The surgery is done as an outpatient procedure at our clinic most of the time. The
woman will be given Mild anaesthesia so she does not feel pain during the procedure.
Using ultrasound images as a guide, the health care provider inserts a thin needle
through the vagina and into the ovary and sacs (follicles) containing the eggs.
The needle is connected to a suction device, which pulls the eggs and fluid out
of each follicle, one at a time.
The procedure is repeated for the other ovary. There may be some cramping after
the procedure, but it will go away within a day.
In rare cases, a pelvic laparoscopy may be needed to remove the eggs.
The problem with IVF can be less percentage of fertilisation. With ICSI we are making
sure that we inject one sperm in each egg and so fertilisation rate is supposed
to be better with ICSI.
So there shouldn’t be a standard protocol for IVF or ICSI to be done, it should
be decided by embryologist in the best interest of the patient.
Whenever patients are having very bad quality sperms or very low motility then embryologist’s
work is very crucial in creating the good quality embryos. even if one million sperms
are there that means few sperms from that 10 lac sperms to be choosen for ICSI,
so embryologiat’s training, education, qualification and experience makes a whole
lot of difference in the outcome of positive or negative results.
In IVF , we mix the sperms and eggs in one dish and culture them. In ICSI, we choose
one sperm, immobile and catch the sperm and we inject the sperm inside the egg.
Here we don’t wait for the sperm to enter the egg on its own but we do inject each
egg with one sperm.
Step 3: Embryo transfer
Embryos are loaded in the embryo transfer catheter and transferred to endometrium.
Anaesthesia is not recommended for embryo transfer procedure but for selected cases
it can be done under anaesthesia.
This is probably the last and the most crucial step of the whole cycle. Embryo transfer
is an art and it is the key for a successful pregnancy. After embryo transfer the
catheter is checked for retained embryo if any and if it is so, it can be transferred
Only good quality embryos are transferred and the spare good quality embryos can
be vitrified for future use.
We transfer two embryos and maximum three if patient is willing. If embryo quality
is good , endometrium is good , rest of the treatment has gone smoothly then Chances
of pregnancy are high.
If blastocyst transfer is there we transfer one most of the times and few times
two. If 4 cell or 8 cell embryos are there we transfer two in most of the cases
and in selected cases we transfer three embryos. This help us in decreasing multiple
pregnancy rate ( triplets)!!
Step 4: Embryo Biopsy : PGS/PGD
Patients having hereditary diseases, who have abortions multiple times, whose ivf
have failed multiple times , whose husband’s semen quality is very bad ( Y chromosome
microdeltions) are the patients we need to undergo embryo biopsy and PGS ( Preimplantation
Those couples who are worried about specific diseases to run in their family they
can go for PGD ( Preimplantation Genetic Diagnosis).