In Vitro Fertilisation Cost in Delhi NCR

The doctor will recommend In Vitro Fertilization in following cases:

• Blocked or damaged fallopian tubes: Though procedures like Tuboplasty are available to repair damaged fallopian tubes but in certain cases it may not be successful and the chances of pregnancy are greater with IVF.
• Male infertility issues like low sperm count or motility can be managed by using ICSI (Intracytoplasmic Sperm Injection) to inject the sperm directly into the egg in the lab. This is effective when, under the normal circumstances, the male sperm is unable to reach the egg or unable to fertilize it due to any unexplained reason.
• Endometriosis, a medical condition in which the cells lining the uterus wall grows outside, also interferes with natural conception. In cases of endometriosis, surgery and medication are suggested first. If they fail, then IVF is recommended.
• Getting pregnant at an advanced age: Women’s ability to conceive decreases with age. However, there is an increasing trend of postponing having children for a later age and by the time they are in their mid-30s women decide to have babies, their capacity has already diminished. This reduced ability can be overcome with IVF.
• Ovulation disorders: The most common being anovulation, which is inability of women to produce or release an egg, can also be managed with IVF using a donor egg.
• Unexplained causes of infertility: In almost 15-20% cases of infertility, the cause never gets diagnosed.

IVF will not be applicable when

• Ovaries are inaccessible
• Earlier pelvic abscess
• When pregnancy may risk life

IVF is emerging as big respite for couples facing pregnancy issues but its high cost, potential pregnancy risks like premature babies or ectopic pregnancies, and chances of multiple gestations like twins and triplets are factors that are making people think twice. It may even require more than one cycle of IVF for success.

Several tests and screenings are conducted before IVF. Common tests include

• Semen Analysis to check the fertility, in case you are planning to use your partner's sperm 
• Infection screening
• Ovarian Reserve Test to check the quality and quantity of eggs
• Uterine Cavity Analysis 

You will be put on birth control pills which may reduce your risk of ovarian hyper-stimulation. Doctor will also use either basal body temperature charting or ovulation predictor kit to detect when you ovulate. Once, the doctor knows this you will be put on a hormonal medication so your ovulation can be controlled.

If you’ve irregular cycles, you’ll be prescribed medicines to bring your periods on time.

The day you get your period is when your treatment will officially begin. On the second day, you’ll be asked for blood tests to check the oestrogen levels in your body. 

Ultrasound to check the size of ovaries and detect the presence of any ovarian cysts which may interfere with the treatment. In case there are ovarian cysts, doctors will either allow them to dissolve in a week’s time or take them out with needle.

Stimulating Ovaries

Under natural conditions, one egg is released by the ovaries every month. However, to increase the chances of success in IVF treatment will be given to produce multiple eggs. Doctors will give injectable hormonal medication for 1 to 2 weeks for stimulating ovaries and produce multiple eggs.

Monitoring appointments

You will be asked to come at least 8 to 9 times for monitoring appointments which will involve:

• Trans-vaginal ultrasound to measure the thickness of the lining of uterus as well as growth of the egg follicles in ovaries.
• Blood testing to measure the levels of estrogen which indicate development and maturation of eggs.
• Each time the test reports come, doctor will provide care instructions, progress information and any changes required in medicines.

Trigger shot 

Based on the monitoring results about the size of your follicles and oestrogen level, doctor will decide when to give you a trigger shot that will fully mature the ovaries and pave way for ovulation. Timing is very important in this stage because just before ovaries are going to ovulate egg has to be retrieved.

Egg retrieval

Roughly, 2 to 3 days after trigger shot you’ll be called to the lab for retrieving the egg. An anesthesia medication will be given to you and a needle will be inserted into each ovary to remove the egg along with the follicular fluid. This will be a small outpatient surgical procedure which will take around 30-45 minutes. 

In case your ovaries are inaccessible through trans-vaginal procedure, then an abdominal surgery will be performed.

Sperm Retrival

Your partner’s sperm will be collected and stored either earlier or on the same day of insemination.

If you are planning to use your partner's semen, then your partner will be asked to provide semen sample through masturbation. Surgical methods like testicular aspiration might be used in some cases.

Sperm is seperated from the semen in the laboratory.

Insemination & Fertilization

Egg retrieval and insemination occurs on the same day. Mature eggs and sperm are mixed and incubated overnight.

If there is a problem with quality of the semen, sperm injection (ICSI) may be used. A single healthy sperm will be isolated and then injected into the egg. This is done in the embryology lab of IVF clinic.

Embryo development 

Once fertilization is complete, embryos began to develop. The growth of these embryos or blastocyst is closely examined by a specialist for at least 1 week.

Embryo transfer

Nearly on the fifth day after the egg retrieval, your appointment will be scheduled for embryo transfer.  Depending on the quality of the embryos, your age and previous medical treatments, either one more embryos will be transferred. For females less than 37 years of age, undergoing first IVF cycle and with good quality blastocysts, doctors may opt for elective Single Embryo Transfer (eSET).

A catheter is used to insert embryo into the uterus.

Pregnancy Test

You’ll have to wait for at least two weeks before pregnancy can be confirmed. You’ll be called for a blood test to check the hCG levels. If more than 25mIU/ml it is considered positive. Still, to be doubly sure doctor may ask for a beta test 2-3 days. If the level of hCG becomes twice after two days, it indicates a healthy pregnancy.

After 6-8 weeks, a vaginal ultrasound may also be done to check for foetal heartbeat and amniotic sac to confirm the positive development of your pregnancy.

For many females, the pregnancy may come out to be negative which would be very disappointing especially after so many weeks of efforts and enthusiasm but don’t let it cloud your hope. Discuss with your IVF specialist who will guide you on next steps.

Your doctor will recommend you to avoid any strenuous activity after the embryo transfer and before pregnancy test. 

Complications in IVF

• Multiple births are the major complication of IVF. This occurs because to increase the chances of success, more than one embryo will be transferred into the women’s womb. Multiple births may increase the risk of other complications like premature delivery, neonatal death, obstetrical complications and lower birth weight. 
• Ovarian Hyperstimulation Syndrome may occur in females if hCG is used for stimulating maturation of ovarian follicles. It causes abdominal pain, nausea and vomiting due to swelling of ovaries. It can be treated with medication. 
• There is a small chance of infection and damage to surrounding areas in bowel and bladder when eggs are retrieved using a needle.  
• In certain rare cases, the fertilized egg may grow outside uterus in fallopian tubes. The condition is known as Ectopic or Tubal pregnancy and demands immediate abortion. 
• Emotional & psychological troubles – When the stakes are high, the stress is increases. This is a basic human nature. Therefore, women mostly feel a range of emotional-psychological issues like depression and anxiety when undergoing IVF. You can discuss coping strategies with your counselor to overcome stress. 
• Preterm delivery, C-section, maternal hemorrhage, gestational diabetes & hypertension may occur. 

Be assured - IVF does not make one vulnerable to cervical cancer, ovarian cancer, endometrial cancer or breast cancer. Birth defects resulting from IVF
Millions of women are turning to IVF for getting pregnant and completing their families. Birth defects may occur but the incidence are not alarming as compared to babies which are conceived naturally.

In general population, the risk of birth defects in a child born through IVF is only 2-3%. The use of intracytoplasmic sperm injection (ICSI) may cause inherent sex chromosomal abnormalities especially in the male offspring like improper development of penis or sperms.

Other common birth defects seen in babies born through IVF are cerebral palsy which interfere with normal development of motor and physical development of the infants; cleft lip, heart defects or hip dysplasia. Research studies are being carried out to monitor the long-term health of babies born through IVF. The excessive doses of hormones during IVF procedure cause dangers of birth defects. Maternal age and causes of infertility also play a greater role in causing birth defects. 

To reiterate what was said earlier, the chances of complications and birth defects are not a cause of worry for those undergoing IVF treatment because they may happen in case of natural births also. With advances in the medical science technology the incidence of such cases have been on decline. IVF-born babies are as much healthy and happy as those though natural conception. You can discuss your concerns and doubts with an IVF specialist or counselor.