Frequently Asked Question on In Vitro Fertilization (IVF) and Intracytoplasmic Sperm Injection (ICSI)

  • Do I need IVF?

IVF is indicated when alternative treatments are either unlikely to achieve a pregnancy or have failed to result in a pregnancy. If you have blocked fallopian tubes or extensive pelvic adhesions preventing the egg from entering the fallopian tubes, IVF is indicated.

Another common indication for IVF is low sperm counts. Because IVF allows us to super concentrate sperm, successful fertilisation can occur even if your partner has low sperm counts.

Infertility is said to be ‘unexplained’ if you are unable to conceive in spite of all tests being normal. In this case, IVF is an option if you have failed to conceive with Intrauterine Insemination (IUI).

IVF may also be advisable if you have Polycystic Ovaries (PCOS) and if ovulation induction with or without IUI has not been successful.

If you have mild to moderate Endometriosis, IUI may be tried before proceeding to IVF, but in the case of severe Endometriosis, IVF is advisable.

 

  • Do I need ICSI?

Intracytoplasmic Sperm Injection (ICSI) has revolutionised the treatment of male infertility. ICSI is advisable if the male partner’s sperm count or a number of motile sperm is very low or the morphology is excessively poor.

Your Fertility Physician at Aster IVF will advise you if ICSI is recommended for you based on the results of the Semen Analysis and other risk factors.

 

  • Is IVF/ ICSI expensive?

IVF/ ICSI involves highly trained professionals with sophisticated laboratories and equipment. The total cost of an IVF/ ICSI cycle largely depends on your age, hormonal test results and the dose of medication required to stimulate the ovaries. It varies from AED 20,000 to AED 25,000 in our facility.

 

  • IS IMSI better than ICSI? Is it a big advance?

IMSI stands for ‘ Intracytoplasmic Morphologically Selected Sperm Injection’. It involves examining the semen sample under an extremely powerful microscope to pick out the best appearing sperm, which is then used in the ICSI protocol. An efficiently performed ICSI carried out by a competent embryologist already ensures that good quality sperms are picked up. Evidence based medicine is yet to conclusively prove the advantages of IMSI over ICSI in terms of pregnancy rates and long term outcomes. We offer IMSI at Aster IVF.

 

  • Are birth defects more common in babies conceived using IVF/ ICSI?

The percentage of birth defects with IVF is roughly the same as in the general population (3-4%). The chances of birth defects after ICSI are rare. Some of the problems that caused the male infertility, however, may be genetic. In these cases, boys conceived with the use of ICSI may have infertility issues as adults.

 

  • What are the health risks for women undergoing IVF/ ICSI cycles?

The drugs used during IVF/ ICSI may on occasion cause side effects. There is a small but significant risk of Multiple Pregnancies, Ectopic Pregnancy, Pelvic Infection and rarely Injury to nearby organs. Controlled Ovarian Hyperstimulation (COH) is associated with a risk of Ovarian Hyperstimulation Syndrome (OHSS). Symptoms of OHSS include the following in varying degrees of severity: nausea, vomiting, diarrhea, extreme bloating, rapid weight gain, difficulty breathing etc.

Aster IVF has put into practice an OHSS-free protocol called IVF LiteTM.

 

  • What do we do if extra Eggs remain after an Egg Retrieval Procedure?

Extra Eggs remaining after the Egg Retrieval Procedure may be frozen by the CryotechTM Vitrification procedure which gives almost 100% survival. This makes future ART cycles simpler, less expensive and less invasive than the initial cycle, since the woman does not require ovarian stimulation or egg retrieval.

 

  • What are the Success Rates?

Our Group success rates are among the best globally. They are the result of years of experience and constant fine-tuning of our stimulation protocols, our laboratory culture conditions and our embryo transfer guidelines.

The most important factors determining the success of a cycle are the woman’s age and the reason for the infertility. We will be pleased to discuss your individual case history with you and provide advice that is tailored for you.

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Do Milder IVF stimulation techniques mark the end of conventional IVF procedures?

Introduction and improvement in IVF techniques have increased the chances of women with infertility issues to conceive. Milder Stimulation protocols in IVF are now gaining increasing popularity, given the belief that they are safer and have more chances of success than conventional IVF methods in selected patient groups.

Aster IVF & Women Clinic is the only fertility clinic in UAE to efficiently perform both conventional and minimal stimulation IVF techniques. Mild stimulation IVF or Aster’s IVF Lite is a new and improved technique that can be used to help women get pregnant with minimal risks. Conventional IVF and IVF Lite are forms of ART (Assisted reproductive technology).

IVF is a procedure in which the egg and sperm are fertilised outside the body in a laboratory dish and the embryo is later transferred into the uterus. With IVF a woman is stimulated with fertility injections or hormone treatments to control egg production. These fertility injections are usually high dosage injections and are high stimulants which cause the woman to produce multiple eggs. Conventional IVF techniques have certain side-effects, the major ones being the risk of causing OHSS (Ovarian Hyper Stimulation Syndrome) and risk of multiple births. Multiple births is a pregnancy problem that causes certain complications like increased chances of pre-term births, chances of having a C-section, miscarriages, baby being born with birth defects/ genetic disorders etc. Multiple pregnancies conceived by assisted reproductive technology poses a greater risk of pregnancy problems.

OHSS occurs in certain susceptible women taking hormonal injections to stimulate the production of eggs, where the ovaries over react and produce an excess number of eggs. Mild cases of OHSS can be managed with conservative measures but extreme cases may even lead to the death of the patient. These complications occur in very few woman and there are ways of preventing them.

Conventional IVF methods have been used for a long period of time and have had success rates as well. Now with the presence of an improved technique of ART called IVF Lite, more and more couples tend to prefer this technique over the conventional one.

IVF Lite or minimal stimulation technique is a simpler treatment method that Aster IVF & Women Clinic provides to make the process of ART less invasive for women. IVF Lite involves oral fertility medications instead of fertility injections leading to milder stimulation with better quality eggs. It is often said that the older a woman, lesser are her chances of conceiving which is true because, with age, a woman’s ovarian reserve becomes less. This belief holds true in today’s time and age where couples wish to grow professionally and are completely financially sound before having a baby. Even IVF success rates drop after women cross the age of 40. IVF Lite is a technique that helps couples increase their chances of getting pregnant even after a designated age. IVF Lite technique can be used to treat women who wish to get pregnant even after the age of 40 and Aster IVF & Women Clinic has been successfully treating women over 40 with the low ovarian reserve with this method. IVF Lite technique can be used to treat women who have had failed prior IVF attempts, poor and hyper responders and women with endometriosis.

Dr. Gautam Allahbadia, IVF Consultant and Head of Aster IVF & Women Clinic states that “Infertility is a major issue in this region and the number of women seeking infertility treatment only seems to be increasing. A common issue faced here is that couples delay their pregnancy due to various reasons and also delay in seeking medical help. They consult a specialist only years after unsuccessful attempts at being pregnant. Age, health complications like PCOS, obesity are all reasons of infertility and IVF success rates drop drastically after a certain point. Age is surely a reason to cause infertility, but it is a misconception that this issue is seen only in older women. At Aster IVF & Women Clinic we have seen patients below the age of 25 with fertility issues. Of late easier and less expensive fertility treatment techniques have greater demand because of its advantages. IVF Lite is one technique of ART, which was originally introduced to treat women with low ovarian reserve but in the recent past, it has shown to have positive results in women over 40 as well, which a great advantage in today’s age is given the changing ideologies and lifestyle preferences.”

Mild ovarian stimulation method or IVF Lite has a great number of advantages over conventional IVF techniques including fewer medications, safer and with quality eggs. IVF Lite is also a feasible choice for couples who chose the cost-effective technique. IVF Lite also presents very favourable pregnancies in women who are over the age of 40 and those who have had previous unsuccessful IVF attempts.

Experts recommend IVF Lite as a new approach for women who are poor or hyper responders, suffer from endometriosis, have previous unexplained IVF failures or are over 37 years old. Aster IVF & Women Clinic offers IVF Lite as a safer and patient friendly alternative to conventional IVF treatments.

 

 

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Frequently Asked Questions About IVF Lite

Did you know? In IVT treatments, gonadotropin injections are used to stimulate the ovaries to increase the number of available eggs. But unfortunately, conventional IVF protocols can be expensive, inconvenient and are often associated with uncomfortable side effects.

That’s why at Aster IVF, we’re offering IVF Lite, a.k.a. Minimal Stimulation IVF, which has regained favour due to the realisation that it is associated with fewer side effects, incurs a lower risk of ovarian hyperstimulation syndrome (OHSS), has a lower cost and good success rates! Aster IVF offers IVF Lite as a cost-effective and safer alternative to the standard IVF program.

What is IVF Lite?
IVF Lite involves a soft stimulation protocol with the lesser amount of fertility drugs. When combined with Egg Accumulation using the Cryotech Vitrification Technology (ACCU-VIT), it provides a very efficient and cost-effective alternative to conventional IVF.  It is designed to retrieve only a few eggs in each ovarian stimulation cycle. Stimulation in this manner has been associated with better quality eggs and hence better quality embryos. In other words, it is a simpler treatment schedule with lower doses of drugs, fewer risks (from Multiple Pregnancy and Over-stimulation) and consequently reduced cost.

IVF Lite goes easy on your ovaries and easier on your finances.

What is Cryotech Vitrification and can you tell me more about ACCU-VIT?
Cryotech Vitrification technique has overtaken the conventional slow freezing technique. The eggs to be frozen are placed in a very small volume of vitrification medium, which is then cooled at an extreme rate so that the eggs are flash frozen and preserved intact. Survival rates after vitrification & thawing and subsequent pregnancy rates are much better than they were with conventional slow freezing.

In the IVF Lite protocol, one or more Minimal Stimulation IVF cycles are carried out and all the resulting eggs are frozen using the Cryotech Vitrification technique to accumulate a sufficient number of eggs (ACCU-VIT) for a remote PGS (if indicated) and frozen thawed embryo transfer. In cost-conscious environments, IVF Lite is the only type of IVF that is going to be the future.

What does the Minimal Stimulation IVF procedure involve?
Instead of the high doses of fertility injections used in conventional IVF cycles, Clomiphene Citrate tablets, a low dose of fertility injections (Gonadotropins) and GnRH Antagonist injections are used in the softer IVF Lite stimulation protocol. Egg retrieval is planned 34-36 hours after the hCG trigger. All retrieved eggs are frozen and in a subsequently chosen month, the endometrium is prepared using estrogen tablets to increase implantation rates. In this month the eggs are thawed and fertilised with husband’s sperm and an Embryo Transfer is planned in this remote cycle.

Am I a suitable candidate for IVF Lite?
Today we can offer IVF Lite to almost everyone requiring IVF. The groups which traditionally benefitted from minimal stimulation IVF are Poor Responders, Older Patients (above age 40), women with multiple previous conventional IVF Failures and Hyper-responders (like patients with PCOS who go repeatedly into Ovarian Hyperstimulation). Today, because of the cost advantages & much higher success rates,  we have extended the indications of IVF Lite to all patients requiring IVF/ ICSI. If IVF LiteTM sounds appealing to you, discuss with your Fertility Physician at Aster IVF whether it is suitable for you.

What are the Advantages?
With IVF Lite, painful and expensive injections of conventional IVF in the initial part of the cycle are substituted by inexpensive oral medications. Lesser injections improve patient compliance. IVF Lite decreases the number of visits to the clinic so that there is very little interference with work schedules and other regular commitments.

IVF Lite gives rise to more number of Euploid eggs and Embryos on PGS leading to higher pregnancy rates in women with low AMH.

IVF Lite gives Pregnancy Rates (PRs) comparable to conventional IVF in patients with a normal Ovarian Reserve and PRs better than conventional IVF in Older Patients, patients with previous conventional IVF Failures, Poor Responders & Hyper-responders.

IVF Lite means a simpler treatment schedule, a lower drug dose, a good outcome, fewer risks (from Multiple Pregnancy & Ovarian Hyperstimulation Syndrome) and a lower cost. By all accounts, this is patient-friendly IVF.

What are the Disadvantages?


With the IVF Lite protocol, fewer eggs are formed per cycle, necessitating the need for multiple cycles in order to accumulate an optimum number of good quality eggs. This form of IVF needs proper counselling so that patients are aware and are mentally prepared for multiple attempts. IVF Lite can occasionally result in poor or no response at all, necessitating cycle cancellation.

A well-equipped laboratory capable of successfully vitrifying and thawing eggs is absolutely mandatory for this form of IVF.

What are the Success Rates?
At Aster IVF, our success rates with Minimal Stimulation IVF Lite are similar to conventional IVF for women with a normal Ovarian Reserve. For Poor Responders, our success rates are as high as 40%. 

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