“Test Tube babies” – all you need to know about subfertility, IUI, and In Vitro Fertilization (IVF)

“Test Tube babies” – all you need to know about subfertility, IUI, and In Vitro Fertilization (IVF)

Colombo Creative was the integrated communications and activations partner of Lanka Hospitals’ announcement of 1000 IVF baby deliveries.

Gone are the days when nature, clinical disability or gender-based social misconceptions ruled a couple’s inability to rear offspring. The advancement in global medical technology and evolving processes in the field of fertility have proven that a conception is possible even for a mother who has had numerous failed attempts at getting pregnant.

Proving its leadership in success in the regional and global context, Lanka Hospitals Fertility Centre Colombo has made great strides in the field of IVF (In Vitro Fertilisation) and plans to announce the 1000th successful IVF baby birth in the near future. Since the inception in 2008, The Fertility Centre of Lanka Hospitals continued to fulfil the dreams of thousands of parents who had otherwise lost hope in having a child of their own.

Miuru Jayaweera spoke to Dr. Madara Ralapanawe – Clinical Embryologist/ Head of Fertility Centre of Lanka Hospitals and Dr. Nishendra Karunaratne – Consultant Obstetrician & Gynaecologist; on all things IVF.

 Dr. Madara Ralapanawe
Dr. Nishendra Karunarathna
Dr. Madara Ralapanawe

Dr. Madara Ralapanawe – Head of Fertility Centre, Lanka Hospitals / Clinical Embryologist & Dr. Nishendra Karunaratne – Consultant Obstetrician & Gynaecologist, Lanka Hospitals with the 900th IVF baby of Lanka Hospitals.

Question: “What is IVF and when and why would a couple opt for IVF?”

Dr. Madara: “In Vitro Fertilisation (IVF) is a laboratory-controlled clinical process that helps a couple have a child of their own when the natural process of conception fails. The failure in the natural process can be due to subfertility in the couple.”

Question: “What is sub-fertility?”

Dr. Nishendra: “Sub- fertility in a female is the failure to conceive after 6 months to 1 year of unprotected sexual intercourse. This can be due various reasons including conditions such as irregular cycles due to anovulation, endometriosis, polycystic ovarian syndrome, etc. Sub- fertility in males is largely to do with sperm quality, motility, morphology of the sperm and the sperm count at ejaculation.”

Question: “What causes subfertility?”

Dr. Nishendra: “About one third of  subfertility can be attributed to male factor, and about one third to female factor. The remaining one third can be due to a combination of issues concerning both partners and in about 20 percent of such cases the condition is unexplained.”

Question: “Please explain the process of natural conception.”

Dr. Nishendra: “Fertility period of a young female is between 12th and 16th days of regular menstrual cycle. Intercourse ejaculates millions of sperm into the vagina. In natural conception most of the good live sperm will swim up the cervix into the womb, from the womb, sperms swim through the fallopian tube. A sperm fertilizes the egg in the fallopian tube if ovulation takes place during this time and an egg is released from the ovary. A couple has the option of seeking fertility treatment if the female partner do not conceive within a year through this natural process.

Question: “Is IVF the only solution for subfertility between couples?”

Dr. Madara: “Intra uterine insemination (IUI) is one of the first line treatment choices in case of mild male factor infertility or women with cervical factor and unexplained subfertility. It’s a interventional process that involves the placing of sperm inside a woman’s uterus to facilitate fertilization. Though the sperm could be deposited, even with the development of follicles or release of the egg  the female partner might not yet conceive through IUI. Thus failed fertilization or failed development could yet happen as one cannot see what takes place within the fallopian tubes. But by then – especially for the female – who has gone through numerous hormone interventions by then, her hormone levels might be too high for even IVF to commence affecting quality of the eggs. More patients are seen idling themselves engaging in other procedures such as IUI; sometimes 15 – 20 IUI’s, by going to as many IUI centres as possible for years.

Question: “What is the process of IVF?”

Dr. Madara: “In vitro fertilization (IVF) is an assisted reproductive technique (ART) in which the egg and the sperm are united in the laboratory (In vitro). There are 2 methods in IVF called Standard and ICSI (Intra Cyto-Plastic Sperm Injection). Following the extraction of matured eggs from the mother’s ovaries, In standard IVF, 2 to 3 eggs are inseminated with 80,000 to 100,000 sperms & will be kept in an incubator which mimics similar ambience of a fallopian tube – at 370 C – similar to body temperature, with 6% carbon dioxide & 5% Oxygen. Even the culture media used is similar to content in the fallopian tube. Here, the sperm has to penetrate  itself in the natural way. In ICSI, or (Intra Cyto-Plastic Sperm Injection) where sperms are directly injected to mature eggs the sperm’s entering of the egg can be confirmed in a lab setting. Similar to the natural process the sperm will go in & the egg will be fertilized becoming two pronuclear or a zygote & subsequently, further ‘division’ of cells takes place. The success rate of fertilization is higher in ICSI as the sperms are being directly injected to the egg & fertilization is as same as that occurs in the natural process.”

Lanka Hospitals

Dr. Miuru Jayaweera

Dr. Miuru is an executive director at Colombo Creative.

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