Dr Nisha Bhatnagar
In recent decades, advancements in medical science have opened up new possibilities for couples struggling with infertility. One of the most groundbreaking developments in this field is In Vitro Fertilization (IVF). IVF has brought hope and joy to countless families worldwide, but its technical intricacies can be shrouded in mystery for many. So, lets try to demystify the science behind IVF, shedding light on the complex processes that make this fertility treatment possible.
Before delving into the technical aspects of IVF, it’s crucial to understand why couples might turn to this procedure. Infertility can result from various factors, including issues with sperm quality or quantity, irregular ovulation, fallopian tube blockages, or unexplained causes. IVF provides an alternative path to parenthood for couples facing these challenges.
The Basics of IVF
In Vitro Fertilization, literally “in glass fertilization,” involves fertilizing an egg with sperm outside the body. This process includes several key steps:
- Ovulation Induction: The woman is given hormonal medications to stimulate the development of multiple eggs in her ovaries. Monitoring is essential to track egg development, ensuring they are at the right stage for retrieval.
- Egg Retrieval: Once the eggs reach maturity, they are retrieved through a minimally invasive procedure known as transvaginal ultrasound-guided follicular aspiration. This involves a thin needle passing through the vaginal wall to collect the eggs.
- Sperm Collection: A sperm sample is collected from the male partner or a sperm donor.
- Fertilization: The eggs and sperm are combined in a laboratory dish, allowing fertilization to occur. This can happen through conventional insemination (mixing eggs and sperm) or Intracytoplasmic Sperm Injection (ICSI), where a single sperm is directly injected into an egg.
- Embryo Culture: Fertilized eggs, now embryos, are cultured in a controlled environment for several days to monitor their development and ensure their viability.
- Embryo Transfer: One or more healthy embryos are selected and transferred into the woman’s uterus, typically three to five days after fertilization. This step is minimally invasive and does not require anesthesia.
- Pregnancy Testing: Approximately two weeks after embryo transfer, a pregnancy test is performed to determine if the procedure was successful.
Advanced Techniques in IVF
While the basic IVF process remains the same, several advanced techniques have been developed to increase the chances of success and address specific infertility issues:
- Preimplantation Genetic Testing (PGT): PGT screens embryos for genetic abnormalities before transfer, reducing the risk of genetic disorders.
- Cryopreservation: Unused embryos can be frozen for future use, allowing couples to undergo additional cycles without the need for egg retrieval.
- Donor Eggs or Sperm: When one partner has fertility issues, donor eggs or sperm can be used in the IVF process.
- Surrogacy: In cases where carrying a pregnancy is not possible, a surrogate can carry the embryo to term.
- Single Embryo Transfer (SET): To minimize the risk of multiple pregnancies, a single healthy embryo is transferred, reducing potential complications.
- Laser-assisted hatching (LAH): It is a technique used in in vitro fertilization (IVF) procedures to assist with the embryo implantation process. The goal of LAH is to make it easier for the embryo to break out of its outer shell, known as the zona pellucida, and attach to the uterine lining for successful implantation.
- Microfluidics: Selecting sperm with specific characteristics or isolating high-quality sperm for various reproductive and assisted reproductive techniques can involve specialized techniques beyond traditional methods. Microfluidic devices can be used to sort and select sperm based on their motility, morphology, or DNA integrity. These devices use microchannels and fluid dynamics to separate sperm based on size, shape, or other physical characteristics.
In Vitro Fertilization is a remarkable achievement in reproductive medicine, offering hope and new possibilities for couples facing infertility. While the technical aspects of IVF may seem complex, they are based on a deep understanding of human biology and reproductive science. With ongoing advancements and research, the field of fertility treatment continues to evolve, providing even more options for couples seeking to start or expand their families. As science continues to demystify infertility, IVF remains a beacon of hope for those on their journey to parenthood.
Dr Nisha Bhatnagar is Medical Director, Aveya IVF and Fertility Clinic