• Basic sonography,hormonal evaluation & blood investigations are done.
• Husband’s semen analysis, culture ,basic blood investigations & hormonal evaluation are done.
• Initial clinical examination of the couple is done.
• Ovarian Stimulation with Fertility Medication.
• The fertility medications used in IVF are designed to stimulate the ovaries to produce multiple mature eggs (oocytes) rather than a single egg that normally matures during the natural cycle. Retrieval of multiple eggs increases the probability of pregnancy since it means several embryos may be available for placement into the uterus.
• Depending on the case history,age and weight of the patient,type and dosage of hormonal medications are given for stimulation.Certain adjuvant medicines are given to improve the egg quality and blood supply to the lining of the uterus.

This procedure is planned 34-35 hours post injection given for rupture of the follicles.Retrieval of eggs or the ovum pickup is done or performed transvaginally using Sonography guidance under general anaesthesia. Patient has to come fasting minimum of 6 - 7 hours & the follicles will be punctured & fluid will be collected & seen under microscope & the eggs are picked up & transferred in the culture media for further treatment with sperms.

After the eggs have been transferred in the culture media,they are washed in the media & then depending on the count of husband further treatment with sperms is done. Semen is washed & prepared. Depending on the count it is either IVF i.e In vitro fertilization where sperms & eggs are kept close to each other for fertilization or ICSI (i.e. Intra Cytoplasmic Sperm injection) is done where you manually pickup one sperm under microscopic vision which is a special instrument by itself called as micromanipulator and inject in the oocyte or egg. In the lab they are fertilized till Day 2,3, or Day 5 depending on how they are progressing.

Embryos are transferred into the uterus through a catheter. This procedure is done under short anaesthesia or without anaesthesia under sonography guidance and is painless.

The embryos are loaded with a small amount of fluid inside the catheter, which is passed through the cervix at the time of a speculum examination. The embryos are deposited in a manner so they reach the top part of the uterus. Depending upon the quality of the embryos, one to three embryos may be transferred in one treatment cycle.

ICSI (Intra Cytoplasmic Sperm Injection) or Micromanipulation is a technique in which one egg is mechanically fertilized with single sperm.
Do we need ICSI? ICSI is an excellent advancement in the field of assisted reproduction which is required in certain situations where IVF may fail.We recommend ICSI in following conditions

• When the male partner has an extremely low sperm count,poor sperm motility(the speed with which the sperms move),abnormal looking sperms.
• When sperms are retrieved surgically from male testicles in patients having zero sperm count.
• Couples with previous failed IVF cycles
• Unexplained infertility

The ICSI technique makes use of a powerful inverted microscope at the magnification of about 400X and micromanipulator to inject a single sperm in to the ooplasm. The skilled Embryologist with the help of fine pipette holds a single egg by applying gentle negative pressure and injects a single sperm in to the egg with the help of other micro injecting pipette.