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abuse |
 Test
tube baby (In vitro fertilization IVF) is a revolutionary treatment for
those couples who can't have a baby on their own because of various types of
infertility. First developed by Drs. Patrick C. Steptoe and Robert G. Edwards of
Great Britain (where the first "test tube baby was born under their care in
1978), the technique was devised for use in cases of infertility when the
woman's fallopian tubes are damaged or the man's sperm count is low. It is also
now used to enable prospective parents with other reproductive problems (e.g.,
inability to produce eggs, poor sperm quality, or endometriosis) to bear a
child.
What is a Test Tube Baby?
A test tube baby is the term that refers to a child that is conceived outside
the woman's body. The process is referred to as "in vitro" (outside the body)
fertilization. Simply put, eggs are removed from the mother's ovary and
incubated with sperm from the father. After fertilization, the "pre-embryos"are
allowed to divide 2-4 times (in a "test tube", hence the name) and then returned
to the mother's uterus where they can develop normally. Through these
procedures, women with otherwise untreatable infertility problems have given
birth to healthy babies.
In vitro fertilization IVF
During IVF, a physician collects ova from the woman at the time of her
ovulation, using a high-tech procedure called laparoscopy. In the next step the
man's sperms and woman's egg are combined in a laboratory dish, where
fertilization occurs. The resulting embryo is then transferred to the woman's
uterus, for normal development in the uterus, or frozen for later implantation.
Eggs can also now be frozen and fertilized later. The basic steps in an IVF
treatment cycle are super ovulation (stimulating the development of more than
one egg in a cycle), egg harvest, fertilization, embryo culture, and embryo
transfer. Even though conceived differently than most, the baby does not look
any different and, in fact, is no different from other babies.
How is I.V.F. carried out?
During superovulation, drugs are used to induce the patient's ovaries to grow
several mature eggs rather than the single egg that normally develops each
month. The idea is that if one has several follicles available for egg
retrieval, then if more than one egg is successfully fertilized and transferred
back into the uterus, the odds are greater that at least one of them will
successfully implant. The progress of the growth of the follicles is closely
monitored either by blood and urine tests or by ultrasound measurement of the
follicles.
Once the follicles are ready for ovulation, Human Chorionic Gonadotropin (H.C.G)
of 5,000 units is given. The eggs are retrieved 33-36 hours following the H.C.G.
injection.
There are two methods, which clinics may use for egg retrieval.
1. Ultrasound-guided aspiration. In this
method the ultrasound probe is inserted through the vagina, which emits
high-frequency sound waves, which are translated into images of the pelvic
organs and displayed on a monitor, so that the mature follicles can be seen as
black bubbles on the screen. The doctor guides a needle through the vagina into
each mature follicle. The follicular fluid containing the egg is then sucked out
through the needle into a test tube, and all the follicles are aspirated, one by
one.
2. Laparoscopy. This is carried out under
general anesthetic. The eggs are retrieved from their follicles using a very
fine suction needle. However, this method is rarely used today, because the
vaginal-ultrasound guided method is much quicker, easier and safer.
3. T.U.D.O.R. This stands for Trans-vesical,
Ultrasound Directed Oocyte Recovery. This is an outpatient procedure performed
under a local anesthetic. In this method, a suction probe is guided by
ultrasound control through the bladder. This technique also has the advantage of
being able to retrieve eggs from an inaccessible ovary even if it is covered by
adhesions. The eggs are now incubated for 4-24 hours in a specially prepared
culture medium in order to ensure that adequate maturation has occurred.
100,000-1,000,000 specially prepared progressively swimming sperms are then
added to the incubated eggs. Fertilisation takes place within the next 24 hours.
2-3 days later the embryo transfer takes place. This is a painless procedure and
no anesthetic is required.
For whom is I.V.F. advisable
Candidates for I.V.F. are usually those women with irreparably damaged tubes,
endometriosis; immunological problems; unexplained infertility and male factor
infertility. I.V.F. can also be the treatment of last resort in the case of
problems like oligospermia, major cervical mucus hostility factors and certain
cases of unexplained infertility.
A woman's age must be considered. Older women feel additional pressure as they
feel their biological clocks are ticking and time is running out. However, there
is no upper age limit at which IVF should not be done, - and in fact, for older
women, it might represent their only chance of success. It's not really the age
of the woman, which is the limiting factor - it's the quality of her eggs.
Patients who stand a very poor chance of success with IVF include the
following.
-
Older women, whose ovaries are
failing. However, there is no upper age limit at which IVF should not be done,
and, infact, for older women, it might represent their only chance of success.
It's not really the age of the woman, which is the limiting factor; it's the
quality of her eggs.
-
Men whose sperm count are very
low. Again, IVF may be the only option these men have to father their own
biological child, and, therefore, there is no " magic" number of sperm, which
a man must have before considering IVF for him.
-
Women with a damaged uterus (for
example, because of healed tuberculosis) because the chance of successful
implantation of the embryo in the uterus becomes very poor.
Tips for greater chances of
I.V.F success
For Women……..
-
No smoking or alcohol use.
Studies show both can result in lower pregnancy rates and a greater risk of
miscarriage.
-
No more than two caffeinated
beverages per day.
-
Avoid change in diet or weight
loss or fad diets during IVF cycle. A healthy well balanced diet works best.
-
Refrain from intercourse three to
four days prior to egg retrieval and following embryo replacement until
pregnancy determination is made.
-
Normal exercise may continue
unless enlargement of your ovaries produces discomfort.
- Avoid hot tubs or saunas.
For
Men……..
-
Drugs, alcohol, and cigarette
smoking should be avoided for three months prior to treatment and at all times
during the ongoing IVF treatment cycle to get the best results.
-
Sitting in hot tubs and saunas is
not recommended. Even a single episode in the hot tub can adversely effect
sperm function. Please refrain from this for at least three months prior to
treatment.
-
Abstain from intercourse for at
least three days, but not more than seven days prior to collection of semen
for egg collection and during treatment.
-
Fever greater than 100.4o one to
two months prior to IVF treatment may adversely affect sperm quality. Consult
your doctor immediately.
What is the cost of one
IVF treatment cycle?
The cost of a single IVF treatment cycle varies widely from
approximately Rs 30,000 to more than Rs 75,000 depending on the program and the
items included in the fee. The number of treatment cycles needed to achieve
pregnancy will, of course, determine the final cost.
What is the success rate of I.V.F?
The success rate of pregnancy associated with this treatment
ranges between 15-30%. Therefore it is also not advisable to go in for IVF
treatment without trying simpler treatment options first. IVF is a complex
procedure involving considerable personal and financial commitment, so other
treatments are usually recommended first.
GIFT
GIFT stands for gamete intrafallopian transfer. Specialists
generally agree that pregnancy rates are higher for GIFT than for IVF- in fact,
GIFT is about twice as successful as IVF. A gamete is a male or female sex cell
- a sperm, or an egg. During GIFT, sperm and eggs are mixed and injected into
one or both fallopian tubes. After the gametes have been transferred,
fertilization can take place in the fallopian tube as it does in natural,
unassisted reproduction. Once fertilized, the embryo travels to the uterus by
natural processes. As in IVF, a GIFT treatment cycle begins with ovulation
enhancement, which is followed by egg harvest, usually by means of laparoscopy.
During this same laparoscopy procedure, which takes about an hour, eggs are
mixed with sperm and the gametes are transferred.
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