As mentioned earlier, in IVF treatment eggs are fertilised with sperm and then placed back into the womb for further pregnancy duration. This process, right from the selection of egg to be retrieved till the time of birth is a combination of series of steps. The procedure chosen may differ on the basis of medical condition of patient, legal regulations of the country, etc.
However, let us now take a brief look at some of the crucial stages in an IVF treatment:
Under this step doctors try to achieve generation of multiple healthy eggs for retrieval procedure. Factors like antral follicle count, anti mullerian hormone level serves a key role while performing ovarian hyperstimulation.
Also, GnRH agonist protocol and GnRH antagonist protocol are two major methods used under ovarian hyperstimulation so as to control spontaneous ovulation.
Interestingly, ovarian hyperstimulation can be achieved with or without using any drugs depending case to case.
In order to retrieve eggs just which they are fully mature, a trigger shot namely ‘human chorionic gonadotropin (hCG) is injected to assist ovulation. However, eggs are retrieved a few hours before they naturally rupture.
In this procedure, with the help of ultrasound lead needle the vaginal walls are pierced to reach ovaries. It is known as transvaginal oocyte retrieval. This may take around 45 minutes, depending upon number of folliciles to be retrieved.
Once the eggs are kept under laboratory culture be it metaphse1 or metaphase 2, the semen is washed so as to get rid of any inactive cells or seminal fluid before it is ready for use. This process is called sperm washing.
Under this stage eggs and sperm are co-incubated and kept in a culture media so that fertilisation can take place.
Cleavage stage: Two to four days after co-incubation.
Blastocyst stage: Five to six days after co-incubation.
Among various methods available to select the best quality of embryo, a morphological scoring system is termed to be the most appropriate strategy of all.
Embryos are placed into uterus using a thin plastic medical instrument known as catheter, which goes down the vagina and cervix. Number of embryos to be transferred depends upon various factors like patient’s age, relevant hormonal count, legal regulations, patients own choice, etc.
To ensure a successful implantation of embryos, during the luteal support progesterone, hCG, progestins, etc are given along with estradiol.
The cost for IVF treatment not just includes medication charges, consultation fees but also includes other sundry expenses such as travel, food and accommodation expenses that one has to bear every time they visit hospital during the treatment cycle.
Also number of pregnancy one wants to conceive (single, twins, etc) plays an important role in determining the cost of treatment.
Age, medical history, infertility duration of patient are some key defining factors for cost of IVF treatment.
In India, Assisted Reproductive Technology (Regulation) Bill 2020, was passed in December 2021 by Lok Sabha with a view to regulate IVF centres, egg and sperm banks etc.
However, using IVF as a measure of gender selection is banned under Pre-Conception and Pre-Natal Diagnostic Techniques Act, 1994.