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How IVF Works, The Process Day by Day, Do's n Dont's

The literal meaning of in-vitro (in Latin) means in the glass. IVF, in vitro fertilization, means fertilization of sperm and egg in the glass, or outside the body. IVF is indeed the foremost treatment model that has been invented to help millions of childless couples over the years. Newer technologies that are introduced are primarily to make IVF a better treatment option for couples.

IVF treatment (also known as test tube baby treatment) though may seem a little expensive but is not with better technologies and treatment options increasing the success rate. More than 1 in 5 couples need Fertility treatments to conceive. And around 8 million babies have been born to date since 1975. These “test-tube babies” are as normal as babies born through natural conception.

The In Vitro Fertilization (IVF) process can vary depending on the clinic and the patient’s individual needs. However, here is a general overview of the IVF process with a step-by-step guide from day 1 to day 30:

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  • Day 1: Menstrual Cycle Start
On the first day of your menstrual cycle, you’ll visit the clinic for a baseline evaluation, which includes blood tests and an ultrasound to check your hormone levels and the number of follicles in your ovaries
  • Day 2-4: Ovarian Stimulation
You’ll begin daily injections of fertility drugs to stimulate your ovaries to produce multiple eggs. You may need to continue these injections for 8-14 days, depending on your body’s response to the medication.
  • Day 5-7: Monitoring
You’ll have regular monitoring appointments to check the development of your follicles and hormone levels. These appointments will include blood tests and ultrasounds.
  • Day 8-10: Trigger Shot
Once your follicles have reached a certain size, you’ll receive a trigger shot to prepare your body for ovulation.
  • Day 11-12: Egg Retrieval

About 36 hours after the trigger shot, you’ll undergo an egg retrieval procedure. You’ll receive anesthesia to ensure that you’re comfortable during the procedure, which involves using a needle to remove eggs from your ovaries.

  • Day 13-14: Fertilization

After the egg retrieval, the eggs will be fertilized with sperm in a lab dish. This process is called insemination or ICSI (Intracytoplasmic Sperm Injection), depending on the case.

  • Day 15-19: Embryo Culture

The fertilized eggs will be monitored in the lab for several days to allow them to develop into embryos. The embryos will be evaluated for quality and graded based on their development.

  • Day 20-21: Embryo Transfer

On day 20-21, one or more embryos will be transferred to the uterus using a thin, flexible catheter. This is a quick and painless procedure that does not require anesthesia.

  • Day 22-30: Luteal Phase and Pregnancy Test

After the embryo transfer, you’ll enter the luteal phase, which is the time between the transfer and the pregnancy test. During this time, you may be instructed to continue taking progesterone supplements to support the growth of the embryo.

Two weeks after the embryo transfer, you’ll take a pregnancy test to determine if the IVF cycle was successful.

It’s important to remember that the IVF process can vary from person to person and that it may take more than one cycle to achieve a successful pregnancy. Your healthcare provider will guide you through the process and provide support and information at every step.

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Stages of embryo development

Embryo development occurs in several stages, starting with fertilization and ending with the blastocyst stage. Here are the key stages of embryo development:

Fertilization

This is the moment when the sperm penetrates the egg and fertilizes it.

Two-cell stage

This is when the fertilized egg divides into two cells.

Four-cell stage

The two cells continue to divide, resulting in four cells.

Morula stage

At this stage, the cells begin to cluster together, forming

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When to do IVF or Test Tube Treatment

  • Fallopian Tube Issues: Fallopian tube in women, which carries the egg to the uterus may be damaged or blocked. This makes it difficult for an egg either to mate the sperm or the fertilized embryo to travel the uterus for implantation.
  • Ovarian Issues: In high age or ovarian issues or premature ovarian failure, the ovulation process cannot be normal and only a few eggs may be available for fertilization.
  • Endometriosis: Uterine tissues when grows outside the uterus, like vary, fallopian tubes, pelvic organs, the chances of pregnancy reduces.
  • Fibroids: Fibroids are benign tumor-like growths that happen in the wall of the uterus. These fibroids obstruct the implantation of the embryo into the lining.
  • Sperm Problems: Men can have different medical conditions like poor sperm quality or weak movements of sperm, or abnormal size, or shape. These sperm are not capable of fertilizing a sperm.
  • Genetic disorder: Certain patients carry genetic issues in their genes. These genes can be passed on to the child if they conceive naturally. So to avoid that, Pre-Genetic Testing can be done on the embryos.
  • Unexplained infertility: Unexplained infertility means we are unable to evaluate any cause for infertility.

Why FET (Frozen Embryo Transfers) have Higher Success?

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Expected Complications during IVF Program (disadvantages)

Below are some of the expected complications in IVF.

  • Multiple pregnancies: One of the most common complications of IVF is multiple pregnancies. When multiple embryos are transferred to the uterus, there is a higher chance of more than one embryo implanting, leading to the birth of twins, triplets, or even more. Multiple pregnancies can increase the risk of complications during pregnancy and childbirth, such as premature labor and low birth weight babies.
  • Ovarian Hyperstimulation Syndrome (OHSS): OHSS is a potentially serious complication that can occur when a woman’s ovaries are stimulated to produce multiple eggs during the IVF process. Symptoms can include abdominal pain, bloating, nausea, and vomiting. In severe cases, OHSS can lead to fluid buildup in the abdomen and chest, and even blood clots or kidney failure.
  • Ectopic pregnancy: Ectopic pregnancy occurs when a fertilized egg implants outside of the uterus, usually in one of the fallopian tubes. This can be a life-threatening condition and may require emergency medical attention. The risk of ectopic pregnancy is higher in women who have had previous pelvic surgeries, such as tubal ligation, or in women with a history of pelvic inflammatory disease.
  • Failed IVF cycles: IVF is not always successful, and some couples may require multiple attempts before achieving a pregnancy. The reasons for failed IVF cycles can be multifactorial and include issues with embryo quality, implantation failure, or underlying medical conditions that affect fertility.
  • Emotional stress: The process of IVF can be emotionally and mentally taxing on couples. The stress of the procedures, financial burden, and uncertainty of the outcome can take a toll on one’s mental health. It is important for couples to have a strong support system in place and consider seeking counseling or therapy during the IVF process.
  • Financial burden: IVF can be expensive, and many insurance plans do not cover the cost of treatment. Couples may need to pay out-of-pocket for medications, procedures, and other related expenses. The financial burden of IVF can add to the stress and emotional strain of the process.

In conclusion, IVF can be an effective fertility treatment for couples struggling with infertility. However, it is not without potential complications. Couples should discuss the risks and benefits of IVF with their healthcare provider and consider all of their options before deciding on a course of treatment.

Outcomes

About 12 days or two weeks after egg retrieval, we request you to run a blood test to find if you are pregnant.

  • If you’re pregnant, you will continue your medications and protocols suggested by us till about 12 weeks. Post this we will refer you or you may go back to your obstetrician.
  • If you’re not pregnant, you are requested to stop taking all the medications. You should expect menses in the next 10 odd days. We can then plan another IVF cycle or another embryo transfer.

Freeze all your embryos, DON'T TRANSFER!

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IVF Success Rate

Lot of clinics will claim a success rate of 70%+ and usually are just marketing gimmicks. The success rate is not an absolute ratio but depends on many causative factors. Eg:

  • Age
  • BMI
  • Miscarriages history
  • Reason of infertility
  • Previous deliveries

Success rate usually is presented with statistics referring to age. The reason being, with age the quality of the egg deteriorates and thereby reduces the chance of pregnancy.

  • Below 30 years: Success Rate can be around 62%
  • 30 – 35 years: Around 55%
  • 35 – 40 years: Around 30-45%
  • >  40 years: 2 – 15%

WHAT TO DO AND NOT TO DO DURING IVF (In Vitro Fertilization)

There are certain things you should do and not do to maximize your chances of success. 

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What to do during IVF

  • Follow your doctor’s instructions: Your doctor will provide you with a specific set of instructions tailored to your individual case. Make sure to follow these instructions closely to increase your chances of success.
  • Maintain a healthy lifestyle: A healthy lifestyle can boost your fertility and improve your chances of success during IVF. This includes getting enough sleep, exercising regularly, and managing stress.
  • Take your medications as directed: You will likely be prescribed several medications during IVF. Make sure to take these medications exactly as directed by your doctor.
  • Attend all appointments: IVF involves multiple appointments with your doctor. It is important to attend all of these appointments to monitor your progress and make any necessary adjustments to your treatment plan.

What not to do during IVF

  • Avoid smoking and drinking: Smoking and drinking can negatively impact your fertility and the success of your IVF treatment. It’s best to avoid these substances altogether.
  • Don’t engage in strenuous exercise: While exercise is important, strenuous exercise can put unnecessary strain on your body and may impact your fertility. Stick to gentle exercise like walking or yoga.
  • Don’t skip meals: It’s important to maintain a healthy and balanced diet during IVF. Skipping meals can throw off your body’s balance and negatively impact your chances of success.

IS IVF PAINFUL

In vitro fertilization (IVF) can involve some discomfort and pain, but the level of pain can vary from person to person. Here are some things you can expect during an IVF cycle that may cause discomfort or pain:

  • Hormone injections: Hormone injections are given to stimulate the ovaries to produce multiple eggs. Some women may experience pain, swelling, and bruising at the injection site. This is the most common procedure assocaited with pain.
  • Egg retrieval: Egg retrieval is a minor surgical procedure that involves inserting a needle through the vaginal wall to extract the eggs from the ovaries. This procedure is done under sedation, so you shouldn’t feel any pain during the procedure itself. However, some women may experience discomfort or cramping afterward.
  • Embryo transfer: Embryo transfer involves transferring the fertilized embryos into the uterus. This procedure is usually painless, but some women may experience mild cramping or discomfort.

It’s important to note that the discomfort and pain associated with IVF are usually temporary and mild. Your doctor can provide you with pain relief medication and other strategies to help manage any discomfort or pain you may experience. If you have concerns about pain management during IVF, you should discuss them with your doctor.

WHAT TO EAT AND NOT TO EAT DURING IVF

What to eat during IVF

  • Eat a balanced diet: A balanced diet that includes plenty of fruits, vegetables, lean proteins, and whole grains can help support your overall health and fertility.
  • Eat foods high in antioxidants: Antioxidants can help protect your eggs and sperm from damage. Foods high in antioxidants include berries, nuts, and leafy greens.
  • Eat foods high in omega-3 fatty acids: Omega-3 fatty acids can help regulate hormones and improve egg quality. Foods high in omega-3s include fatty fish, chia seeds, and flaxseeds.

What not to eat during IVF

  • Avoid processed foods: Processed foods can be high in sugar, unhealthy fats, and other additives that can negatively impact your fertility.
  • Limit caffeine intake: Caffeine can interfere with fertility and may reduce the chances of success during IVF. It’s best to limit your caffeine intake or avoid it altogether.
  • Avoid alcohol: As mentioned earlier, alcohol can negatively impact your fertility and the success of your IVF treatment. It’s best to avoid alcohol altogether during IVF.

Know the costs for IVF

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