# data[].attributes.headline
𝐖𝐇𝐀𝐓 𝐈𝐒 𝐈𝐕𝐅?                                                                                                 IVF is a type of assisted reproductive technology used for infertility treatment where the ovum is combined with sperm outside the body,i.e, in vitro ("in glass"). The process involves monitoring and stimulating a person's ovulatory process, removing an ovum or ova  from her ovary and letting sperm fertilise them in a culture medium in a laboratory. After the fertilised egg (zygote) undergoes embryo culture for 2–6 days, it is implanted in the same or another person's uterus, with the intention of establishing a successful pregnancy.          

# data[].attributes.subject
𝐖𝐇𝐀𝐓 𝐈𝐒 𝐈𝐕𝐅?                                                                                                 IVF is a type of assisted reproductive technology used for infertility treatment where the ovum is combined with sperm outside the body,i.e, in vitro ("in glass"). The process involves monitoring and stimulating a person's ovulatory process, removing an ovum or ova  from her ovary and letting sperm fertilise them in a culture medium in a laboratory. After the fertilised egg (zygote) undergoes embryo culture for 2–6 days, it is implanted in the same or another person's uterus, with the intention of establishing a successful pregnancy.          

# data[].attributes.headline
𝐖𝐇𝐄𝐍 𝐈𝐒 𝐈𝐕𝐅 𝐏𝐄𝐑𝐅𝐎𝐑𝐌𝐄𝐃?

# data[].attributes.subject
𝐖𝐇𝐄𝐍 𝐈𝐒 𝐈𝐕𝐅 𝐏𝐄𝐑𝐅𝐎𝐑𝐌𝐄𝐃?

# data[].attributes.body
It is generally performed when Fallopian tube damage or blockage inhibits egg from getting fertilized or embryo from travelling to the uterus.

# data[].attributes.headline
𝐒𝐓𝐄𝐏𝐒 𝐎𝐅 𝐈𝐕𝐅:

# data[].attributes.subject
𝐒𝐓𝐄𝐏𝐒 𝐎𝐅 𝐈𝐕𝐅:

# data[].attributes.body
1.Final maturation induction-:
When the ovarian follicles have reached a certain degree of development, induction of final oocyte maturation is performed, generally by an injection of human chorionic gonadotropin (hCG). Commonly, this is known as the "trigger shot."hCG acts as an analogue of luteinising hormone, and ovulation occurs between 38 and 40 hours after a single HCG injection,but the egg retrieval is performed at a time usually between 34 and 36 hours after hCG injection, just prior to the rupturing of follicles. This avails for scheduling the egg retrieval procedure at a time when the eggs are fully mature.

2.Egg retrieval-:
The eggs are retrieved from the patient using a transvaginal technique called transvaginal oocyte retrieval, involving an ultrasound-guided needle piercing the vaginal wall to reach the ovaries. Through this needle follicles can be aspirated, and the follicular fluid is passed to an embryologist to identify ova. The retrieval procedure usually takes between 20 and 40 minutes, depending on the number of mature follicles, and is usually done under conscious sedation or general anaesthesia.

3.Sperm and ova selection-:
In the laboratory, the identified eggs are stripped of surrounding cells (also known as cumulus cells) and prepared for fertilisation. An oocyte selection may be performed prior to fertilisation to select eggs that can be fertilized, as it is required they are in metaphase II. If oocytes are in the metaphase I stage, they can be treated with posterior sperm injection. In the meantime, semen is prepared for fertilisation by removing inactive cells and seminal fluid in a process called sperm washing.

4.Co-incubation-:
The sperm and the egg are incubated together at a ratio of about 75,000:1 in a culture media in order for the actual fertilisation to take place. A review in 2013 came to the result that a duration of this co-incubation of about 1 to 4 hours results in significantly higher pregnancy rates than 16 to 24 hours.[72] In most cases, the egg will be fertilised during co-incubation and will show two pronuclei. In certain situations, such as low sperm count or motility, a single sperm may be injected directly into the egg using intracytoplasmic sperm injection (ICSI). The fertilised egg is passed to a special growth medium and left for about 48 hours until the egg consists of six to eight cells.

5.Embryo culture-:
The main durations of embryo culture are until cleavage stage (day two to four after co-incubation) or the blastocyst stage (day five or six after co-incubation). Embryo culture until the blastocyst stage confers a significant increase in live birth rate per embryo transfer, but also confers a decreased number of embryos available for transfer and embryo cryopreservation, so the cumulative clinical pregnancy rates are increased with cleavage stage transfer.Transfer day two instead of day three after fertilisation has no differences in live birth rate. There are significantly higher odds of preterm birth (odds ratio 1.3) and congenital anomalies (odds ratio 1.3) among births having from embryos cultured until the blastocyst stage compared to cleavage stage.

6.Embryo selection-:
Laboratories have developed grading methods to judge ovocyte and embryo quality. In order to optimise pregnancy rates, there is significant evidence that a morphological scoring system is the best strategy for the selection of embryos. Since 2009 where the first time-lapse microscopy system for IVF was approved for clinical use, morphokinetic scoring systems has shown to improve to pregnancy rates further. However, when all different types of time-lapse embryo imaging devices, with or without morphokinetic scoring systems, are compared against conventional embryo assessment for IVF, there is insufficient evidence of a difference in live-birth, pregnancy, stillbirth or miscarriage to choose between them.Active efforts to develop a more accurate embryo selection analysis based on Artificial Intelligence and Deep Learning are underway. Embryo Ranking Intelligent Classification Assistant (ERICA),is a clear example. This Deep Learning software substitutes manual classifications with a ranking system based on an individual embryo's predicted genetic status in a non-invasive fashion. Studies on this area are still pending and current feasibility studies support its potential.

7.Embryo transfer-:
The zygote or early embryos(upto 8 blastomeres) are transferred into fallopian tube via ZIFT and embryos with more than 8 blastomeres into the uterus via IUT.The number to be transferred depends on the number available, the age of the woman and other health and diagnostic factors. In countries such as Canada, the UK, Australia and New Zealand, a maximum of two embryos are transferred except in unusual circumstances. In the UK and according to HFEA regulations, a woman over 40 may have up to three embryos transferred, whereas in the US, there is no legal limit on the number of embryos which may be transferred, although medical associations have provided practice guidelines. Most clinics and country regulatory bodies seek to minimise the risk of multiple pregnancy, as it is not uncommon for multiple embryos to implant if multiple embryos are transferred. Embryos are transferred  through thin, plastic catheter.

# data[].attributes.body
1.Multiple birth-:
The major complication of IVF is the risk of multiple births. This is directly related to the practice of transferring multiple embryos at embryo transfer. Multiple births are related to increased risk of pregnancy loss, obstetrical complications, prematurity, and neonatal morbidity with the potential of long term damage. Strict limits on the number of embryos that may be transferred have been enacted in some countries (e.g. Britain, Belgium) to reduce the risk of high-order multiples (triplets or more), but are not universally followed or accepted. Spontaneous splitting of embryos in the womb after transfer can occur, but this is rare and would lead to identical twins. A double blind, randomised study followed IVF pregnancies that resulted in 73 infants (33 boys and 40 girls) and reported that 8.7% of singleton infants and 54.2% of twins had a birth weight of less than 2,500 grams (5.5 lb). There is some evidence that making a double embryo transfer during one cycle achieves a higher live birth rate than a single embryo transfer; but making two single embryo transfers in two cycles has the same live birth rate and would avoid multiple pregnancies.

2. Risks to the egg provider/retriever-:

A risk of ovarian stimulation is the development of ovarian hyperstimulation syndrome, particularly if hCG is used for inducing final oocyte maturation. This results in swollen, painful ovaries. It occurs in 30% of patients. Mild cases can be treated with over the counter medications and cases can be resolved in the absence of pregnancy. In moderate cases, ovaries swell and fluid accumulated in the abdominal cavities and may have symptoms of heartburn, gas, nausea or loss of appetite. In severe cases patients have sudden excess abdominal pain, nausea, vomiting and result in hospitalisation.During egg retrieval, there exists a small chance of bleeding, infection, and damage to surrounding structures such as bowel and bladder (transvaginal ultrasound aspiration) as well as difficulty in breathing, chest infection, allergic reactions to medication, or nerve damage (laparoscopy)..Ectopic pregnancy may also occur if a fertilised egg develops outside the uterus, usually in the fallopian tube which requires immediate destruction of the foetus.

3. Birth defects-:

A review in 2013 came to the result that infants resulting from IVF (with or without ICSI) have a relative risk of birth defects of 1.32 (95% confidence interval 1.24–1.42) compared to naturally conceived infants. In 2008, an analysis of the data of the National Birth Defects Study in the US found that certain birth defects were significantly more common in infants conceived through IVF, notably septal heart defects, cleft lip with or without cleft palate, esophageal atresia, and anorectal atresia; the mechanism of causality is unclear.However, in a population-wide cohort study of 308,974 births (with 6,163 using assisted reproductive technology and following children from birth to age five) researchers found: "The increased risk of birth defects associated with IVF was no longer significant after adjustment for parental factors." Parental factors included known independent risks for birth defects such as maternal age, smoking status, etc. Multivariate correction did not remove the significance of the association of birth defects and ICSI (corrected odds ratio 1.57), although the authors speculate that underlying male infertility factors (which would be associated with the use of ICSI) may contribute to this observation .The authors of the Danish national registry study speculate: "our results suggest that the reported increased prevalence of congenital malformations seen in singletons born after assisted reproductive technology is partly due to the underlying infertility or its determinants."

# data[].attributes.headline
POTENTIAL FACTORS INFLUENCING PREGNANCY THROUGH IVF-:-

# data[].attributes.subject
POTENTIAL FACTORS INFLUENCING PREGNANCY THROUGH IVF-:-

# data[].attributes.body
-   Higher Antral follicle count giving higher success rates.[20]

Anti-Müllerian hormone levels, with higher levels indicating higher chances of pregnancy, as well as of live birth after IVF, even after adjusting for age.

Factors of semen quality for the sperm provider.

Level of DNA fragmentation as measured, e.g. by Comet assay, advanced maternal age and semen quality.

People with ovary-specific FMR1 genotypes including het-norm/low have significantly decreased pregnancy chances in IVF.

Progesterone elevation on the day of induction of final maturation is associated with lower pregnancy rates in IVF cycles in people undergoing ovarian stimulation using GnRH analogues and gonadotrophins.At this time, compared to a progesterone level below 0.8 ng/ml, a level between 0.8 and 1.1 ng/ml confers an odd ratio of pregnancy of approximately 0.8, and a level between 1.2 and 3.0 ng/ml confers an odds ratio of pregnancy of between 0.6 and 0.7. On the other hand, progesterone elevation does not seem to confer a decreased chance of pregnancy in frozen–thawed cycles and cycles with egg donation.

Characteristics of cells from the cumulus oophorus and the membrana granulosa, which are easily aspirated during oocyte retrieval. These cells are closely associated with the oocyte and share the same microenvironment, and the rate of expression of certain genes in such cells are associated with higher or lower pregnancy rate.

An endometrial thickness (EMT) of less than 7 mm decreases the pregnancy rate by an odds ratio of approximately 0.4 compared to an EMT of over 7 mm. However, such low thickness rarely occurs, and any routine use of this parameter is regarded as not justified.

As the maternal age increases, the likelihood of conception decreases and the chance of miscarriage increases.

With increasing paternal age, especially 50 years and older, the rate of blastocyst formation decreases.

Tobacco smoking reduces the chances of IVF producing a live birth by 34% and increases the risk of an IVF pregnancy miscarrying by 30%.

A body mass index (BMI) over 27 causes a 33% decrease in likelihood to have a live birth after the first cycle of IVF, compared to those with a BMI between 20 and 27. Also, pregnant females who are obese have higher rates of miscarriage, gestational diabetes, hypertension, thromboembolism and problems during delivery, as well as leading to an increased risk of fetal congenital abnormality.Ideal body mass index is 19–30.

Salpingectomy or laparoscopic tubal occlusion before IVF treatment increases chances for people with hydrosalpinges.

Success with previous pregnancy and/or live birth increases chances.

Low alcohol/caffeine intake increases success rate

The number of embryos transferred in the treatment cycle

Embryo quality

Some studies also suggest that autoimmune disease may also play a role in decreasing IVF success rates by interfering with proper implantation of the embryo after transfer.

# data[].attributes.headline
SUCCESS RATE OF IVF-according to the 2017 summary compiled by the Society for Assisted Reproductive Technology (SART)

# data[].attributes.subject
SUCCESS RATE OF IVF-according to the 2017 summary compiled by the Society for Assisted Reproductive Technology (SART)

# data[].attributes.body
In July 1978, Louise Brown was the first child reported to be successfully born after her mother received IVF treatment. Brown was born as a result of natural-cycle IVF, where no stimulation was made. The procedure took place at Dr Kershaw's Cottage Hospital (now Dr Kershaw's Hospice) in Royton, Oldham, England. Robert G. Edwards was awarded the Nobel Prize in Physiology or Medicine in 2010. The physiologist co-developed the treatment together with Patrick Steptoe and embryologist Jean Purdy but the latter two were not eligible for consideration as they had died and the Nobel Prize is not awarded posthumously.The second successful birth of a test tube baby occurred in India just 67 days after Louise Brown was born.The girl, named Durga was conceived in vitro using a method developed independently by Dr. Subhash Mukhopadhyay, a physician and researcher from Kolkata, India. Adriana Iliescu held the record as the oldest woman to give birth using IVF and a donor egg, when she gave birth in 2004 at the age of 66. In 2018 it was estimated that eight million children had been born worldwide using IVF and other assisted reproduction techniques.

# data[].attributes.headline
IVF PROCEDURE EXPLAINED THROUGH ANIMATION-

# data[].attributes.subject
IVF PROCEDURE EXPLAINED THROUGH ANIMATION-

# data[].attributes.attachment_link.title
Ivf, ivf process, ivf procedure, ivf process in detail, ivf process step by step - IVF animation