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The first ever baby who was created in the lab ( i.e. IVF ) is “Louise Brown” in 1978 by P. C. Steptoe and R. G. Edwards. IVF (In vitro fertilization) is a technological process where several eggs are retrieved from a woman’s ovaries and then fertilized by the husband’s sperm outside the body in a controlled environment of the laboratory. The fertilized eggs then develop into embryos and these are returned to the woman’s uterus, by a procedure called embryo transfer. Fallopian tubes are the host for the union of egg and sperm to create an embryo. Blockage of the tube leads to loss of fertility potential in spite having good eggs and a healthy uterine cavity.

Though the first procedure was carried out for blocked fallopian tubes, subsequently it was found that other problems such as endometriosis, oligospermia also can be effectively treated by this innovative treatment modality. Over the past 30 years, In Vitro Fertilization has seen many changes that include continuous refinement techniques, development of patient selection criteria, and patient preparation to improve success rate

At Genesis fertility clinic & IVF center – we have a team dedicated to providing the highest quality of health care. The aim of Genesis fertility clinic & IVF center is to achieve the highest possible standards in all aspect of medical practice – a personalized, clinical approach that aims to minimize medical and surgical intervention, yet offers you the best treatments and option available. We encourage you to learn as much as you can about the IVF program at our center. This section of the Web site offers an overview of medications, procedures, success rates and financial issues related to IVF. You will also have the opportunity to tour our state-of-the-art medical facilities, post your queries you may have related to infertility.

The IVF Program -
Many couples willing to have their own child are still unable to become pregnant after first line therapy such as ovulation induction, intrauterine insemination, or reproductive surgery. For these couples, the next logical step is to explore the Assisted Reproductive Technologies (ART) like In Vitro Fertilization (IVF) popularly known as Test Tube Baby.

A. Indications for ART

  • 1. Both Fallopian tubes blocked as a result of any disease or previous surgical procedure
  • 2. The partner with reduced sperm count (Oligozoospermia) or motility (Asthenospermia)
  • 3. Antibodies to the gamete.
  • 4. Endometriosis i.e. the endometrium (lining of womb) which is normally inside the uterus, appears on the structures outside the uterus.
  • 5. Unexplained Infertility (refer to couples in whom no obvious pathology is found but who cannot conceive in spite of primary treatments like ovulation induction and IUI).
  • 6. IVF also helps women who have absent ovaries or where there are no eggs in the ovaries provided any young member of the family with proven fertility is willing to donate her oocytes.

B. IVF Medications-

It is necessary to take certain medications during the IVF cycle in order to prepare the body for the treatment. The instructions for each medication vary from patient to patient. The medical team at Genesis fertility clinic & IVF center will analyze your case closely to determine which medications to use, what dosage to take, when to administer the medications and how long to take them.

C. The Preliminary Investigations are

    • For Wife -
    • 1. Hysteroscopy & measurement of Uterocervical length.
    • 2. Ultrasound Examination of uterus and ovaries. (To exclude uterine pathology and cyst in ovaries)
    • 3. Hormonal Profile (TSH, Prolactin, FSH & LH on 2 nd or 3 rd day of the period).
    • 4. CBC, ESR, Blood VDRL, Blood Sugar PP, Blood group and Rh factor, HbsAg (Australia Antigen), HIV, HCV antibodies, Bleeding Time & Clotting Time, X-Ray chest.
    • For Husband -
    • 1. Semen analysis.
    • 2. Semen culture and antibiotic sensitivity test.
    • 3. Antisperm Antibody test for husband and wife
    • 4. Sperm Survival test and semen harvesting.
    • 5. Blood for Australia Antigen, HIV Antibodies, HCV Antibodies

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D. Procedure Guide

  • Initial Consultation:
    The couple should bring along their records of infertility workup that they possess, such as hysterosalpingogram films, semen analysis report, basal body temperature chart, previous laparoscopy test results. The IVF specialist Dr Neelam Bhise will counsel the couple about the program and some further investigations may be necessary to establish the chances of success. The woman may have to be scheduled for a screening laparoscopy, hysteroscopy, and ultrasonography, if needed to assess the pelvic anatomy and accessibility of the ovaries for egg retrieval.
  • Hormonal Stimulation:
    The treatment start from the previous cycle and stimulation begins in early phase of next cycle, so as to get higher number of eggs. The medications are meticulously calibrated according to patient’s need and response.

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  • Monitoring the maturity of the Eggs:
    Blood tests are drawn frequently from the onset of stimulation to determine the progress of stimulated ovaries. Serial Ultrasound examinations are conducted several times to visualize the developing follicles. The size of the follicles and result of the blood tests will determine the time of egg collection. Egg maturation is achieved by injections after the appropriate size of the follicle is reached.
  • Egg retrieval:
    Eggs are retrieved transvaginally by needle aspiration guided by ultrasonic imaging. This requires local anaesthesia / IV sedation / General anaesthesia. The eggs thus obtained are immediately placed in a cultured dish that contains a special nourishing fluid. The patient can be discharged from the IVF center soon after egg retrieval in 2-3 hours.
  • Semen Specimen Collection:
    Semen sample is collected preferably by masturbation at the time of collection of the eggs. There is separate and private facility for semen collection at Genesis fertility clinic & IVF center. There is a facility of freezing the semen sample before egg collection. We can freeze semen for longer duration also as per patient’s requirements. Also it is preferable to do backup freezing, to tackle on time difficulties of procuring semen sample. The sperm cells are separated from the seminal fluid, mixed with the eggs and then are placed in incubator unit till such time, as the eggs are ready to be fertilized.
  • Fertilization and Cleavage:
    Fertilization is the process of sperm penetrating the egg. The egg being fertilized is now called an embryo. The growth and development of the embryo is monitored continuously. The cells of embryos then divide or multiply normally.
  • Embryo Transfer:
    Embryo transfer is done between day 2 to day 5 depending upon number and quality of embryos available. The embryos are placed into uterus using thin tube (catheter) through the mouth of the womb (Cervix). The procedure is done on outpatient basis. The patient can be discharged from IVF center soon after transfer procedure. When indicated, blastocyst stage transfer is offered. Generally 2 to 3 embryos are transferred and spare embryos, if any, are cryopreserved for future for the patient’s own use with patient’s consent.
  • Luteal support:
    In order to improve implantation of embryo in uterus, pure progesterone is given as luteal support in the form of vaginal pessaries, or gel or injections. Supportive medications to increase the blood circulation and endometrial stabilization are also started. The medications are tolerated by patients comfortably.
  • Blood Tests:
    Blood test for beta HCG titer is performed to confirm pregnancy approximately 12 days following embryo transfer.

E. Causes for cancellation in a treatment cycle prior to ovum pick up -

Throughout the stimulation program the response is monitored by ultrasound and blood tests. The aim is to obtain a good number of healthy mature eggs. Thus if the cycle is unsatisfactory, it may be cancelled at any stage. The reasons for this are:

  • 1. Very few follicles are developing which would decrease the chance of obtaining at least one mature egg.
  • 2. There are no follicles developing at all. This is rare but may occur.
  • 3. The blood Estrogen levels are too low for development of healthy eggs or according to the patterns seen over the last 18 months, unlikely to lead to pregnancy.
  • 4. The follicles may have ovulated prior to sonography. Occasionally some women ovulate earlier than the expected or ovulate without our being able to detect the time when the ovulation commenced. Thus it is impossible to accurately predict when ovum picks up should be performed.
  • 5. Sometimes ovarian cysts develop in response to the drugs. These are not serious or harmful. They usually resolve within one month or may require to be aspirated before starting the stimulation.
    Sometimes the patient gets hyper stimulated and it is dangerous to continue the stimulation

F. Assisted Laboratory Procedures -

When beginning an IVF cycle, the ultimate goal of our team is to enable the patient to take home a healthy baby while minimizing the risk of multiples. New advances in laboratory techniques have made it possible to achieve this. Assisted reproductive technologies also include Intracytoplasmic sperm injection (ICSI), Blastocyst culture, assisted hatching and cryopreservation.


The first gamete micromanipulation techniques date back to the late 50’s. In Rome in 1990 there was the first birth by injection of the sperm into the perivitelline space (SUZI) obtained by the team Simon Fishel, Severino Antinori and Franco Lisi The technique was developed by Gianpiero Palermo in 1991 at the Vrije Universiteit Brussel, in the Center for Reproductive Medicine headed by Paul Devroey and Andre Van Steirteghem. The first American baby was conceived with the technique At Reproductive Biology Associates (RBA) in Atlanta, Georgia in 1992 under the direction of Michael Tucker. The first large experience with the technique in the United States was published by Joseph D. Schulman and colleagues at Genetics and IVF Institute in 1995 Intracytoplasmic sperm injection ICSI -This is a well-established technique that enables an embryologist to manipulate both male and female gametes outside the body to maximize the probability of fertilization.

A. Indications for ICSI

  • 1. Sever male factor infertility where the sperm count is extremely low
  • 2. Unexplained infertility,
  • 3. Patients having Immunological factor,
  • 4. Repeated failed IVF etc.
  • 5. Egg zona (outer layer of egg) is excessively thick and impenetrable for the sperm
  • 6.To reduce transmission rates of blood borne diseases

Here, a morphologically normal sperm is selected and is injected into the center of an egg. Whole procedure is closely monitored under inverted microscope at the magnification of about 400X. It has been shown that ICSI resulted in better egg fertilization rates, better quality embryos, better rate of blastocyst formation and therefore better pregnancy rates.

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