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IVF ICSI and Infertility treatment - II
Infertility treatment depends on the cause behind the infertility. When a couple fails to achieve pregnancy in normal way and using low-tech treatments, like medication or surgery there comes the ART technique to their rescue. In Vitro Fertilization (IVF) is a process by which an egg is fertilized by sperm In Vitro or outside the body, in a laboratory. Intracytoplasmic Sperm Injection takes the process one step further and involves the insertion of a single sperm directly into the cytoplasm of a mature egg using a special microinjection pipette.
The heartbreak of infertility can be devastating. After trying for many months and even years, some couples are not able to conceive and carry a pregnancy to term. Causes of infertility or reproductive problems include disease and aging. Male infertility is as common as female infertility.

Infertility or reproductive problems are often treatable with infertility drugs and high-tech procedures. Assisted reproductive technology (ART) is a group of different methods used to help infertile couples. ART works by removing eggs from a woman's body. The eggs are then mixed with sperm to make embryos. The embryos are then put back in the woman's body.

Infertility treatment plan will depend on the cause or causes behind your infertility. Infertility treatment also depends on whether the problem is from the woman's side, the man's side, both sides, or remains unexplained. The good news is that 85% to 90% of couples dealing with infertility are treated with low-tech treatments, like medication or surgery, with less than 3% being treated by Assisted Reproductive Technologies, like IVF, ICSI, Surrogacy.

When a couple fails to achieve pregnancy in normal way and using low-tech treatments, like medication or surgery there comes the ART technique to their rescue. Here presently we deal with the ART Technology - IVF and ICSI.

In Vitro Fertilization (IVF) is a process by which an egg is fertilized by sperm In Vitro or outside the body, in a laboratory. If the sperm fertilizes the egg, an embryo is formed which is allowed to develop in the laboratory and is then transferred into the women’s uterus where it will hopefully implant and develop further. The main steps in an IVF cycle are:

  1. Controlled Ovarian Hyper-stimulation (COH) and Follicular Monitoring.

  2. HCG Trigger and Oocyte Retrieval.

  3. Oocyte Culture, Insemination and Fertilization in the IVF Laboratory.

  4. Embryo Transfer

  5. Luteal Support

    Intracytoplasmic Sperm Injection (ICSI) takes the process one step further and involves the insertion of a single sperm directly into the cytoplasm of a mature egg (oocyte) using a special microinjection pipette (glass needle).

    Do I need IVF?

    IVF is indicated when alternative treatments are either unlikely to achieve a pregnancy or have failed to achieve a pregnancy or have failed to result in a pregnancy. If you have blocked fallopian tubes or extensive pelvic adhesions preventing the egg from entering the fallopian tubes, IVF is indicated. Another common indication for IVF is low sperm counts.

    Because IVF allows us super concentrate sperm, successful fertilization can occur even if your partner has low sperm counts. Infertility is said to be “unexplained” if you are unable to conceive in spite of all tests being normal. In this case, IVF is an option if you have failed to conceive with Intrauterine Insemination (IUI).  IVF may also be advisable if you have Polycystic Ovaries (PCOS) and if ovulation induction with or without IUI has not been successful. If you have mild to moderate Endometriosis, IUI may be tried before proceeding to IVF, but in case of severe Endometriosis, IVF may be advised directly.

    Do I need ICSI?

    Intracytoplasmic Sperm Injection (ICSI) has revolutionized the treatment of male infertility. ICSI is advisable if the male partner’s sperm count or number of motile sperm is very low or the morphology is excessively poor. Fertility Physician will advise you if ICSI is recommended for you based on the results of the Semen Analysis and other risk factors.

    Are birth defects more common in babies conceived using IVF / ICSI ?

    The percentage defect with IVF is roughly the same as in the general population (3-4%). The chances of birth defect after ICSI are rare. Some of the problems that caused the male infertility, however, may be genetic. In these cases, boys conceived with the use of ICSI may have inherited infertility issues as adults.

    What are the health risks for women undergoing IVF / ICSI cycles?

    The drugs used during IVF/ICSI may on occasion cause side effects. There is a small but significant risk of Multiple Pregnancies, Ectopic Pregnancy, Pelvic Infection and rarely Injury to nearby organs. Controlled Ovarian Hyper-stimulation (COH) is associated with a risk of Ovarian Hyper-stimulation Syndrome (OHSS). Symptoms of OHSS include the following in varying degrees of severity: nausea, vomiting, diarrhea, extreme bloating, rapid weight gain, difficulty breathing etc. These symptoms are closely monitored by the doctors to prevent the occurrence of hyper-stimulation.

    What to do with extra embryos that remain after Embryo Transfer?

    Extra embryos of good quality remaining after the embryo transfer may be frozen by the Vitrification procedure which gives an excellent survival rate. This makes future ART cycles simpler, less expensive and less invasive than the initial cycle, since the women do not require ovarian stimulation or egg retrieval.

    What are the success rates?

    Success rates are the result of years of experience and constant fine-tuning of stimulation protocols, laboratory culture conditions and embryo transfer guidelines. The most important factors determining the success of a cycle are the woman’s age and the reason for the infertility. If you are using your own eggs, on average, the younger you are the higher your chances of success. IVF and intra-cytoplasmic sperm injection (ICSI) success rates are very similar.

    Dr. Gautam Allahbadia, an IVF Fertility specialist is an expert in Assisted Reproductive Techniques. He performs in vitro fertilization (IVF), Donor Egg IVF, ovulation induction, intrauterine insemination (IUI) and intracytoplasmic sperm injection (ICSI)


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