IVF + ICSI

In-Vitro Fertilisation (IVF) is also known as ‘test-tube-baby’, as the fertilisation takes place outside the body (inside a test tube).

The indications of In-Vitro Fertilisation (IVF) Process include:

1. Tubal factors (tubal blockage or dysfunction)

2. Endometriosis

3. Male factors infertility

4. Immunological infertility (anti-sperm antibodies)

5. Repeated unsuccessful IUI

6. Unexplained infertility

The female partner undergoes controlled ovarian hyperstimulation (COH), either with long protocol, short protocol or antagonist protocol, depending on her condition. At Metro IVF, an hCG injection is given to mature the eggs when the leading follicles have reached 17mm. 36 hours later, the oocyte pick-up (OPU) will be done.

OPU is the process of aspirating the eggs through the vagina. This is performed under sedation or general anesthesia. At Metro IVF, before OPU, the female partner should comply with the instructions as followed:

1. Nil by mouth (strictly no food and drink) from midnight before OPU

2. Do not put on contact lenses, make-up, perfume, and nail polish on the day of OPU

3. Leave valuable things at home

4. Arrange somebody to take you home after the OPU because you cannot drive within 24 hours after the procedure

During OPU, follicular fluid is aspirated and collected into a test tube using a suction pump with controlled negative pressure. The fluid collected will then be passed to the embryologist in the IVF laboratory which is adjacent to the operation theatre. The OPU will take 15 minutes to one hour to complete, depending on the number of follicles to be aspirated. The embryologist will examine the fluid under a stereomicroscope and look for the eggs. The eggs collected will be cultured in culture media and kept in a CO2 incubator, where the temperature and CO2 are maintained at 37ºC and 5% respectively, for two to four hours so that most of the eggs will reach final maturation (complete Meiosis I).

On the same day, the male partner has to produce his semen by masturbation similar to that in semen analysis. He is advised to comply with the instructions listed below:

1. 3 to 5 days of abstinence prior to semen collection

2. Inform the nurse if he was sick or on any medication for the past 2 months

3. Collection by masturbation is preferred

4. Wash hands with soap and clean with water before semen collection

5. Do not use lubricant, soap, or perfume during semen collection

6. Avoid spillage when semen is collected

After the semen is produced, the laboratory technician or embryologist will process the semen to concentrate live and motile sperm. The sperm will be kept for intracytoplasmic sperm injection (ICSI) later.