nvitro fertilization IVF is one of many Assisted Reproductive Technology carried out at JOJE Fertility Centre. It refers to the creation of embryo outside the body of the woman.
It is a process whereby eggs from the woman are retrieved following ovarian stimulation with medications. These eggs are then fertilized in the laboratory with sperm cells from the partner. The resulting embryo(s) are cultured for some days before they are transferred back into the uterus. It is one process that has revolutionized human reproduction, and made conception possible where hitherto natural conception was not possible.
HOW DO I START AN IVF PROGRAM?
You start by calling the front desk officer to book an appointment to see our fertility specialist for a comprehensive fertility evaluation and investigations.
HOW IS THE SERVICE CARRIED OUT?
Fertility Evaluation & Investigations
At JOJE ABEBE Fertility Centre, before a patient begins an IVF treatment program, the patient will first consult with our fertility specialist and carryout a fertility work up. As part of the work up the patient medical history, reproductive history and social history will be obtained followed by fertility investigations especially ovarian reserve tests to determine how the ovaries will respond to gonadotropins (ovarian stimulatory medications) and the initial drug dosage. After the completion of these investigations, a treatment plan will be discussed with the patient.
Control Ovarian Hyperstimulation
IVF patients will undergo controlled ovarian hyperstimulation with gonadotropin (ovarian stimulatory drugs). These injections are administered according to treatment protocols.
Ovarian stimulation begins on day 2 or day 3 of menstrual cycle following a baseline ultrasound scan. The purpose of this scan is to confirm that the ovaries and the utereus have been properly down regulated and that no cysts are present. Once this is achieved ovarian stimulation using gonadotropin may commence.
Gonadotropin dosages are individualized for each patient based upon age, weight, number of recruitable follicles, cycle day 3 FSH level and estradiol level or AMH level and the response to previous stimulation cycles. The initial dose of medication used at the start of stimulation may be changed depending on response pf ovaries to the injections (number and size of the follicles, estrogen level or the patient’s protocol).
At JOJE ABEBE Fertility Centre patient on controlled ovarian stimulation are subjected to routine ultrasound scans to monitor follicular growth and development. Ovarian stimulation continues until at least 3 follicles measuring at least 17mm are seen, usually after 10 – 11 days of gonadotropin stimulation. The HCG injection is then given for the final maturation of the follicles.
Oocyte retrieval is the process of retrieving matured eggs from the ovaries. It is done 36 hours post HCG injection in a stimulated cycle to avoid losing the eggs through ovulation. Oocyte (egg) retrieval is performed in an operating room under mild sedation or general anaesthesia. The procedure involves the passage of a needle through the thin lateral fornix of the vagina into the ovarian follicles, and then aspirating the oocytes.
On the day of the oocyte retrieval, the spouse sperm is processed and used to fertilize the retrieved oocytes to create embryos. These embryos are allowed to grow in the incubator for three to five days before being transferred. The embryo transfer procedure involves using a small catheter inserted through the cervix under ultrasound guidance. The embryos are placed directly in the uterus with the hope that implant will occur and result in pregnancy.
Biochemical pregnancy test is done 2 weeks post embryo transfer, if positive the patient will continue luteal support medications and clinical pregnancy test is done 2 weeks after (i.e. 4 weeks post embryo transfer). If pregnancy test is negative the patient is properly counselled and luteal support medications are discontinued.
HOW LONG WILL THE SERVICE TAKE?
For any couple preparing for an IVF/ICSI program, about 4-6 weeks is required from the time of down regulation to after the embryo transfer.
WHO QUALIFIES FOR THIS SERVICE?
IVF/ICSI is indicated for the following group of patients;
- Patients with bilateral tubal blockage
- Male factor infertility
- Unexplained infertility
- Anovulation without success with ovulation inducing agents or IUI
WHAT IS THE SUCCESS RATE?
The success rate of IVF/ICSI is largely dependent on the age of the woman. For women less than 35 years, the success rate of one cycle of IVF/ICSI is 30-50%. The success rate reduces significantly after 35 years.
WHAT ARE THE COMPLICATIONS ASSOCIATED WITH THIS SERVICE?
- Ovarian hyperstimulation syndrome (OHSS) is the most severe or dreaded complication of the IVF/ICSI program. To reduce the risk of OHSS developing, we use the most appropriate protocol for those at increased risk of developing OHSS, at JAFC The Control Ovarian Stimulation is monitored closely, avoiding over stimulation and adapting different strategies to prevent OHSS from developing.
- Multiple pregnancies.
WHAT IS THE COST OF THIS SERVICE?
The cost of one cycle of IVF, depend on the type of program and use of medication. Cost of Services
WHAT IS THE CUMULATIVE SUCCESS RATE?
The cumulative success rate after 3 cycles is about 78.4% and after 6 cycles is about 95.7%.
ANY DRAWBACK WITH THIS SERVICE OR TREATMENT ?
- The long period required for treatment.
- The multiple injections needed to be taken
- The fear of developing OHSS
- Multiple pregnancy