In Vitro fertilization (IVF) involves monitoring and stimulating a woman's ovaries, removing eggs and fertilizing them with sperm in a lab dish. IVF is indicated for blocked or damaged fallopian tubes, sperm abnormalities, advanced maternal age, unsuccessful intrauterine insemination, endometriosis, uterine problems, or unexplained infertility. Eggs are retrieved 34-36 hours after an HCG injection under anesthesia. Sperm is then injected into eggs or mixed with eggs, and embryos are selected for transfer into the uterus 2-5 days later. Side effects may include soreness, nausea, mood swings and fatigue. Success rates are 25-30% but vary depending on maternal age, sperm and

1. In Vitro fertilization (IVF)
Janet OLAWOLE
Clinical Embryologist (Trainee)
Sameda clinics

2. Outlines
• Definition of IVF
• Indications of IVF
• Stimulation
• Egg collection/retrieval
• Events after egg collection
• Intracytoplasmic sperm injection (ICSI)
• Fertilization and Embryo Development
• Embryo transfer
• Side effect of IVF

3. In Vitro Fertilization-IVF
• In vitro fertilization is a process of fertilization where an egg is
combined with sperm outside the body. The process involves
monitoring and stimulating a woman's ovaries, removing an ovum
or ova from the ovaries and fertilizing them with sperms in a dish
in the laboratory.

4. Indications of IVF
• Blocked or damaged fallopian tubes
• Sperm abnormality
• Advanced woman’s age (age over 37 years)
• Unsuccessful intrauterine insemination after 3 cycles attempt
• Endometriosis
• Uterine problem
• Sex selection
• Unexplained infertility

5. Stimulation
• The goal is to obtain as many mature eggs as possible. This is done
by daily injections of gonadotropins.
• Regular monitoring of the follicles by ultrasound scan.
• After reaching certain size, the final maturation
of those follicles is done by giving HCG.

6. Egg Retrieval (oocytes)
• Egg retrieval is done 34 to 36 hours post HCG
injection.
• Retrieval is done under general anesthesia, using ultrasound guide.
• A needle is used to aspirate all the follicles.
• The follicular fluid is passed over to the embryologist, who
identifies and separates the eggs.
• The procedure takes about 15 to 20 minutes and not more than two
hours for the patient to recover.

8. Retrieved egg

9. Events after Egg Collection
• Sperm production
• Insemination of the sperm into the egg(conventional IVF)
or Sperm injection into the eggs(ICSI)
• Fertilization check (performed the next day approximately
18 hours after sperm injection or insemination of the
eggs.)
• Observation of growth
• Selection of embryos for transfer

10. ICSI and Convectional IVF

11. Fertilization

12. Embryo Development

13. Blastocyst stage

14. Embryo transfer
• An embryo transfer is the final stage in the In Vitro Fertilization (IVF)
process where the fertilized egg—now an embryo—is placed in the woman’s
uterus.
• The embryo is loaded into a catheter, which is passed through the vagina
and cervix and into the uterus where it is deposited.
• There are different types of embryo transfers: cleavage transfer(day 3),
blastocyst transfer (day 5) or frozen embryo transfer.

15. Side Effects Of IVF
• Soreness or Bruising from Injections.
• Nausea.
• Small risk of damage to other pelvic organs during egg collection
• Mood Swings.
• Fatigue.
• Allergic Reactions.
• Mild Pelvic and Abdominal Pain.
• Multiple birth

16. Success
Chances of achieving pregnancy globally is between 25% and 30%.
However, the factors below affect probability of conception
• Age of the woman
• Condition of the sperm
• Coexisting uterine pathology like fibroids, polyps, scars in the
uterus
• Condition of the laboratory
• Expertise of the team

17. • First Baby By IVF -Louise Brown
Patrick Steptoe and Robert Edwards(Lancet, 1978 )
Awarded The Nobel Prize in 2010

18. Why IVF fails
IVF can fail at any of the various stages mentioned below:
• Treatment cancellation may occur at the stage of ovarian
stimulation due to inadequate follicular development.
• There may be failure to retrieve eggs at egg collection; retrieved
eggs may be immature or mature eggs may not fertilize.
• Poor development of embryos
• Some conditions may prevent the Embryo(s) from being
transferred
• Unexplained IVF failures – Possible autoimmune involvement

19. Thank you