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Egg retrieval a simple procedure is scheduled 36 hours after hCG administration. The liquid which surrounds each egg is sucked out and is carried to the laboratory, where the egg is identified, isolated from the remainder of the fluid and placed in a Petri dish filled with nutrient media to which sperms are added.

Fertilization and Embryo Formation takes place in incubator where they are nourished until they are ready for transfer (3-5 days). Luteal Support of the uterus for implantation is provided with Progesterone.

Transfer of fertilized ova (Embryo) into uterus is a painless procedure done 2 to 5 days after retrieval. Once embryos are mature, they are taken out and placed into the uterus. Following success in all these stages, acceptance by the uterus and firm embedding of the embryos into it is important. If fetal development continues the real fruits of IVF as healthy baby are achieved.

Overall Success Rates are in IVF-ET Over 25 % and inICSI Over 40 %. Successful delivery rate in IVF-ET has been > 40 % in younger women. With 20 % fecundity per natural cycle of fertile couples, this compares favorably. Fertility drops to 10 % in women over 36 years of age and less than 5 % after 40.  

Pioneers Dr Patrick Steptoe, the gynecologist at Oldham , a town adjacent to Manchester in Northern England picked up the eggs from the ovaries of Mrs. Leslie Brown whose oviducts were blocked through pelviscopy. This was taken by Dr Robert Edwards, a scientist of Cambridge who took the eggs in his car to his laboratory 200 miles from Oldham . The eggs were mixed with Mr. John Brown’s sperms, kept in an incubator in the laboratory, where it fertilized. The embryo so formed was placed into the uterus of Mrs. Leslie Brown. Louis Brown, the first Test Tube baby was born 0n 25 th July 1978 at 23:47 hrs by Cesarean section. She weighed 5lbs and 12 oz. The technology improved and today it is a widely accepted technology to achieve pregnancy. Annual IVF cycles worldwide have been above 500,000 resulting in 1 in 100 to 1 in 150 babies born in western countries today being conceived by IVF.

IVF started out with the birth of baby Louise Brown in England . The first IVF birth in USA was in 1983 in Norfolk , Virginia and in Pakistan in 1988 at Lahore . Since that time, various refinements have occurred in the ovarian stimulation using controlled ovarian hyper stimulation (COH) and GnRH analogs as well as in the laboratory with better handling of the gametes and enhancement to encourage fertilization by procedures like ICSI, MESA , TESE, assisted hatching and cryopreservation .

IVF has also opened the floodgates to the research in reproduction. Now we understand reproduction better, can evaluate all the factors and have appropriate treatment for problems so diagnosed.

   
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