In vitro fertilization (IVF) will always be performed in the Best IVF Center in Pakistan with a medically assisted procreation unit. These specialized units will follow the couple in their desire for a child throughout the various stages of IVF.
The principle of IVF
The Latin expression “in vitro” means in glass, as opposed to “in vivo”, which means in the living world.
In vitro fertilization consists of collecting a maximum of mature oocytes and placing them in the presence of many mobile spermatozoa. Thus, fertilization can occur in the laboratory with a greater probability than in the female organism.
If the quantity of mobile spermatozoa is insufficient, a different technique is used, microinjection, which consists of directly introducing a spermatozoon into each oocyte (ICSI = intra-cytoplasmic sperm injection).
Only fertilization and the very first stages of embryonic development (generally in the fallopian tube) are performed in the laboratory. The embryos are then placed back in the uterus, and they can implant themselves in the endometrium and develop until the end of the pregnancy.
1. Stimulation of the ovaries
The choice of ovarian stimulation regimen depends on many factors: your ovarian reserve, your age, the results of previous treatments, etc.
Sometimes, oral contraception (pill) may be prescribed before starting stimulation to program the cycle. This must be created at the beginning of the process (first day of menstruation) and continued without interruption until the date fixed by the doctor in consultation. A second strip is started following the first, without interruption, to reach the required stop date.
Most often, however, treatment will be started at the end of a spontaneous menstrual cycle.
Several hormones will be administered simultaneously or sequentially to obtain several mature oocytes simultaneously (instead of a single oocyte produced each month naturally).
• A first type of hormones will be used to inhibit the pituitary glands’ control over the functioning of the ovaries from avoiding spontaneous ovulation, which would lead to the cancellation of your treatment. Depending on your doctor’s recommended regimen, this medicine will be prescribed as a nasal spray or injections under the skin.
• A second type of hormone (“gonadotropins”) will stimulate the simultaneous growth of several follicles in both ovaries. It is either a hormonal complex consisting of FSH, LH, or FSH.
The ovaries’ response to stimulation varies from one woman to another. Rigorous monitoring will make it possible to adapt the treatment to your response and determine when follicular maturation will be optimal to induce ovulation.
This monitoring consists of measuring:
• The level of hormones produced by the growing follicles (it is established through blood tests).
• The size of the follicles measured by ultrasound (or “ultrasound”) of the vagina.
It exceptionally happens that the response to ovarian stimulation is excessive (hormone level too high). In this case, it is sometimes necessary to abort the cycle or to delay the onset of ovulation while continuing drug inhibition of the pituitary while waiting for the hormone level to drop to a more usual level. The medical term for this break in your treatment is coasting.
2. The puncture
When the ovarian stimulation parameters are optimal, ovulation will be triggered by an injection analog. This injection must be performed many hours before the oocyte retrieval under the supervision of IVF in Pakistan.
Oocyte retrieval is performed vaginally under ultrasound guidance after local anesthesia of the vaginal fundus and intravenous sedation (neuroleptanalgesia).
3. Insemination
It is carried out on the same day as the oocyte retrieval.
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