What is test tube pregnancy?

Test tube pregnancy or IVF

Test tube pregnancy or I.V.F. is a process in which the egg if fertilized outside the body and then the embryo is transferred back into the uterus. This technique has revolutionized the infertility clinics and rekindled the hope of many infertile couples.

What is "test-tube" pregnancy (I.V.F)?

Mr. Steptoe and Dr. Edwards, in 1977, achieved the first successful human pregnancy by the technique of in-vitro fertilization and embryo transfer. This procedure involves fertilizing the egg outside the body; after which the embryo is transferred back into the uterus.

For whom is I.V.F. advisable

Candidates for I.V.F. are by and large those women with irreparably damaged tubes. I.V.F. could also be the treatment of last resort in cases like oligospermia, major cervical mucus hostility factors and some cases of unexplained infertility.

A woman's age needs to be considered. Older women feel additional pressure as their biological clocks are ticking and time is running out. Majority of I.V.F clinics put a ceiling on the age for women eligible for this treatment. The normal limit is 38 years.

This is a very complex procedure and is time-consuming and expensive. While I.V.F. offers hope to many people, its use is only recommended for a very small proportion of the infertile population.

How successful is this treatment

The success rate of pregnancy associated with IVF treatment ranges between 15-30%. In case of a very young patient with severe tubal problem, it's worth attempting tubal surgery first since even the low success of surgery in these circumstances will probably be greater than the probable success of I.V.F.

What tests are undertaken before performing I.V.F.?

Once the couple has been considered to be possibly suitable for I.V.F., a series of tests are to be done which include semen analysis, semen culture and assessment of the menstrual cycle with hormone assays. Depending on the technique that is used to retrieve the eggs (oocytes) a preliminary laparoscopy or ovarian ultrasound scan might be required, so that the accessibility of the ovaries can be determined.

How is I.V.F. carried out?

A combination of Clomiphene and Pergonal is given to promote the maturation of several follicles. The idea is that if one has several follicles available for the egg retrieval, then if more than one egg is successfully fertilized and transferred back into the uterus, the odds are higher that at least one of them will successfully implant. The progress of growth of the follicles is closely monitored either by way of blood and urine tests or by ultrasound measurement of follicles.

Once the follicles are ready for ovulation, H.C.G. of 5,000 units is given. The eggs are retrieved 33-36 hours after the H.C.G. injection.

There are 2 methods which clinics may use for egg retrieval.

  1. Laparoscopy. This is carried out under general anesthetics. The eggs are retrieved from the follicles using a very fine suction needle.

  2. T.U.D.O.R. This stands for Trans-vesicle, Ultrasound Directed Oocytes Recovery. This is an outpatient procedure which is performed under a local anesthetic. Here, a suction probe is guided by ultrasound control through the bladder. This technique has an advantage of being able to retrieve eggs from an inaccessible ovary even when it is covered by adhesions.

The eggs are then incubated for 4-24 hours in a specially prepared culture medium to ensure that adequate maturation has occurred. Nearly 100,000-1,000,000 specially prepared swimming sperms are then added to the incubated eggs. Fertilization takes place within the next 24 hours. Two to three days later the embryo transfer takes place. This is a painless procedure and no anesthetic is needed.

       
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