IVF essentially consists of 4 major steps.

• Receiving injections to the wife for the development of eggs/oocytes
• Aspirating the eggs from your ovaries/egg pick up/ovum pick up
• Fertilization of the egg and the sperm
• Embryo transfer

The process usually starts on the 2nd day of your menstrual cycle. You are asked to visit the clinic for scan and blood tests. If the scan is normal, your doctor will decide the appropriate dose for the injections to be started. On an average, you might have to take the injections for about 9-12 days based on your body response. During this time, you will be asked to visit the clinic a couple of times for scanning. These injections help in the development of multiple eggs from your ovaries. Once the eggs reach a size of about 17-19mm you will receive a new injection called the trigger . This causes the eggs to mature. About 35-36 hours from the trigger you will be scheduled for your egg pick up. The most important things to keep in mind is to take the injections at the same time every day. If you are self-administering the injections ensure that the temperature of the injections is always maintained as per the instructions.

The first and most important thing to keep in mind for the egg pick up is to be on time.

If you miss the timing given by your doctor there is a possibility that your eggs might rupture and the entire process of taking injections might go waste. So please be on time.

You should come to the clinic empty stomach or the last meal should have been 6 hours back.

If you are taking any thyroid medication, take the morning dose with small sips of water.

Don’t wear any perfumes/ body lotions as they can be harmful to your eggs.

The egg pick up will be done under general anaesthesia. You will completely be unconscious during the procedure and it will be absolutely pain free.

The eggs are picked up through the vaginal route using a small needle attached to the scan probe. The procedure lasts for 15-30 minutes based on the number of eggs you have.

After the egg pick up you might have to stay in the clinic for another 3 to 4 hours and then you are good to go home.

Break the fasting by having light food or fluids. You can resume having normal food and regular activities on the same day. You may expect minimal cramping and spotting which will settle in 1 or 2 days.

Continue taking the medications your doctor has advised.

The male partner should give a semen sample for processing on the day of egg pick up. It is ideal to have an abstinence period of 2-3 days before collection.

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Fertilization is the process in which the sperm and the egg react resulting in the formation of an embryo. This happens in the embryology lab under highly controlled environment. There are 2 methods by which sperm and egg can react. One is IVF and other being ICSI. If the sperm count is good, then the sperms and eggs are placed together in a small dish for the sperms to react naturally with the egg.

Once fertilization is done, the embryo is allowed to grow for another 3 days or 5 days in the lab and an embryo transfer is planned. For example, if you have an egg pick up on Monday you might have the transfer on Thursday or Saturday based on the quality of the embryo.

Things you need to know before an embryo transfer

It is NOT done in fasting. So, you can have your regular diet

It IS DONE with your bladder full. So, you are expected to drink at least 2-3 litres of water an hour before the transfer.

All your other medications should be taken as usual.

The embryologist loads the embryos into a very thin 1mm diameter catheter.

These embryos are transferred into your womb under ultrasound guidance and placing the embryos right in the middle of the womb.

Each egg aspirated has the potential to develop into an embryo. Depending on the efficiency of the egg and the sperm this can range between 60-100%. Based the quality and the day of transfer anywhere between one, two or three embryos can be transferred. This decision is taken by the doctor after discussing with you and the embryologist.

All the extra embryos that are not transferred are frozen and stored for future use.

A pregnancy test (blood levels of bhcg) is done 14 days after the embryo transfer.

With each cycle the chances of getting pregnant is around 35-50%. This is mainly determined by the cause of infertility. Women with blocked tubes have better chances of getting pregnant rather than women with endometriosis.

If you have extra set of embryos frozen, then you need not go through the tedious process of receiving injections and egg pick up. The uterine lining is developed using medications and once it’s ready an embryo transfer is done. This is called Frozen embryo transfer.