Various hormonal preparations are used for ovarian stimulation so that several follicles ( optimal number is 10 ) develop in the treatment cycle. The follicular growth is monitored by ultrasound scans and blood tests for hormone levels. All the ultrasound scans are done vaginally so there is no need to drink water to fill up the urinary bladder. The first scan is done normally on day two and the day five of stimulation and the second scan two days later. Appointments are given for the scan when the treatment is started.
At the scan, the ovary is imaged using high frequency ultrasound waves which when directed into the pelvis, reflect the sound waves back at different intensity from the structures on its pathway to produce an image. From the image we can measure each of the ovarian follicles daily to assess the follicular growth. The endometrial (lining of the uterus) thickness is also measured at the same time. It is important to drink at least 3 litres of water per day during ovarian stimulation.
Blood sample taken on the day of the scan is analyzed for oestrogen, progesterone and LH hormone. From these tests it is possible to ensure optimal egg production and maturation. The optimal number of eggs to get is 6-10 depending on the treatment that is planned. Once the optimal follicular growth is achieved, injection of human chorionic gonadotrophin (hCG) is arranged. This is a timed injection and once it is administered, the egg collection operation is performed at a fixed time. If the egg collection is delayed then it is possible that the ovulation may occur spontaneously. The response to the hormone stimulation of ovaries to produce follicles vary from person to person depending on age, amount and type of hormones used also from cycle to cycle in the same person. If the scan and the blood tests show poor ovarian response with very few follicles, then the treatment cycle may be abandoned.
- In-Vitro Fertilization & Embryo Transfer
- Ovarian Stimulation
- Collection of Eggs
- Oocyte Culture & Fertilization
- Embryo Transfer
- Intrauterine Insemination (IUI)
- Ovarian Hyperstimulation Syndrome (OHSS)
- Sperm Freezing
- Embryo Freezing
- Intracytoplasmic Sperm Micro Injection (ICSI)
- Testicular Sperm Aspiration (TESA)
- Assisted Embryo Hatching
- In Vitro Maturation of Oocytes ( IVM )
- Cytoplasmic Transfer (CT)
- Oocyte Freezing
- Fertility Preservation
- Pre-implantation Genetic Screening
- Intra-Vaginal Culture of Oocytes