April 27, 2020
Author Name: Dr. Thokal Pravin Chhaburao || Mentor Name: Dr. RV Singh on April 27, 2020
IVF is a process of fertilization where an egg is combined with sperm outside the body, in vitro and transferring embryo in the uterus. The analogy of ‘seed and soil ’ explains the process of ivf in a simplified manner. On the same lines, as every seed cannot be a plant, similarly every embryo transferred, inspite of the embryo and the uterus being good, will not end in a clinical pregnancy.
So, it is totally a misleading claim that ivf ensures 100% success rate. Overall success rate with self eggs in same cycle is around 30-40%.
Success rate of ivf depends on various factors and advanced techniques that we are using.
1) Age: as age of women advances success rate decreases. Because egg reserve decreases, quality of egg also decreases.
In infertility, previous dictum was that IVF is the last resort as treatment, but in today’s era, IVF done at the right age is the most important determinant in the success .
2) Patient’s nutritional status and healthy lifestyle habits also affects fertility by direct impact on egg quality.
3) Stress level of patient is also an important factor in success rate.
4) Male factors like teratozoospermia, DNA fragmentation also affects success rate.
5) Implantation : Implantation is a process by which embryo get attaches to endometrial surface of uterus and invades the epithelium and then the maternal circulation to form placenta. It is the most important step in success of ivf.
6) Well equipped lab and trained staff: Almost 50-60% success depends on embryo quality. The advanced techniques available in lab , the trained embryologists and good clinician. Because it is a team work of expert embryologist and gynecologist.
1)Optimized ovarian stimulation: Proper ovarian stimulation according to age, AMH is very important factor in obtaining good quality eggs.
2) Closed working chamber: In closed working chamber we maintain proper environment for fertilization which is present in fallopian tubes like Co2 conc,. O2 conc. and temperature.
3)Frozen embryo transfer : FET means transfer of embryos in subsequent cycle after preparing endometrium. FET increase the chances of ivf conception & helps to achieve better success rate as we have time for preparing endometrium, genetic testing of embryos (pgd). Improves success rate by 5-10% as transferring chromosomally normal embryos have better chances of implantation rather than chromosomally abnormal embryos.
4) Blastocyst culture: blastocyst culture means growing embryos in lab for 5-6 days and then transfer into uterus. In average centre embryos are grown till day 3 and then transfer. But blastocyst culture technique ensures that only good quality embryos survives till day 5 and increase the possibility of healthy embryos being transfer . Improves success rate by 10-15%
5) Laser assisted hatching: In this technique, with the help of laser a small crack in the outer coating of embryo was made and then transfer. It helps in easy hatching of embryos and better implantation in uterine lining improves success rate by 5-10%
6) Donor oocyte : If female partner has poor quality eggs or no eggs then we can go for donor eggs . It improves success rate by 10-15 %
7) Hysteroscopy : hysteroscopy means visualizing uterine cavity through an endoscope. It helps in identifying uterine abnormalities and correct them. This will improve chances of conception via ivf.
8) PRP Therapy: Platelet rich plasma extracted through patient’s blood and injected into patient’s ovary or uterine lining. It helps in patient with poor ovarian reserve or patient with thin endometrial lining through healing and regeneration process.
9) PGD/PGS: Embryo biopsy done to screen embryos for euploid status and couple with family history of genetic disorder to have healthy baby. It increases success rate by 15-20%
10) Endometrial receptivity test (ERA) : taking endometrial biopsy and analyzing for 248 gene related to receptivity. It tells us endometrial receptivity for embryos. It also increase success by 15-20%
All these advanced techniques ensures 60-70% overall success rate and in INDIRA IVF we are having all these techniques available which help us to maintain this success rate.
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