In Vitro Fertilization (IVF) is a medical aid to procreation that reproduces (finds something else and performs) fertilization in the laboratory. This PMA technique is offered to patients to optimize their chances of pregnancy.
The goal of this treatment is to obtain one or more embryos of optimal quality that can be transferred to the uterus to allow a pregnancy to occur.
Here are the main stages of IVF Cost in Pakistan.
Step 1: Ovarian stimulation
- The first step during a PMA course, ovarian stimulation helps boost ovulation.
- The woman’s menstrual cycle produces, after approximately 14 days, 1 so-called “dominant” follicle containing 1 mature oocyte, i.e. potentially fertilizable by a sperm.
- As part of in vitro fertilization, it is necessary to obtain several oocytes in a single cycle after 10 to 15 days of IVF treatment, in order to maximize the chances of obtaining at least 1 transferable embryo.
- For this, we use a hormonal treatment for ovarian stimulation with FSH (+/_ associated with LH) which comes in subcutaneous injectable form and must be renewed approximately every 24 hours. You can do these injections yourself at home.
- The daily dose prescribed by your doctor is adapted to your particular case and determined by preliminary evaluation criteria such as the count of antral follicles on ultrasound at the start of the cycle and the level of AMH (anti-mullerian hormone).
- The response to ovarian stimulation treatment is assessed by vaginal pelvic ultrasound, combined with hormonal measurements. This monitoring occurs approximately every 48 hours until an optimal number of mature follicles has reached a size and hormonal level indicating the time of optimal maturity.
During your ovarian stimulation, adjuvant treatments may be offered:
- Upstream of ovarian stimulation, for example, a “blockade”: estrogen-progestogen pill, estradiol, progesterone (by the tablet), or GnRH agonists (by intramuscular, nasal, or subcutaneous route)
- During stimulation to avoid premature ovulation by Gn RH antagonists (Cetrotide, Orgalutran, or Fyremadel Ge.
- The daily monitoring of these hormonal treatments and the results of your examinations, as well as the rest of your treatment, are indicated to you by your doctor via the Wistim monitoring application.
- Once the optimal moment of maturity has been decided, you will need to carry out an injection of hCG (OVITRELLE®) or Decapeptyl® which will trigger the last stage of oocyte maturation.
- This injection must be carried out on an extremely precise date and time to allow the subsequent stages to run smoothly.
Steps 2 and 3: Egg retrieval and sperm collection
This step is essential since it makes it possible to provide the medically assisted procreation (PMA) laboratory with the gametes: spermatozoa and oocytes (ovules).
On the date determined by your doctor, your spouse will collect sperm (or frozen, self-preserved or donor sperm if applicable) which will be used for egg fertilization.
To recover the oocytes, contained in the mature follicles, surgical intervention is necessary. It is carried out in an operating room, using ultrasound guidance via the vaginal route, under local or general anesthesia. Thanks to the ultrasound probe, on which a guide is attached, the doctor will prick each mature follicle on each ovary and a suction system (pump and tube) makes it possible to recover this follicular fluid which is kept at 37° and transmitted in the laboratory.
The laboratory’s biologists and technicians will then carry out the actual in vitro fertilization with your partner’s sperm.
Step 4: Fertilization and embryo culture
The PMA laboratory, which therefore has the gametes of each member of the couple (oocytes for the woman, spermatozoa for the man) will proceed with fertilization: either by a best IVF in Lahore or by an ICSI IVF (put hyperlink to the IVF ICSI article) (intra cytoplasmic spermatozoon injection where for each mature oocyte, a selected spermatozoon is microinjected directly).
24 hours later, the fertilized oocytes are observed and we determine whether fertilization has occurred and the initial evolution of the embryos. Embryo culture in vitro (= in the laboratory) can last from 2 to 6 days and the optimal time for embryo transfer is decided in collaboration between clinicians and biologists.
Step 5: Embryo transfer
The final stage of your care during IVF, it consists of placing in the uterus the embryo(s) which will have been selected according to their evolution by the team to give you the optimal chance of pregnancy.
This procedure is painless and is carried out in consultation, in the gynecological position and consists of introducing via the cervix and after having placed a speculum (as for a standard gynecological examination), a catheter (flexible plastic tube 1mm in diameter approximately) in the uterine cavity.
The biologist will have previously placed the embryo(s) in a micro drop of culture medium (liquid) in this catheter. Embryos are not visible to the naked eye. This procedure is painless and can be performed under ultrasound control.
The catheter after the transfer is returned to the laboratory which checks that it is empty. If embryos other than the one/those transferred evolve well, the laboratory can preserve them by freezing (embryo cryopreservation). This allows you to benefit from a new embryo transfer without a new puncture.
Step 6: The pregnancy test
After the embryo transfer, you will be told when to carry out the pregnancy test: 14 days after fertilization, therefore 14 days after the date of the puncture. This mandatory blood test will determine whether the embryo transfer has progressed favorably and has been implanted in your endometrium.
To do this, take a blood test for the level of beta HCG, a specific hormone produced by the embryo and which diffuses into the mother’s blood.
The rest of the pregnancy monitoring will be specified to you by your doctor.
Adjuvant IUI Treatment Cost in Pakistan are necessary for the proper development of the pregnancy: progesterone (vaginal eggs, vaginal gel, or subcutaneous injections).
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