For couples who haven’t been able to conceive after months or even years of trying, the in-vitro fertilization process is often the last resort. However, with all the myths surrounding IVF, the complexity of the procedure, and the cost associated with it can discourage couples from proceeding with this infertility treatment. In this post, we’ve listed the IVF process step day-by-day to help you understand the treatment and how it works. Without further ado, let’s begin.
What is IVF?
In a natural pregnancy, a woman’s egg (which is released during ovulation) is fertilized when a healthy sperm penetrates it. This fertilized egg goes through many stages before it develops into an embryo, which implants in the woman’s uterus. There, it grows into a fetus.
In an assisted reproductive technology, like IVF, the core procedure, i.e., combining the sperm with the egg, is done outside the woman’s uterus. A fertility specialist retrieves your eggs, puts sperm and the egg together in a controlled environment, and transfers the resulting embryo back into your uterus.
Who Needs It
This raises the question, “How do I know if I am a good candidate for IVF or whether I need it”? If you have these conditions, IVF may be a good choice of treatment:
- Blocked fallopian tubes
- PCOS or other hormonal disorders
- Low sperm count
- Poor sperm quality
- Endometriosis
- Advanced maternal age
- Unexplained infertility
Fortunately, IVF can address most of these issues. That said, it may still not work for problems with the uterus, like a hostile uterine environment.
Understanding the IVF Process
Here’s the IVF process step-by-step:
Step 1: Initial Consultation
Once you have decided to proceed with IVF, the first step is booking a consultation with Lahore’s best fertility doctor. During your initial consultation, you will be asked to share your medical history, any medication you are currently taking, how long you’ve been trying, and other relevant questions. The gynecologist may order tests, such as an ultrasound, a blood test, and a semen analysis. These help figure out the cause of infertility.
Step 2: Ovarian Stimulation
You will be given FSH and LH injections that stimulate egg production. A single shot will be administered every day for 8-14 days (depending on how your ovaries respond). During this period, you will be called for ultrasounds and bloodwork. These help monitor the thickness of the uterine lining and the follicular growth.
The dosage of the above hormones can be adjusted based on these reports. Once your follicles reach an optimal size (approximately 18-22 mm), a final trigger shot will be administered to mature the egg.
Step 3: Egg Retrieval (Aspiration)
The ovulation occurs within approximately 37-38 hours after the trigger shot. Egg retrieval is a fairly quick procedure and is painless. You will be sedated to ensure you don’t feel anything. The first step is inserting the needle through the vagina and into the ovaries under transvaginal ultrasound guidance.
The next step is aspiration of the fluid from the follicles through this needle. The fluid is sent to the embryology lab to confirm the finding of mature eggs. These are kept in an incubator, in a controlled environment, until the next step.
It’s normal to feel off for some time after you wake up. Mild cramps and bloating are also normal, as your ovaries start shrinking after the eggs are aspirated. You will most likely be discharged in 60-90 minutes and can resume work in one to two days (depending on how you feel and your doctor’s instructions).
Step 4: Sperm Collection and Preparation
Around the same time, your partner’s semen sample is collected. In cases of severe male-factor infertility, the sperm can be retrieved through a minor surgical procedure, called TESA (a procedure that inserts a needle into the testicles to collect sperm). The fluid is then sent for cleaning and isolation. A special liquid is used to separate motile and healthy sperm from poor-performing sperm. These are preserved for fertilization.
Step 5: Fertilization and Embryo Culture
Around 2-4 hours after egg retrieval, eggs and sperm are put together in a lab dish. There are two options for fertilization, and your healthcare team may choose the best depending on your fertility case. Here’s how they work:
Conventional IVF: Sperm and eggs are combined and kept overnight for natural fertilization, just like it happens in your body. The sperm finds the egg and penetrates it, forming an embryo.
Intracytoplasmic Sperm Injection: The embryologist may inject a single, healthy sperm (after evaluating it for movement, shape, speed, and other factors) into a mature egg.
After fertilization, a zygote forms. It’s kept in an incubator that mimics the environment in your uterus and fallopian tube, so that it grows normally. It’s a one-cell structure initially. On day 2, it contains 2-4 cells, and by the final blastocyst stage, it has hundreds of cells. That’s when it’s ready for transfer.
Step 6: Embryo Transfer
The final stage of the IVF treatment process is embryo transfer. It’s a quick, outpatient procedure. It doesn’t require anesthesia. Your surgeon will load the catheter with one or multiple embryos.
They use ultrasound guidance to locate your uterine lining and unload the catheter carefully to transfer the embryos to the right place. After the transfer, you may need to rest for 10-20 minutes. An ultrasound can be used to check if the embryos were transferred successfully.
Go ahead with a pregnancy test 2 weeks after the embryo transfer, or get a blood test done at your fertility clinic. The blood test detects HCG levels, which are produced when an embryo implants successfully. If the report is positive, another blood test will be scheduled around 48 hours after the pregnancy test to confirm if the HCG levels are rising.
Success Rates of IVF in Lahore
Knowing the success rates of IVF in Lahore will help you set realistic expectations for your treatment. Know that the success rate is not the same for every couple. Here are a few factors that affect your success rate.
Maternal Age: IVF offers the highest success rate for women below 35. Although it’s possible to conceive through IVF after 40, the chances are pretty slim.
Lifestyle Choices: Smoking, excessive consumption of alcohol, stress, and unhealthy food choices can all lead to a failed IVF cycle.
Clinical Expertise: Your doctor’s experience, ability, and skills can also influence the success rate of your treatment. Choose a clinic that’s equipped to handle all kinds of infertility issues and has a proven track record of successful pregnancies through IVF.
Overall Health: Some underlying medical issues, like PCOS or endometriosis might affect your chances of conceiving through IVF.
The success rate of IVF in Lahore is between 40% and 45%. However, that’s not the same for every couple.
Here’s what you can do to boost your success rate.
- Getting early treatment (before 35 years if possible)
- Eating a healthy diet
- Staying active
- Keeping your weight in check
- Practicing meditation to stay stress-free
Choosing the Right IVF Clinic in Lahore
There’s one important thing that can make the difference between a successful and failed IVF: Your choice of fertility clinic in Lahore.
The faculty, technology, infrastructure, level of care, personalized treatment, and kind staff matter a lot when it comes to fertility treatments. IVF is a highly sensitive procedure. You may want to work with a fertility specialist team that not only has experience but also offers compassionate care to all patients. They should maintain confidentiality, listen to you, and create a personalized plan.
Lahore has many reputable IVF clinics, but not all are top-rated or recognized ones. Selecting a fertility center that can provide you with the best care, assist in the success of your initial IVF attempt, and—above all—offer moral and emotional support throughout your journey is crucial.
When selecting an IVF clinic, take into account the following factors:
- Qualifications and experience of the fertility specialists
- Success rate
- Patient testimonials
- Ethical consideration
- Cost
Questions to Ask Your IVF Doctor
It’s normal to feel overwhelmed at your first appointment. You may be hesitant to learn about the technical sides of the procedure. But know that it’s your best time to clear your doubts and ask everything that’s on your mind.
Here are a few examples:
- What are the chances we will conceive through IVF?
- Will our baby look like us?
- Is IVF painful?
- How many embryos do you transfer to the uterus? What about the remaining ones?
- Do you follow Shariah?
- What about the risks?
Common IVF Myths and Facts
Many parents who want to seek fertility treatment read news or articles that convey misleading information. We’ve debunked some common myths:
Myth 1: IVF is Not Ethical or Permissible in Islam
Fact: According to Dar al-Ifta al-Misriyyah, IVF is halal as long as it doesn’t cross the shari’ah’s boundary. The egg and the sperm must not be from donors, and the embryo must not be implanted into another woman’s uterus.
Myth 2: IVF is for Older Women
Fact: Advanced maternal age is one of the reasons why couples opt for IVF, but it’s not the only one. It’s a viable approach for couples who can’t conceive immediately or others who’ve tried to conceive for over a year but couldn’t get results.
Myth 3: IVF can lead to Twins or Triplets
Fact: Earlier, multiple embryos were transferred in the hope that one of them would attach successfully to the uterine lining. This often led to twins or triplets. Now, the modern fertility clinics focus on transferring a single embryo at a time to give you the best chance at conceiving a single baby.
Myth 4: IVF is Always Successful
Fact: No fertility treatment guarantees a 100% success rate. The success of IVF has improved over time, but it doesn’t always result in pregnancy for all women.
Emotional and Psychological Aspects of IVF
A little anxiety and stress are completely normal. You are going through a minimally invasive procedure that involves several injections, regular monitoring, and multiple visits to the fertility center. However, it is important to keep stress levels in check for a healthy pregnancy. Here are a few tips that can help:
Don’t Bottle Up: If you are stressed, talk it out. Share it with people you trust or care about the most. Share them with your partner. If needed, seek professional support. A counsellor is there to just listen to you.
Practice Meditation: There are many ways to reduce stress, such as journaling or doing what you love to do the most, but the most effective option is meditation. Choose a quiet place and practice deep breathing to release your worries.
Self-care helps: Don’t let stress affect your physical well-being. Eat a healthy, nutritious diet, read, take regular breaks from work, and get enough sleep.
Don’t Set Unrealistic Expectations: Many among the couples opting for IVF experience a failed cycle. They try it again and succeed. It may take multiple trials for a couple to conceive through IVF. While it’s possible that you may conceive through IVF in the first attempt, don’t get your hopes up. Be prepared for whatever news (positive or negative) you’ll hear after embryo transfer.
Post-IVF Care and Next Steps
After embryo transfer, the biggest challenge is the two-week waiting period. You may have many questions about what to do to improve your chances of pregnancy or what to avoid. The fact is, whether or not you conceive after embryo transfer has little to do with what you do after the procedure. Still, a few things can make a difference. Here’s what to do.
Keep Taking Medication: If your doctor puts you on progesterone, it’s to prepare your uterine lining for a healthy pregnancy. Some women need to continue these injections after transfer.
Eat Healthy: If your embryo has implanted and you’re pregnant, now is the best time to make dietary changes to support the growing baby.
Start Folic Acid Supplements: Folic acid is the most crucial vitamin for pregnancy. It prevents neural tube defects in babies. So, make sure to add supplements, especially if your diet alone does not contain enough.
Nausea, vomiting, breast tenderness, tiredness, and missed periods are all positive signs after embryo transfer.
Things to Avoid
- Sexual intercourse
- High-intensity exercises
- Heavy lifting
- Taking a pregnancy test immediately
- Ignoring severe symptoms, like excessive abdominal pain, bloating, diarrhea, and bleeding.
If your IVF cycle fails, that’s not the end of the world. Remember, you can go through subsequent cycles.
Conclusion
IVF can be challenging. From ovarian stimulation to your pregnancy test, the IVF treatment process can take a toll on your mental and physical health. That said, all the worries will disappear when you see those positive test results. Stay positive and seek professional support when needed.
FAQs
How is IVF treatment done step by step?
IVF treatment follows these steps:
- Initial consultation
- Ovarian stimulation
- Egg retrieval
- Fertilization
- Embryo culture
- Embryo transfer
What is the hardest step of IVF?
For most patients, the two-week wait period is the hardest, as it brings feelings of anxiety, uncertainty, and many emotions.
What is the most painful step in IVF?
Many women describe egg retrieval as a slightly uncomfortable procedure, as it causes cramping and bloating afterward.
Is IVF safe?
Yes, when done by a professional fertility doctor, it’s safe and effective.
