1. What exactly is IVF?

Ans – IVF or In Vitro fertilization is a process where sperm fertilizes the eggs in the dish in an IVF laboratory rather than in the fallopian tube of a woman. IVF involves aspirating eggs from the ovaries, then fertilizing them, and then the fertilized embryo is grown in the lab for 5 to 6 days and transferred back in the woman’s uterus through the help of an ultrasound-guided embryo transfer process.

2. How long should I wait before consulting a fertility doctor?

Ans – If you are unable to get pregnant after a year of having sexual intercourse without using any form of birth control, it might be a good time to consult a fertility doctor. If you are 35 years or older then you should wait only 6 months, however, the best thing to do is go in for preconception counseling wherein you visit a fertility expert much before you even start trying to conceive so that most problems can be identified and rectified in time.

3. How successful is IVF?

Ans – Success rates can vary widely, globally IVF success rate is somewhere around38-39 %., and the most important parameter to influence is the female age. women, more than 35 years of age might need repeated cycles of IVF for success.

4. How long does IVF take?

Ans – Generally, an IVF procedure takes approximately 4-6 weeks, from the starting of medications to egg retrieval and embryo transfer.

5. Will IVF significantly increase my chances of having twins or triplets?

Ans – You can opt for what’s called an elective single embryo transfer (eSET). means that only one embryo is transferred instead of two or three as has been common practice in the past. But with more and more clinics now switching to blastocyst transfer, only one or if the maternal age is above 35 we might transfer 2 embryos. This considerably reduces the chance of multiple births.

6. Are there any side effects associated with IVF treatment?

Ans – IVF is generally a very safe procedure and most who have it experience no problemsad such, However, there are some risks to be aware of, which include:
● Multiple pregnancy or birth (twins, triplets, or more)
● Ovarian hyperstimulation syndrome (a reaction to fertility drugs)
● Ectopic pregnancy

7. When should I opt for IVF?

Ans – Women who are unable to conceive naturally, and have issues like blocked tubes, male infertility, endometriosis or unexplained infertility opt for the common treatment known as IVF. When a woman undergoes IVF, she is put on medicines (fertility hormones) to stimulate the ovaries to produce several eggs. The eggs are then collected and mixed with sperm in a laboratory.

8. What is the difference between IVF and ICSI?

Ans – A classical IVF is the mixing of the sperms with a few eggs in a dish in a laboratory, ICSI involves the injection of a single sperm directly into the cytoplasm of each egg. ICSI is a suitable approach for couples where the sperm parameters are not up to the mark.

9. Is the fertilization rate of ICSI better than IVF?

Ans – According to a recent study, the routine use of ICSI does not improve fertilization and is not recommended in patients with non-male factor infertility. in patients with male infertility, ICSI is the choice of treatment and it shows better fertilization than IVF

10. What is cryopreservation?

Ans – In an IVF cycle, if more embryos are formed than needed, the remaining embryos are frozen and stored for future use, this procedure to preserve and store embryos is known as cryopreservation.

11. Can I freeze my eggs for future IVF treatment?

Ans – Yes, we can preserve a woman’s fertility by egg freezing, so she can try to have a family in the future. It involves collecting eggs by the process of egg retrieval and then freezing them. The eggs are then thawed when the woman is ready to go ahead with fertility treatment.

12.HOW EFFECTIVE IS EGG FREEZING

Ans – Egg freezing is an important fertility preservation method.
Earlier Egg freezing used to be a difficult process. The inferior “slow freezing” methods have subsequently been replaced by the superior “vitrification.”
Vitrification is a fabulous invention whereby embryos/eggs are frozen in a way that prevents ice crystals from forming and instead takes on a glass-like structure.
So, the survival rates have gone up to 80 %, but this is highly dependent on the embryologist’s technical abilities. Another factor that influences survival rates is age. Generally, women >35 have a lower egg thaw survival rate compared to women
<35, with a difference of about 20%.

13. Is the egg retrieval procedure painful?

Ans – The egg retrieval or ovum pick-up is a day procedure done under anesthesia, to ensure that you do not feel any pain and there is no discomfort whatsoever during the procedure.

14. Is it done under anesthesia?

Ans – Yes, Egg retrieval is done under anesthesia, you are sedated very lightly so that you don’t feel any pain.

15. Is it an ultrasound-guided process?

Ans – Yes, egg retrieval is a vaginal ultrasound-guided procedure.

16. Do I need to take leave from work after the procedure?

Ans – After egg retrieval, 24 hours of bed rest is recommended, then you can resume your normal life.

17. Can we get a semen sample from home?

Ans – The semen should be provided not before an hour of egg retrieval, it is generally preferred that your partner come to the facility and provide sperm through ejaculation.
In special cases, you will be allowed to get the sample from home, but it is generally discouraged.

18. What is embryo grading?

Ans – Each clinic uses its grading system to allow them to believe they are the best embryos. day 3 and day 5 embryos are graded separately. Day 3 embryos are graded generally 1-4. Whereas a blastocyst grade is presented by a number and 2 letters (A to C). The number suggests the stage of expansion and the letters relate to the cell mass. The first letter relates to the inner cell mass and the second relates to the trophectoderm cells.

19. Is complete bed rest advised after the embryo transfer?

Ans – After the embryo transfer you are generally advised to rest for some time, you may subsequently resume a normal life, this will not affect in any way your chances of successful implantation.

20. How much rest is required immediately post-transfer, before one leaves the hospital?

Ans – A maximum of 30 min rest is good enough before one leaves the IVF facility. After that, you can walk, climb stairs slowly. Vigorous exercise is best avoided.It doesn’t hamper your chances of implantation.

21. Does one need to take many injections even post transfer?

Ans – Injections can be of two types

1. Progesterone injections
2. Injections to support implantation and pregnancy Both of these injections are not necessary in every case and are decided by the doctors as per the individual need of the patient.

22. DOES EMBRYO GLUE IMPROVE EMBRYO TRANSFER OUTCOMES?

Ans – Embryo glue is a hyaluronan-based culture media that is supposed to help the embryo stick to the uterus, Hyaliuran is a glycoprotein that provides a viscosity environment in the uterus. A Cochrane review has shown a moderate increase in live births.

23. What is embryo donation?

Ans – Embryo donation is similar to egg donation. However, instead of borrowing the egg only hereboth the egg and the sperm are derived from donors. and then they are fertilized and embryos are formed .then these embryos are donated. couples are recruited for embryo donation when both the partners are infertile, and when couples are at risk of passing genetic disorders to their child

24. DOES FOLLICLE SIZE INFLUENCE EGG QUALITY

Ans – The quality ofan egg depends on 2 parts
The nucleus and cytoplasm.

The nuclear component consists of chromosomes DNA
The cytoplasmic component involves the cytoplasm, maturation of both the components is important for better egg quality.
When follicles are bigger, it’s an indication that The cytoplasmic maturation process has begun!
To put it another way, eggs from larger follicles are of higher quality! Embryos of higher grade are more likely to be produced.
When follicles grow too large (>23 mm).postmature oocytes can occur These embryos have a worse quality and are more likely to deteriorate following ICSI or not fertilize

25. What is aneuploidy?

Ans – Aneuploidy is defined as having an abnormal number of chromosomes.
It is a condition in which one of your 23 chromosome pairs is missing or there is an extra one.
A Euploid embryo has the right number of chromosomes. So that’s 46, or two pairs of 23.

1. What is OHSS?

Ans – Ovarian hyperstimulation syndrome (OHSS) can result in some patientsundergoing IVF treatment, the administration of injections for follicle development can cause the enlargement of the ovary causing the hormonal levels to increase which can result in overstimulation of ovaries

2. What are the symptoms of OHSS?

Ans – The symptoms depend on the severity of OHSS

• IN CASES OF Mild OHSS
  • – Mild abdominal swelling or bloating,
  • abdominal discomfort and
  • nausea

• In cases of Moderate OHSS

– Symptoms of mild OHSS but the swelling and bloating are worse due to fluid build-up in the abdomen. The intensity of abdominal pain and vomiting increases.

• Severe OHSS

• • Symptoms of moderate OHSS plus
  • Extreme thirst and dehydration
  • Decreased urine output

Shortness of breath

3. What causes it?

Ans – Fertility drugs stimulate the ovaries to produce eggs. Sometimes there is an excessive response to fertility drugs as a result large numbers of follicles are developed and this causes OHSS.
Overstimulated ovaries enlarge and release chemicals into the bloodstream that make blood vessels leak fluid into the body. Fluid leaks into your abdomen causing bloating and swelling.

4. Who gets it?

Ans – Mild symptoms are common in women having IVF treatment. As many as one in three (33%) women develop mild OHSS. About one in 20 (5%) women develop moderate or severe OHSS.

The risk of OHSS is increased in women who:

• have polycystic ovaries
• are under 30 years
• are thin built
• have had OHSS previously
• get pregnant, particularly if this is multiple pregnancies (twins or more).

5. What measures do we take to reduce the chances of OHSS

Ans – At renew healthcare we identify

• at risk’ women and start medicines like Metformin which reduce the incidence
• Prescribe higher intake of proteins
• Customize the drug dose for each patient care based on age, AMH levels, and BMI values.
• Use Antagonist protocol while making eggs
• Use special injections for final egg maturation instead of using hCG
• Use medicines and injections after egg collection to minimize OHSS
• Avoid transferring fresh embryos and instead, go for frozen transfers.

6. How long does OHSS last?

Ans – Most of your symptoms should usually resolve in a few days. If you have mild OHSS, you can be looked after at home.

• If your fertility treatment does not result in a pregnancy, OHSS will get

better by the time your period comes.

• If your fertility treatment results in a pregnancy, OHSS lasts up to a few weeks or longer.

7. What should I do if I have mild OHSS?

Ans –

• Mild OHSS can be treated at home, infirm your consultant, they will help you through it
  
• Make sure you drink clear fluids at regular intervals. If you have pain, take ordinary paracetamol or codeine (no more than the maximum dose). avoid anti-inflammatory drugs
  
• Avoid exercise or intercourse as it can result in twisting of the enlarged ovaries.
  
• Call for medical help if you develop any of the symptoms of severe OHSS, particularly if you are not getting any pain relief, If you start to vomit, have urinary problems.

8. When will I need to stay in the hospital?

Ans – In cases of severe OHSS, we may advise you to get admitted to the hospital. At the hospital, we will carry out the tests for mild OHSS such as blood tests and ultrasound.
If you are vomiting, you may need a drip to replace the fluids you have lost.

9. is there any test to diagnose OHSS?

Ans – There is no specific test that can diagnose OHSS. A diagnosis is made based on your symptoms. The doctor might examine you and according to the symptoms will decide on your treatment plan.

10. What is the treatment for OHSS?

Ans – No treatment can reverse OHSS.
OHSS will get better with time, so treatment is to help reduce the symptoms and prevent
problems.

• pain relief such as paracetamol or codeine
  
• anti-sickness drugs to help reduce nausea and vomiting
  
• an intravenous drip to rehydrate you