Following are the situations where one could consider IVF:

• Tubal blockage
• Persistent Low sperm count in spite of treatment
• Endometriosis
• Uterine abnormalities
• Unexplained infertility
• Women of older age
• Previously failed IUI procedure
• Problems with ovulation
• Antibody against the sperm

IVF is a totally painless procedure. The only pain, if at all, is that of the repeated blood tests and injections the woman has to take. The injections cause only mild discomfort as most of them are given with a fine short needle just under the skin (Similar to Insulin)

The egg retrieval procedure is performed through the vagina using a fine needle under ultrasound guidance.  The patient will not feel anything as it is done under short general anesthesia.  It usually takes about 10 to 30 minutes.  The patient wakes up as soon as the procedure is over and can go home the same evening after a few hours of observation.

Transferring the embryo into the uterus is similar to a vaginal examination.  However, if the patient wishes she can request for sedation during the procedure.

These are the basic five steps of an IVF cycle

• Ovulation Induction: – Medicines, both injections and tablets are used to stimulate the ovaries to develop of multiple mature follicles that contain eggs.
• Egg retrieval: – After a few days of medication when the ultrasound scan shows that the follicles are mature, eggs are removed from the ovaries. This procedure is performed using a fine needle through the vagina. It is completely painless as it is done under short anesthesia as a day care procedure.
• Fertilization and embryo culture: – Sperms are either mixed (IVF) or injected into the eggs (IVF-ICSI). The fertilized eggs (embryos) are kept in an incubator for 3 or for 5 days.
• Embryo transfer: – With the help of a fine tube embryos are delicately transferred into the uterus.
• Pregnancy test: – About 11 days after embryo transfer a blood test is done to check for pregnancy.

The success rates of pregnancy vary from 30% to 55%. A large number of factors play a role in the success rates.  In the IVF Center, the experience of the doctors, the quality of medicines used, skill and presence of full-time embryologists, the air quality in the laboratory (Clean room with HEPA filtered air) and the equipment used are important factors.

As far as the patient is concerned the most important factor is the woman’s age. Younger the woman, better is the quality of the egg and higher is the success rate.  Usually the success rate is good upto the age of 35-37 after which the rates drop.  Most centers report success rates of women below the age of 35 years.

Other factors that can influence are the quality of the inner lining of the uterus, presence of fibroids, abnormally shaped uterus, endometriosis, pelvic infections, body weight and ability of the ovary to produce adequate eggs.