The desire to have a child is a central life goal for many individuals. However, if the anticipated pregnancy does not occur, it can be distressing—especially when all conventional options have been exhausted. In such cases, In-Vitro Fertilization (IVF) offers an effective alternative.
Costs and Organization of In-Vitro Fertilization in India
Before deciding on treatment, you should receive comprehensive consultation from your gynecologist or fertility specialist. In India, the costs for initial examinations are often partially covered by insurance, but the actual therapy usually needs to be financed privately. These expenses typically range from ₹5,00,000 to ₹7,00,000 and include hormone therapy, egg retrieval, fertilization, cultivation, and embryo transfer. Additionally, freezing and storing excess embryos incurs approximately ₹60,000 for cryopreservation and around ₹35,000 annually for storage fees. The cost of hormone medications can vary depending on the product and dosage, ranging from ₹1,00,000 to ₹2,00,000.
Step-by-Step: How Fertilization Works in the Lab
In-Vitro Fertilization follows a clear process, implemented in several precisely coordinated steps:
- Ovarian Stimulation: Initially, an ultrasound is performed to check if all conditions for egg maturation are met. In the following two to three weeks, hormonal preparation takes place. Subsequently, daily hormone injections stimulate the growth of multiple ovarian follicles. The dosage is determined based on the hormone levels measured in the blood (e.g., estrogen levels). Once the egg growth reaches an optimal stage, an additional injection triggers the final maturation.
- Egg Retrieval: About two days after the trigger injection, the follicles are punctured to extract the eggs. The procedure usually takes 10 to 15 minutes and can be performed under general anesthesia or with the help of painkillers. One to two hours later, patients are allowed to leave the clinic but should not drive on the same day.
- Insemination of Eggs: After retrieval, the eggs are assessed for their fertilization capability. The semen sample is processed to isolate viable sperm. Then, approximately 100,000 motile sperm are added per egg. If sperm quality is significantly compromised, Intracytoplasmic Sperm Injection (ICSI) may be performed additionally.
- Embryo Cultivation: The fertilized eggs mature in an incubator for two to five days. After 16 to 18 hours, it becomes apparent whether fertilization has occurred. After another 40 to 64 hours, the embryos ideally show multiple cell divisions. If necessary, they are further cultured until the blastocyst stage.
- Embryo Transfer: Depending on the developmental stage, one or two embryos are transferred into the uterus. In the case of a blastocyst transfer, usually only one blastocyst is implanted. The transfer is done using a soft catheter and is generally painless. To optimally prepare the uterine lining for implantation, progesterone is administered starting from the day of egg retrieval.
- Cryopreservation of Embryos and Blastocysts: Unused embryos can be frozen and stored for up to ten years. Thanks to modern cryopreservation techniques, they often remain viable after thawing and offer similar success rates in future transfers.
Pregnancy Test: When and How?
Approximately 12 to 14 days after the embryo transfer, a blood test is conducted to determine the possibility of pregnancy. If the result is positive, the first ultrasound examination takes place about ten days later.
Luteal Phase: Progesterone Support
From the day of egg retrieval, patients receive progesterone to prepare the uterine lining for potential implantation. If the pregnancy test is positive, this support continues until approximately the 10th week of pregnancy.
Natural Fertilization in the Lab: Fewer Hormones, Fewer Eggs
A natural variant of the treatment largely avoids intensive hormone therapies, allowing only one to two eggs to mature. While this reduces potential side effects and costs, it also decreases the probability of successful fertilization due to fewer available eggs.
ICSI: When Sperm Quality is Compromised
Intracytoplasmic Sperm Injection (ICSI) is primarily used in cases of male infertility, such as OAT syndrome (Oligo-, Astheno-, and Teratozoospermia). In this procedure, a single sperm is directly injected into the egg to increase the chances of fertilization when sperm quality is severely impaired.
Latest Advances and Trends
- Personalized Treatment Plans: Individually tailored protocols based on genetic data for higher success rates.
- Artificial Intelligence & Predictive Analytics: Algorithms support the optimal selection of embryos and the planning of treatment courses.
- 3D Imaging & Monitoring: New technologies like EmbryoScope+ allow continuous observation of embryonic development.
- Mitochondrial Replacement Therapy (MRT): Replacement of defective mitochondria to prevent related genetic disorders.
- Preimplantation Genetic Testing (PGT): Identification of chromosomal abnormalities to select healthy embryos.
- Laser-Assisted Hatching: Facilitates implantation by making a small incision in the embryo's outer layer.
- Artificial Wombs: A research field aimed at allowing embryos to develop outside the body.
- Stem Cell Therapies & Genome Editing: Correction of genetic defects using CRISPR and stem cell technologies.
- In-Vitro Gametogenesis (IVG): Generation of eggs and sperm from the body's own cells for specific fertility cases.
Potential Downsides and Risks
Artificial fertilization provides many couples and individuals with new opportunities, but it is not without challenges:
- Physical Strain: Hormonal stimulation can lead to side effects such as headaches or mood swings. Egg retrieval carries risks like infections or bleeding.
- Mental Stress: Doctor visits, waiting periods, and uncertain treatment outcomes can create significant emotional pressure. Psychological support or a stable support network can be very valuable here.
- Multiple Pregnancies: Transferring multiple embryos increases the risk of twins or triplets. Such pregnancies are often associated with higher health risks.
- High Costs: The treatment is expensive and is often only partially covered by insurance. Additional expenses may arise from medications or freezing and storage fees.
Legal Aspects in India
In India, artificial fertilization is governed by specific legal frameworks:
- Donor Anonymity: Donors generally remain anonymous, though there is ongoing discussion about the rights of children to obtain donor information.
- Legal Parenthood: In most cases, the social partner is considered the legal father when donor sperm is used.
- Embryo Protection: Only a certain number of embryos may be transferred; the sale of embryos is prohibited.
- Contract Law: Contracts between donors and recipients must be legally sound to avoid conflicts.
Alternative: RattleStork
In addition to traditional methods of artificial fertilization, our platform RattleStork offers a private and flexible way to realize the desire for children. Here, couples and individuals can directly communicate with sperm donors to find individualized solutions.
Conclusion
In-Vitro Fertilization offers couples and individuals an effective way to fulfill their desire for children, even under challenging circumstances. Thanks to rapid advancements in reproductive medicine, success rates are continuously improving. Additionally, platforms like RattleStork open up further avenues to realize the dream of having a family in a personalized manner.