Understanding Test Tube Babies First successful human pregnancy by in-vitro fertilisation and embryo transfer was performed in 1977 by Mr. Steptoe and Dr. Edwards.
Because the egg is fertilised with a sperm in the laboratory under artificial conditions (literally, in glass) it is called test-tube pregnancy. After fertilization the embryo is transferred into the uterus of the mother.
IVF is a treatment option for women with:
Besides a woman’s wish to conceive, certain factors that your doctor will consider are:
Although it seems to be a simple procedure, it is a very complex technique which is quite time-consuming and expensive. Even today, the technique is available to a very small proportion of the infertile population.
In-vitro fertilisation is very successful in making embryos in the laboratory, but implantation process is still not under our control. Every embryo transfer does not become a baby and this can be very frustrating and agonizing for both the patient and the doctor. Successful pregnancy occurs in 15-30 percent of the patients after in-vitro fertilisation.
In young patients with a severe tubal problem, the doctor may advise tubal surgery as even the low success rate after surgery is probably greater than the likely success of IVF.
After you are considered suitable for IVF your doctor will do a series of tests which will include tests such as semen analysis, semen culture and assessment of the menstrual cycle with hormone assays, ultrasound scan.
The major steps involved in an IVF cycle are:
Superovulation: In this stage, clomiphene and pergonal is usually given to stimulate development of more than one egg in a cycle. The basic idea is that if there are several follicles available for egg retrieval and fertilisation, then there are higher chances that at least one of the fertilised eggs will successfully implant. Growth and development of the follicles is monitored using blood and urine tests or by ultrasound measurement of the follicles.
Egg retrieval: Once the follicles appear mature and are ready for ovulation, 5000 units of hCG is given. Eggs are retrieved 33-36 hours after administration of hCG.
Methods used for egg retrieval are:
Laparoscopy: Under general anesthesia, the eggs are retrieved from the follicles using a very fine suction needle under laparoscopy.
TUDOR (Trans-vesical, Ultrasound Directed Oocyte Recovery): In TUDOR, eggs are retrieved from the follicles under local anesthesia. The suction probe is guided using ultrasound through the bladder. The major advantage of this technique is that eggs can be retrieved from an inaccessible ovary even if it is covered by adhesions.
Fertilisation: The harvested eggs are incubated for 4-24 hours in a specially prepared culture medium conducive to fertilisation in a laboratory dish. About 100,000-1,000,000 well prepared sperms obtained form the husband or donor are then added to the incubated eggs. Fertilisation generally occurs within the next 24 hours.
Embryo culture and Embryo transfer: The zygote is allowed to develop in the laboratory and after 2-3 days, the embryo is transferred into the uterus of the mother. The procedure is a painless and most women do not require anesthesia.
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