’s sperm. If the sperm (or the eggs) are of poor quality, the ICSI procedure might be used to aid in fertilization. The embryos are cultured in the IVF laboratory for 2-6 days.

V. Embryo transfer

The embryo transfer procedure is done which places the embryos in the woman’s uterus where they will hopefully implant and develop to result in a live birth. This is like a Pap smear for the woman. There should be no discomfort. If there are leftover embryos (of sufficient quality) beyond the number that is transferred, many couples prefer to have them frozen (cryopreserved) for use in a future cycle. Embryo cryopreservation can be used for another attempt at having a baby if the “fresh” cycle fails or as an attempt to have another child if the fresh cycle is successful. We usually recommend the patient to be transferred only 1-2 embryos each time. We transfer routinely D5-D6 stage embryo, which is able to give highest success rate.

VI. Luteal Support

After eggs retrieval, the woman is given medicines for luteal support. The medicines comprise of 4-5 kinds varies from patient to patient. The medicines have to be used until pregnancy test. If the pregnancy test is positive, the woman has to continue the medicines until around 12 week gestation. These medicines help embryo for implantation.

VII. Pregnancy test

10 days after embryo transfer, the woman has blood test for pregnancy.

Success Rate

IVF live birth success rate statistics: success rates for IVF procedures vary considerably by the program handling the case. This is an important factor to consider and not well understood by many consumers of infertility and IVF services. Make sure that you discuss pregnancy and delivery success rates in detail with your doctor before you start a cycle. You should ask about their pregnancy and delivery rates for couples similar to you (e.g. same age group and diagnosis). At Safe fertility and PGD center, we achieve over all pregnancy rates around 40% in women under 40 years who using her own eggs. However, cumulative pregnancy rate is around 80% within three cycles. Our success rate in women n under 40 years old is around 60% in the first attempt and 90% if they don’t give up

What is different in success rate of fresh vs frozen embryo transfer?

Frozen Embryo Transfer achieved higher success rate than fresh embryo transfer.

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