ICSI steps

What is IVF ? 

IVF of In vitro (Vitro is Latinfor glass) fertilization (IVF)  is a form of assisted reproductive technology (ART) during which the process of fertilizing eggs with sperm is done outside of the human body. Once the eggs are fertilized, the resulting embryos are placed in the woman’s uterus hoping for a successful pregnancy. The entire process of retrieving eggs from human body, fertilizing it and culturing it to an embryo is done within an IVF Lab of an IVF Clinic.

IVF Labs require state of art equipment and good embryologists. Thankfully our IVF centre in Indore is among the best IVF centres in the city and is equipped with such high end lab as well as excellent Embryologist.

Video showing the entire IVF Process that happens in IVF Lab

Is Test Tube Baby same as IVF ?

Decades back, females who had blocked tubes, did not stand any chance of pregnancy until scientists and IVF doctors devised a way to fertilize eggs outside human body. Since the process of fertilization of eggs was done in IVF lab instead of fallopian tube, the term test tube baby was used by laymen who did not understand the complexities of IVF. Essentially “Test Tube Baby” is same as IVF and is used interchangeably. Many IVF Center’s in India still use the term Test Tube Baby Centre for the benefit of common man. Hence if you come across any test tube baby centre in Indore, you can be rest assured that they are the same as IVF centres or IVF clinics.

When is IVF recommended ?

IVF is definitely not the first line of infertility treatment for patients who suffer from fertility issues. 

The first step of infertility workup for a couple includes basic fertility screening test for both partners. Such tests are usually available in any IVF Clinic. in Indore. However many IVF Centers in Indore outsource such fertility test to other pathology or sonography center. Try to get the fertility test done at any standard IVF Center so that the reports are standard.

Our center is one of the best IVF center in Indore in terms of fertility testing, reporting on time and IVF results.

For men, the basic fertility test is Semen Analysis or Semen test often colloquially called Sperm Test.  Semen Analysis is done at any IVF center to assess the sperm count or sperm concentration along with sperm motility and sperm morphology. If your city does not have any good IVF center or IVF Clinic, try to get the test done from a nearby city with good IVF facility.

For females, a baseline pelvic ultrasound, preferably transvaginal scan is done to assess ovarian status as well as uterine structure to rule out uterine anomalies/defects. Some females will also be asked to assess tubal patency using either HSG or diagnostic laparoscopy test. Tubal Patency test is test to assess if tubes are open or closed. This test is usually not done in most IVF Clinics in Indore as it requires X-Ray machine. You may be asked to visit any Pathology lab with X-Ray facility for the test.

Once the infertility test results are out, IVF is suggested by the IVF specialist for the following causes of infertility:

  • Damaged or blocked fallopian tubes (can be caused by Pelvic Inflamatory Disease or prior reproductive surgery or if tubes are tied previously – tubal ligation )
  • Severe Endometriosis or mild to moderate endometriosis not responding to IUI.
  • Advanced reproductive age, as time to conception is critical and pregnancy rates with other therapies are low
  • Severe male factor infertility (sperm counts or sperm motility is low)-ICSI is recommended.
  • Severe Asthenozoospermia – very poor motility of sperms leading to male infertility.
  • Azoospermia – Nil Sperm report. IVF needs to be done with ICSI and TESA
  • Unexplained fertility problem in which other modalities have not been successful including multiple (3 to 4) cycles of IUI.

How is IVF Procedure done?

IVF treatment is not just one simple procedure, but a series of steps interlaced with each other and done over several weeks (usually 6 weeks). The steps involved in IVF treatment that are typically followed by IVF doctor are:

  • Stimulating the ovaries – Super Ovulation
  • Collecting the eggs – Egg Retrieval
  • Fertilization of eggs – Insemination and Fertilization
  • Embryo Culture
  • Embryo Transfer
 

What is the cost of  IVF Cycle at Indore ?

IVF Cost is dependent on many factors. It is not a one price fits all. It is best to let the IVF Specialist review your case history and reports once before he or she is ready to quote the cost of IVF cycle.

You can share your reports on whatsApp with us to understand the exact cost for your case.

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PersonalizedIVFStimulationProtocol
Step 1: Stimulating the ovaries

Hormones (Fertility Drugs) are usually given by the IVF Specialist to stimulate the ovaries to produce more than the usual one egg per cycle. This is done to enable the collection of several eggs.
The development of the eggs is monitored by blood tests and Trans Vaginal Ultrasounds that ensure eggs are collected by at precisely the right time.

These drugs used to stimulate the ovaries are one of the main contributors to IVF Cost. There are many manufacturers of IVF drugs and it is not fair to compare one manufacturer to the other. However all standard companies produce high quality IVF injections and can be administered safely.

Our IVF center in Indore specialized in highly personalized stimulation protocols for the patient, depending on their medical history, age and previous IVF cycle results.

Instructions before OPU
Step 2: Egg Retrieval

During the IVF Cycle, at the time of ovulation the eggs are collected in a process called Ovum PickUp or Egg Collection. An ultrasound probe is placed within the vagina while the woman is under light sedation. The ultrasound monitor shows where the follicles are within the ovaries.  The needle is connected to a suction device, which pulls the eggs and fluid out of each follicle, one at a time. The procedure is repeated for the other ovary. The woman may have some cramping after the procedure, but it usually goes away within a day.

The egg retrieval process is normally done as an outpatient procedure in the Operation Theater under General Anesthesia

If a woman does not or cannot produce any eggs, donated eggs may be used.

The Ovum Pickup if done by experienced and best IVF doctors, results in collecting of all the mature follicles within the ovary. This skill needs good amount of surgical acumen and practice. If done by inexperienced IVF specialist, it may lead to collection of less number of mature eggs and hence impact the IVF success rate. Try to locate an IVF specialist in Indore who has decent amount of experience in terms of IVF cycle as the skill of Ovum pick up gets better with practice.

Step 3: Insemination and Fertilization

On the day of egg collection, the male partner provides a sample of semen. As a precautionary measure a semen sample of the husband is taken at the onset of stimulation and Cryopreserved. 

The best IVF center in Indore prefer to cryopreserve the husband’s sample before the day of OPU. This safeguards the couple from any mishap in producing semen sample on day of OPU.

In a standard IVF treatment, the semen and best quality eggs are placed together in an environmentally controlled chamber called the incubator. This process of mixing the egg and sperm is called insemination.  The sperm usually enters (fertilizes) an egg a few hours after insemination.

If the Embryologist feels that the chances of Fertilization using IVF is low, he/she may directly inject the sperm into the egg. This is called IntraCytoplasmic Sperm Injection (ICSI).

Step 4: Embryo culture

When the fertilized egg divides, it becomes an embryo. An embryologist will regularly check the embryo to make sure it is growing properly. Within about 3-5 days, a normal embryo has several cells that are actively dividing.

Couples who have a high risk of passing a genetic (hereditary) disorder to a child may consider Pre-Implantation Genetic Diagnosis (PGD) or PGT. The procedure is done about 3 -5 days after fertilization. An experienced Embryologist from a good IVF Clinic usually removes a few cells from each embryo and screen the material for specific genetic disorders. Pre-implantation genetic testing can help doctors decide which embryos to implant, which decreases the chances of passing a disorder onto a child.

The best IVF center in Indore usually own a Laser that helps in performing Embryo Biopsy.

ElectiveSingleEmrbyoTransfer
Step 5: Embryo Transfer

Once the embryos have grown to a predetermined size in the IVF Lab, one to a maximum of three embryo’s will be transferred back to the woman’s womb 3 – 5 days after egg retrieval and fertilization. During this procedure your IVF Doctor will pass a very fine plastic tube (catheter) through the cervix and into the uterine cavity under ultrasound guidance. Pregnancy results if an embryo implants in the lining of the womb and is able to grow successfully.

Embryo transfer is very similar to a Trans Vaginal Ultrasound, is generally painless and usually involves no anesthetic. More than one embryo may be placed into the womb at the same time, which can lead to twins, triplets, or more. The exact number of embryos transferred is a complex decision that depends on many factors, especially the woman’s age. It is best to have this discussion with your IVF specialist before the day of Embryo Transfer.

The best IVF clinic will most frequently transfer a single Blastocyst to a patient. There are many benefits of transferring a single blastocyst. Please read our blog to understand the process of Elective Single Embryo Transfer better.

Unused embryos may be frozen and implanted during a later Frozen Embryo Transfer Cycle or donated at the will of both partners at a later date.

Two weeks after the Embryo transfer, blood is taken and tested to determine if the woman is pregnant.

The blood test that is done to confirm pregnancy is called Quantitative Serum b-HCG test. Make sure that you get the quantitative test done that mentions the quantity of bHCG in blood

In recent times a newer protocol of IVF is being popularly used, it’s called a Freeze All IVF Protocol. In this protocol the Embryo’s are NOT transferred in the same cycle. Instead the Emrbyo’s are frozen and Embryo Transfer happens in the subsequent natural cycle of the patient.

What to expect during IVF Treatment ?

IVF requires a significant physical, emotional, financial, and time commitment. Stress and depression are common among couples dealing with infertility. Studies have shown that reducing stress levels can drastically improve the results of IVF. Hence it is very important to keep a positive attitude during the treatment.

From start to end a typical IVF treatment cycle lasts upto 6 weeks. During these six weeks, based on the Steps indicated above, a woman should expect the following:

  • Multiple visits to the IVF Clinic in Indore.
  • Injecting or Ingesting Fertility Drugs at pre decided dates by the IVF Specialist.
  • Multiple Trans vaginal Ultrasounds to monitor the follicles (Follicular Monitoring)
  • An outpatient procedure for Egg Retrieval or OPU which usually is done under General Anesthesia
  • An outpatient procedure for Embryo Transfer
  • Daily Progesterone dose either orally or as an injectable  or as a vaginal gel to help the embryo implant.
  • A two week time period to patiently wait before you can perform a pregnancy test
  • Lots of Positive thoughts and a heart to deal with a Cycle failure since not all IVF Cycles are successful

What are the Risks or Side Effects of IVF ?

There is no clear evidence that infertility medicines and IVF injections, if used properly, increase the risk of birth defects or cancer. The increase in the hormone estrogen can cause breast tenderness, slight nausea, dizziness and slight abdominal swelling.

Occasionally, during Ovarian Stimulation too many follicles develop and the levels of the hormone estrogen rise too high, causing a condition called Ovarian Hyperstimulation Syndrome (OHSS). This is an unpleasant experience, which may include marked abdominal swelling, nausea, vomiting and diarrhoea, lower abdominal pain and shortness of breath. OHSS is rarely severe enough to require hospitalisation.

The best IVF center’s usually have very low OHSS rate as over the years IVF stimulation protocols have become very patient friendly.

There is also a theoretical risk (very rare) of damaging other organs, or causing infection or bleeding, with the collection needle.

What is the success rate of IVF?

According to the Society of Assisted Reproductive Technologies (SART), the approximate chance of giving birth to a live baby after IVF is as follows:

  • 41-43% for women under age 35
  • 33-36% for women age 35 – 37
  • 23-27% for women ages 38 – 40
  • 13-18% for women over age 41

The main potential factors that influence pregnancy and live birth rates in IVF have been suggested to be maternal age, duration of infertility and ovarian function.Optimal woman’s age is 23–37 years at time of treatment.In women of age more than 38 years, if sufficient number of their own oocytes are not available, IVF with oocyte donation is a good option.

Please note that with each passing year efficiency and safety of IVF is increasing which eventually leads to improvement in take home baby rate.

When IVF Cycle Fails!

IVF has a reasonable rate of success. Overall, approximately 35 percent of IVF cycles will end in a live birth after single attempt, and the cumulative chances of success are higher when more than one cycle of IVF Embryo Transfer is done.

However, an individual’s chance of success depends on several factors, including the woman’s age, cause of infertility, and treatment approach. Also with newer protocols like Freeze All IVF Cycle, the chances of conception are as high as 70%.

It can be difficult to deal with the emotional highs and lows of  Infertility Treatment. This is especially true if the woman (and her partner) have been trying to conceive for a long time or if there are any underlying problems in the couple’s life (eg, medical, family or partner, job, financial).

Counseling services are at times needed to counsel a couple especially after a failed IVF Cycle. Since results of IVF are best when more than one cycle is tried, it is important that a couple stays focused and positive during the entire treatment rather than being stuck upon a single failed result.

Please refer the following Quick Reference Chart for knowing the cost of IVF Cycle at our centre

Cost of IVF
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FAQs

IVF is a type of treatment done to help infertile patients to get pregnant and deliver healthy babies. During IVF the process of fertilization is done outside the human body within an IVF lab.



IVF cost is dependent on many factors like the patient's age, the underlying cause of infertility, and response to ovarian stimulation. Typically IVF cost ranges from 1 lakh to 1 lakh 50 thousand in Indore. The actual cost can only be calculated after assessing the patient’s reports.

It is very important to assess the reason for IVF failure before trying another cycle. IVF can fail due to poor quality gametes (both poor sperm and poor eggs), failure to produce Blastocyst, failure of implantation, or miscarriage after implantation.

Knowing the reason for failure can warrant corrective action at each step. However, in case of very advanced maternal age or very low AMH with multiple failures, your IVF specialist may advise you to think about donor oocytes or donor eggs.

During an IVF process the health of the baby born is completely dependent on the health of embryo and the course of pregnancy.

Instead of being fixated on chances of abnormality, it is best to understand the following things:

IVF treatment is not an elective treatment, it should be indicated and hence we should know that only couples who cannot conceive naturally will undergo IVF. So since there is not alternative to IVF our focus should be on what can be done to make it safer:

  1. Quality of eggs and sperm depend on your lifestyle and age. So maintain a healthy lifestyle and dont be too late.
  2. Choose a good IVF center so that you know that they have a good IVF lab which consistently delivers best IVF success rate.
  3. Choose to transfer only one embryo, this will ensure an uncomplicated pregnancy.
  4. Monitor pregnancy well and stay away from stress.

IVF treatment cost is inclusive of the cost of follicular monitoring, cost of drugs for stimulating the ovaries, cost of semen processing and freezing, cost of disposables and media used in the IVF lab, and above all cost of the time that an IVF specialist doctors and embryologist gives for your case.

Typically IVF treatment cost less in Indore as compared to metros however since the cost of IVF drugs and Media are costlier in non-metro cities because of transportation charges, the cost of IVF cycle in Indore is typically about 15% cheaper than in Metros.

An IVF cycle can cost anywhere between 1 Lac, to 1 Lac 50 thousand if opted with self gametes.

Average number of eggs for patients under 35 years of age with regular ovarian reserve is about 8 to 10. So per IVF cycle we expect on an average 8 to 10 eggs. However for patients above 35 years of age and or poor ovarian reserve (low AMH) the average number of eggs per cycle could be as low as 5 or less.



If IVF has resulted in successful pregnancy, and progressed to the second trimester then the chances of taking home a healthy baby is very high, actually it is as high as chances in normal pregnancy. 

After successful implantation of IVF embryos which is detected by bHCG blood test, the pregnancy is monitored by ultrasound to assess fetal heart beat. The chances of miscarriage in IVF pregnancy before establishment of cardiac activity is slightly higher (before 8 weeks). However the miscarriage rate after establishment of cardiac activity is similar to that of natural pregnancy.

It is worthwhile to note that multiple embryo transfer that results in twin or multiple pregnancies, always has a higher risk of miscarriage. So it is always best to opt for single Blastocyst transfer. To know more, please read the following blog:

https://www.indoreinfertilityclinic.com/elective-single-blastocyst-embryo-transfer/

Fertility Drugs are researched over years and show no significant rise in abnormality in the resulting baby. Nor does the ultrasound waves cause any abnormality. IUI is very safe if done under proper guidance from good IVF doctor.

Multiple pregnancies like twin pregnancy is a result of transferring more than one embryo to the uterus. Any good IVF centre will transfer only single good blastocyst which will result in a single pregnancy. However in rare incidences even a single blastocyst / embryo can result in a monozygotic twinning (identical twins).

On an average a patient would need to administer 12 days worth of injections. These injections are usually intra muscular. Even though it may seem a lot, but considering the out come of a successful IVF treatment, it is definitely worth the prick. You may want to read the following article on the same:

https://www.indoreinfertilityclinic.com/is-ivf-painful/

IVF doctors will first get a few basic investigations done to assess the reason for infertility. Based on the outcome of the result, doctors will decide on the course of treatment. For male partner the investigation ordered is Semen Analysis. Female partner is advised baseline ultrasound to assess uterine cavity and or follicular monitoring.