This will include a telephonic verbal explanation of the procedure (supported by written email information) where obviously you will have the opportunity to ask questions. It is critical that everything is clear to both partners before beginning treatment for a baby with IVF (also known as test tube baby). You will also be told how to use the various drug therapies needed and, where appropriate, you will be taught how to administer them.
Once you confirm your agreement for the treatment in India, different types and brands of the drugs that may be prescribed to you. The precise drug therapies you use will depend on your personal situation and the clinic's general policy. Usually the women's own hormone production must be suppressed initially. Various methods are available for this. The IVF process begins.
The egg cells are found in fluid-filled follicles in the ovaries. The size of a follicle provides an indication of the maturity of the egg cell. During the treatment, you will have frequent checkups at the outpatients department to track the reaction of the ovaries to drug therapy using vaginal ultrasonography. The size of the follicles and the viscosity (thickness) of the cervical mucus are measured at each check-up to determine the right time for the puncture. Blood may also be taken to measure the hormone levels.
At the point when the egg cells are almost mature, ovulation is artificially induced by means of an injection of human Chorionic Gonadotropin (hCG).
It is crucial that this injection is carried out correctly and at exactly the stated time. This injection stimulates the final maturation of the egg cells so that they are released from the follicles. The egg cells are removed from the body by needle biopsy (puncture) 35 hours after the injection.
Puncturing the follicles is called follicle puncture. The puncture is carried out via the vagina with the aid of vaginal ultrasonography. You are generally given an anaesthetic for this, although practice may vary from clinic to clinic. The vaginal ultrasonic probe is fitted with a thin needle holder. A special hollow needle is then inserted into this holder. Both the needle and the follicles are visible using ultrasonography on the monitor. The follicles are punctured with the needle one at a time and aspirated (collected). You can follow the procedure yourself on the screen.
In the laboratory, embryologists then examine the fluid removed from the ovary for egg cells. The egg cells are graded according to their maturity, to see whether they are suitable for fertilisation. If fresh sperm is used, the male partner is asked to supply sperm. A semen analysis is then carried out and the sample is washed with a special nutrient solution to isolate the more motile sperm.
Then comes fertilisation. Exactly which process is used depends on the clinic and the type of infertility involved. In standard IVF, the sperm is placed in a dish along with the egg cells. Within 18 hours the embryologist can tell whether fertilisation has occurred.
After the puncture, the woman is often prescribed drugs to prepare the uterus (womb) for embryo transfer. Embryo transfer usually occurs two to three days after fertilisation. There are special criteria against which the quality of an embryo can be assessed.
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(Only for international patients seeking treatment in India)