THE CONCEPT OF IVF
The first successful baby born from in-vitro fertilization (IVF) was in 1978, revolutionizing the field of reproductive medicine.
IVF is one of the fastest developing field and in the past 40 years the techniques used have improved drastically.
These techniques range from the use of intracytoplasmic sperm injection (ICSI), preimplantation genetic testing (PGT) for embryo selection,
Culture media quality, and surgical sperm removal (SSR), in addition to oocyte, sperm and embryo storage (Cryopreservation) for fertility preservation.
When undergoing IVF, the following steps are followed:
- Ovarian Stimulation: Stimulators (medicines/Hormones) are given to the female during a specific period of time to ensure the maximum number of oocytes produced to increase the chances of pregnancy.
- Retrieval of stimulated oocytes by aspiration.
- Fertilize the eggs with the husband given sperms in IVF laboratory. (According to the case, the eggs either will be mixed or injected by embryologists.).
- The following day the embryos are checked to see if fertilization occurred and are transferred back into the uterine cavity on day 3 or day 5.
Who needs to go through IVF cycle:
Any married couples who are facing pregnancy delay, are advised to go start testing the reason of the delay, many reasons can cause the same, such as:
- Women that have blocked of missing Fallopian tube.
- Decrease in sperm count.
- Premature ovarian failure.
- Ovulation disorder.
- Obesity may cause a delay in pregnancy.
- Unexplained reasons, where the male and female have no fertility issue but yet cannot get pregnant.
- Many other reasons that might cause infertility.
The overall chance of getting pregnant varies depending on the women’s age, ovarian reserve, previous obstetrical history and the cause of infertility. Generally speaking, the pregnancy rate in young women is around 55%-60%. In some cases, more than one embryo are transferred back which may result in twin pregnancies in 10%-15% of the cases.
FACT
Over the past few decades, plenty of improvements have occurred with the medication administered, the stimulation protocols, laboratory culture media and equipment resulting in safer and more successful outcomes.
The Difference between IVF and ICSI
IVF Method
The sperm which fertilizes the egg is naturally selected similarly to what occurs normally in the fallopian tube, this is the concept of conventional IVF.
The conventional IVF method is still used today and is very suitable in cases when the seminal fluid analysis is in the normal ranges and there is an adequate number of oocytes.
ICSI Method
In the mid-90s, intra-cytoplasmic sperm injection (ICSI) was introduced to the world of assisted reproduction.
ICSI is the process where a single motile sperm is selected and injected into the oocyte using microscopic vision resulting in better fertilization and pregnancy rates in men with suboptimal semen.
ICSI is considered the largest breakthrough in assisted reproduction, revolutionizing the treatment for male infertility.
Research shows that the pregnancy rate with conventional IVF is slightly higher than pregnancy rates with ICSI, however on the other hand there is a higher risk of no fertilization with conventional IVF. Furthermore, the use of ICSI is always required in PGD
FACTS
An additional method used recently is intra-cytoplasmic morphologically selected sperm injection (IMSI) which is the selection of the best morphologically normal sperm under maximum magnification.
Using IMSI increases the chances of producing a normal healthy embryo which might improve the chances of a healthy pregnancy.
For that reason, there has always been a balance between applying similar methods to natural conception and getting involved in more sophisticated medical micro interventions.
However, there is not a specific procedure which suits all cases. Thus, the importance of individualizing the treatment and management for each and every case.