In-vitro fertilization technology (IVF) is a key infertility treatment procedure for which every year there is a growing influx of tourists into countries where advanced infertility clinics exist with an arrangement of the latest procedures for IVF. Invitro fertilization fundamentally aims at the fusion of male sperms and female eggs in a closely monitored laboratory ambiance on a dish when the mother’s womb fails to provide the right atmosphere for fertilization.

Normally, after a successful intercourse the sperms and the eggs fuse inside the body of the female partner itself and the process of fertilization takes place. The fertilized egg cling to the inside membrane of the womb and its development continues further. This growth process of the embryo to a fetus and being nurtured inside the mother’s body is called a pregnancy that culminates in the birth of a baby. But when there is a difficulty in the successful fusion inside the body owing to some biological defects of the mother, in-vitro fertilization becomes imperative without which the fertilization can never happen. In-vitro fertilization is an integral part of assisted reproductive technology (ART) that employs the latest medical techniques to help a mother, who is otherwise incapable of offering the right body environment for fertilization, conceive and give birth to a baby. A limited number of countries with sophisticated infertility treatment clinics would offer IVF. Hence, fertility tourism in the quest for a guaranteed IVF is on the rise.

IVF is achieved through five fundamental stages that need to be carried out with high precision techniques and in a very carefully monitored laboratory environment:

(a) Stimulation procedure:
This process is also known as the super ovulation procedure where fertility drugs are administered on the woman who would be the egg donor substituting the biological mother for her incapability to produce healthy eggs. The effect of this infertility medicine would boost up the egg production of the egg donor. As per normal process, a woman can produce only one egg in a month, but upon being stimulated by the fertility drug the ovaries are now capable of producing several eggs.  During ovary stimulation step, the egg donor would be put through regular trans-vaginal ultrasound test to evaluate the health of the ovaries and examine the blood to monitor the hormone levels.

(b) Egg retrieval:
In the second step, which is termed egg retrieval, a small surgery called follicular aspiration is affected to retrieve eggs from the woman’s body. A local anesthesia is given so that the woman doesn’t feel any pain due to the incision made in her body. Now for monitoring the entire process, an ultrasound image is provided by the clinic and a fine needle is inserted through the vagina penetrating the ovary and egg sacs known as follicles. The needle is fitted with a device which literally sucks out the eggs and the fluids from each follicle one at a time.
This procedure is carried out for the second ovary as well. The donor experiences a little cramping that subsides after sometime. In certain complicated cases, which are though very rare, a pelvic laparoscopy may be required for egg removal.

(c) Artificial Insemination and fertilization:

The third stage involves artificial insemination followed by fertilization. Out of the eggs retrieved from the egg donor, best quality eggs are selected and placed together with the participating male sperms so that both the male and female cells get fused in a laboratory dish and this is insemination. The fused entities are then preserved in an incubator under a controlled environment with respect to temperature, light and atmospheric pressure. After a time lag post insemination, the sperm enters an egg normally and fertilization happens. However, if the sperm is incapable of penetrating an egg it is injected directly to an egg by a medical procedure called Intra-cytoplasmic sperm injection (ICSI).

1. d) Pre-implantation genetic diagnosis:
   Cell multiplication starts in a fertilized egg turning it into an embryo after sometime. Its growth is closely monitored by the clinic specialists to ensure healthy development. Within a week, the embryo achieves full growth with several cells, which are active showing normal cell division. However, this is also a vulnerable stage of development where genetic disorders of parents may pass into an embryo. For this, PGD (Pre-implantation genetic diagnosis) is available for identifying and eliminating defective embryos.
   IVF is a highly successful and demanding infertility solution available to childless couples that drive them to fertility tourism for searching clinics around the world ensuring this unique procedure.