If you are considering going through the IVF treatment, it’d be helpful for you to read through the Patient Journey for IVF so that you can familiarize yourself with the process.
Step 1 – Beginning of IVF Cycle
Once the decision for IVF is taken, you will go through a thorough counselling regarding the IVF procedure , including costs, success rates, what happens at each visit, in detail Once registered, we will start with the IVF procedures. These include:
- 1st Ultrasound Scan
- Start medication
- Blood Tests
- 1st payment of IVF cycle
We usually advise you to come to the clinic for the administration of injections in the morning. Some patients may be able to take the injections in the comfort of their home by themselves depending on the injections and their own comfort at taking them. Further tests would be performed as prescribed.
Step 2 –2nd ultrasound Scan
During the 2nd ultrasound scan, we will discuss with you about the further course of action to be taken about your medication, with alterations as necessary and perform blood tests. For this stage, we will:
- Continue medication and adjust if necessary
- Blood Tests
Step 3 –Further Ultrasound Scans
During the next few ultrasound scans, we will discuss with you about the further course of action to be taken about your medication and alter as necessary and perform necessary blood tests. The response to stimulation and making sure that adequate follicles are being formed with the given dose and as per the expected ovarian reserve is checked during these scans. The lining of the uterus called the endometrium is also monitored during these scans. For this stage, we will:
- Continue medication and adjust if necessary
- Blood Tests
- Balance payment of IVF cycle
Step 4 – Trigger injection for ovulation
The trigger injection for ovulation will be administered during this stage. It takes just over 38 hours for ovulation to occur after an injection of hCG. Eggs are mature and can float free from about 34 hours after hCG, giving a four-hour window for egg retrieval, which is scheduled 35-36 hours after the hCG injection.
Step 5– Egg & Sperm collection
The egg and sperm collection from the couple will be done during this stage. The egg collection happens under a short General anaesthesia and is completely painless. Anaesthesia fitness is done and you will have to come on an empty stomach for the procedure. The procedure is done transvaginally with an ovum pick up needle and the eggs thus aspirated are collected are then immediately transferred to the lab under controlled conditions.
The embryologist will then keep these oocytes in the incubator for incubation and after some time carry out the fertilization process. After this, the IVF or ICSI procedure will be carried out as decided. Hence this stage would include:
- Egg Collection
- Sperm Collection
- IVF or ICSI procedure
- Embryo Culture
- Blastocyst Culture
Step 6 – Embryo Transfer
During this stage the embryo transfer will take place. The embryos are placed into the uterus of the female with the intent of establishing a pregnancy. We usually transfer two embryos and never more than three under exceptional circumstances. The remaining embryos are frozen for later use if required. This is a painless procedure and does not need any anaesthesia. You can eat a light meal and come for the procedure. After about 4 hours of rest post procedure you can go back home.
Step 7 – The 14 day period between embryo transfer and pregnancy confirmation
During this time period all the medications that have been given should be taken regularly at the designated timings. You are not required to be on bed rest and can continue all routine activities. Please take care to avoid any hectic activity, stress and any pressure on the abdomen. We usually ask you to refrain from intercourse during this time.
Step 8- Pregnancy blood test
This is the day that you have been waiting for! Although you should stay positive about the outcome, and have faith in yourself and the doctor, do keep in mind that it may sometimes take several procedures before you are able to conceive.
Step 9 – Pregnancy Confirmation and further treatment
Once pregnant, the hormone medications need to continue till a particular gestational period. These medicines are monitored and changed as required and antenatal follow up done. You will be advised to get Ultrasound scan s for pregnancy to be done from outside as and when needed. This is an ultrasound examination that is usually carried out vaginally at 6-10 weeks of pregnancy. The aims of this scan are to determine the number of embryos present and whether the pregnancy is progressing normally inside the uterus.
Follow up counselling will be performed if required.
Step 10 – Pregnancy care
Pregnancy care up to completion of 12 weeks of gestation will be performed according to appointment schedule with the doctor.
In the event of the pregnancy test being negative, a consultation is done to review the case and the next possibilities. We usually work on the principle of One IVF stimulation cycle leading to a pregnancy or even to complete a family. This means that usually the oocytes retrieved during the first IVF stimulation cycle, should be able to yield enough embryos, so that the excess embryos can be frozen and utilized when required. Hence the next step would be a Frozen Embryo Transfer.