Sunday, 7 September 2014

Frequently asked questions in IVF/ ICSI

There are many myths surrounding IVF and ICSI, read through and I hope to clear all your doubts. IVF is the process by which eggs are removed from the ovaries and mixed with sperm in a laboratory culture dish. Fertilisation takes place in this dish and the resulting embryo is transferred to the uterus. ICSI is the most successful form of treatment for men who are infertile and is used widely in IVF treatments. ICSI  requires only one healthy sperm, which is injected directly into the egg. The fertilised egg (embryo) is then transferred to the uterus.


1. What will be the total cost of IVF/ICSI?
The cost of IVF will be around Rs 1.5 lakhs and ICSI is around Rs 1.8 lakhs. Medication charges can vary case to case, so the  total charges will also diverge.

2. Why is IVF  so expensive ?
The medicines and media used for the procedure are imported and very expensive. The lab equipments are also very expensive and needs regular calibration and high maintenance.

3. Are the medications safe ? Any S.E.?
The medications are generally safe and do not have any major side effects.

4. Are the injections painful ?
The injections can be taken by self and they are not painful.

5. Do I have to be admitted in hospital ?
No. You may have to spent 1 day in the hospital, during the Egg pick up. The egg pick up is a minor surgical procedure and may need GA. 

6. How frequently do  I need to come to hospital ?
The patient needs around 3 scans for follicular study.

7. Do I need rest, Can I work ?
There is no need for rest, except on the day after egg collection. You can continue to work.

8. Can I have access to a female Doctor. ?
Yes. If you are particular that you want to consult only female Doctor during your  visit, please inform in advance while taking appointment.

9. Do you give information Leaflets ?
Information Leaflets are provided for all medical conditions related to your disease.

10. Will the procedure of Donor sperm / egg be confidential ?
Yes. The procedure of donor egg/ sperm  is highly confidential.

11. Do you provide separate room/privacy for semen collection ?
Yes. there is facility for separate room and full privacy will be there for semen collection.

12. Is there need for my husband to be there for every checkup, does he have to take leave from work?
No. Once the investigations are completed for the male partner, only the wife needs to come for regular scans.

13. Will you give us the reports  of lab tests ?
All the reports will be kept as a file of  Infertility Record, copies of results will be given to you.

14. Can I still conceive if am menopausal ?
Yes. You can, but you will need to have donor egg.

15. Can the sterilizations be reversed-- ?
Yes. Laparoscopically or  Laparotony surgical process can reverse sterilization.

16. Will I be seen by same Doctor each visit ?
Infertility treatment is done by a team and you will be seeing  one member of the same team.

17. Can I do my own injections?
Yes. You will be taught to take self injections, if they are sub cuticular.

18. What is In Vitro Fertilization (IVF)
In IVF, eggs are removed from the woman's ovaries and mixed with the man's sperm in a dish in a laboratory. Once the egg have been fertilized with the sperm, they are implanted in the women’s uterus.

19. Do I have to take medicines ?
Only vitamins are given as supplements  and after ET (embryo transfer) , progesterone is given for luteal support.

20. When are the eggs retrieved?
You will be closely monitored by following your follicular growth. Ultrasounds will be done regularly  to ensure that your eggs are getting ready to be retrieved. 

21. How much time does the entire procedure require?
Each cycle of IVF takes four weeks to complete. The process of IVF requires that both you and your partner need to spend about half a day at the clinic for the egg retrieval and fertilization procedures. The female partner has to return in a few days for the embryo to be transferred to the uterus.

22. How are the eggs retrieved?
Egg retrieval requires an anesthetic. After the  ultrasound is done and the eggs identified, with a fine needle, the eggs are retrieved under ultrasound guidance under general anesthesia. The entire procedure takes about 15-30 minutes and there is minimal pain after the procedure.

23. What happens to the eggs?
Your partner's sperm is combined with your eggs in a dish containing a special nutrient medium, which is then cultured in an incubator to fertilize. After about 48 hours, the embryo (fertilized eggs) is  transferred to the uterus for implantation.

24. How is the embryo transferred to the uterus?
The embryos are carefully transferred to the uterus under sterile conditions. The embryos are placed in the uterus with a fine tube. To avoid the risk of multiple pregnancy physicians never implant more than 1-2 embryos. Any extra embryos are frozen for future use, in case the present attempt at conceiving is not successful.

25. Is there an age limit to IVF?
There are no strict age limits but the protocol is that it is best for women around the ages of 35-45. The older a woman is, the lesser are the chances of conceiving .

26. When does one know if the IVF is successful?
If the implantation is successful and the embryo implants in the uterine wall, then within 10-14 days, the pregnancy test will be positive. If the pregnancy test is negative 2 weeks after implantation, it means that the procedure has failed. 

27. What is risk of multiple births?
The risks of multiple births is always a concern and can also affect the health of the babies in the womb.  The risks of multiple births are increased if more number of embryos implanted. There can be premature delivery , growth retardation and also there are more chances for abnormalities in multiple pregnancies.

28. What is the success rate?
The outcome is dependent on numerous factors. All data indicate that the younger the female, the greater the chance of success. Unbiased data indicate that the chance of success can vary widely and is between 20 to 60%. 

29. What are side effects or complications of IVF?
IVF treatments increase a woman's risk of ectopic pregnancy, wherein the embryo implants not in the uterus but in the fallopian tubes. The risk of OHSS is high in PCOS patient .

30. Is IVF associated with birth defects?
All the data available indicate that IVF is safe and not associated with any birth defects. However, long-term effects of IVF remain to be determined. 

Dr. Anita Mani
Infertility& Surrogacy Specialist at Gift IVF Centre

Dr. Anita Mani is a renowned infertility specialist in south India with 15 years experience in ART (Assisted Reproductive Technology). Dr. Anita has successfully set up ART hospitals in Cochin and Bangalore,  along with her spouse  Dr. S Mani, who specialises in surrogacy. She completed MRCOG, from Royal College of Obstetrician and Gynaecologist  London, DFFP from  ART Warwick university and  worked in UK for 5 years. Dr. Anitha believes in scientific and ethical practice and is currently the director of Gift Gyno IVF centre Cochin and  Bangalore.  Apart from advanced laparoscopic surgeries, she is also an expert in various ART techniques including IVF, IUI, ICSI , donor egg / sperm  and surrogacy . Her proficiency is in genetic abnormalities and high risk pregnancies.

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