INTRODUCTION:

According to Indian society of assisted reproduction, infertility currently affects about 10-14% of Indian population, with higher rate of urban area. Where 1 out of 6 couple is impacted. Nearly 27.5million couples actively suffer from infertility in India (May 30, 2018). Infertility gives the couples anxiety & depression of conceiving by the treatment also it can also bring couples close together. The beginning of the treatment is selection of perfect physician who helps the couple to clear doubts regarding whole procedure. Firstly complete the investigations like blood test, scan, and hormonal test etcetera³. Then day 2 of your period is the first day of IVF treatment. Ovaries are stimulating by MENOPURI.P.75 IU& CLOMIPHENE 100 mg. (as physician order) after that egg retrieval. Than sperms are meet with ICSI for Blastocyst culture. Also the other fertility medications are included. Than approximately at 13 days embryo is implanted².

Definition:

IVF stands for in vitro fertilization.it is widely known as assisted reproductive technology (ART).in which eggs meet with sperms and fertilize in lab to make the embryo¹.

Indications:

· Tubal disease: when fallopian tubes are blocked. Then hydrosalpinx is done to increase the success rate of IVF¹.

· Male factor: when there is defect in sperms quality& difficulty in penetrating the egg. ICSI is used in such cases. In some cases sperm aspirated by TESA¹.

· Endometriosis: patient having ovarian cyst in this case endometrioma is done¹.

· Ovulatory dysfunction: if patient is having polycystic ovarian diseases (PCOS) & other ovulatory problems. IVF is successful in treatment in these cases¹.

· Unexplained infertility: patient with no obvious cause of infertility can have benefit from IVF¹.

Diagnostic test:

Test for men¹:

· Semen analysis

· Hormone testing

· Genetic testing

· Testicular biopsy

· Imaging

· Others specialty testing

Test for women¹

· Ovulation testing

· Hysterosalpingography

· Ovarian reserve testing

· Other hormone testing

· Imaging testing

· Hysteroscopy (few cases)

· Laparoscopy (few cases )

Procedure:

Step 1: ovulation induction

The physician will monitor the ovaries to produce optimum quality of drugs& maintain the hormones level. For that medication & injections are given till 10-12 days of cycle with regular TVS monitoring. If eggs cannot produce than doctor suggest for donor eggs or minimal stimulation ( In this procedure women will have minimum three cycles with lower dose of fertility medication & injection to produce eggs these are for those women who do not want to take donor eggs.)³

Step2: Egg Retrieval

In this step under anaesthesia & pain medication a very thin needle is passed through the upper vaginal wall with ultrasound fluid is removed from the follicles with suction. The oocyte is isolated from the follicles fluid placed in a culture dish with nutrient media & than transferred in to incubator. In some cases hysteroscopy is also done to maintain the cavity enhancement³.

Step3: fertilization

In this process eggs are meet with most active sperm of partner or donor sperm with ICSI. Then, both placed in an incubator for healthy embryos³.

Step 4: Embryo Transfer & Implantation

This is the final step first of all health embryo of grade 1 is selected and implanted with the help of a speculum in to the vagina with a small plastic tube placed through the cervix in to uterine cavity. Usually 24 hrs bed rest is advised after the procedure⁴.

IVF SUCCESS RATE

The success rate is depending upon the age of the women, the younger have higher chances. Likewise <35 is 41.3%, 35-37 is 31.7%,38- 40 is 21.6%,41-42 is 10.6%,>42 is 3.4%. It also depends on the cause of infertility. Moreover it also varies according to fresh donors embryos is 55.1% and thawed donors egg embryos is 33.8%. In addition to this it varies according the multiple cycles leads to increased cumulative birth rates. For Instance, 45%-53% in three attempts & 51%to 71%to 80% in six attempts².

Complications of IVF:

· Multiple births⁵

· Premature delivery with low birth rate ⁵

· Ovarian hyper stimulation syndrome ⁵

· Miscarriage⁵

· Ectopic pregnancy⁵

· Birth defects ⁵

· Ovarian Cancer⁵

· Embryonic demise⁵

Psychological Issues on couples:

· Maladjustment with the society^4.

· Anxiety related to infertility leads to low self esteem^4.

· Mood deterioration due to infertility^4.

· Unsuccessful IVF leads to depression4^.

· Failed IVF gives tension to the couple’s leads to crises⁴.

· Depression due to infertility leads to mental illness^4.

· Low sexual self esteem^4.

NURSE ROLE ON IVF:

· Nurse gives psychological support to the couples to relieve from stress due to infertility.

· Fertility nurse offers non-judgemental emotional support &counselling to couple.

· Provide proper knowledge regarding the treatment

· Fertility nurse educate the couples about the pros & cons of treatment.

· Fertility nurse clear all the doubts regarding the whole process if IVF.

· Fertility nurse acts as a stress reliever for the couples by providing all the answers about the stress they having due to infertility.

· Fertility nurse provides knowledge regarding healthy diet, timely medication, follow up & precautions after pregnancy achieved.

· Fertility nurse should monitor the couples psychological level & provide them support in case of any complication.

CONCLUSION:

IVF can be acts an boon for the infertile couple’s proper guidance & good doctor can provide favourable result. However, the fortune is not in our hands but efforts can help the individual to attain victory. So, it advisable to infertile pair has courage and be optimistic every clouds have silver lining. Each health professional should spread knowledge regarding flourishing IVF rates which help the childless couple to full fill their ambition of becoming parents.

REFERENCES:

1. https://www.mayoclinic.org>drc2

2. https://www. Attain fertility.com >ivf.101

3. https://en.wikipedia.org/wiki/IVF

4. www.aaem.pl>pshychological

5. https://www.arc fertllity.com >PROBA

Received on 28.09.2019 Modified on 25.10.2019

Int. J. Nur. Edu. and Research. 2020; 8(1): 123-124.

DOI: 10.5958/2454-2660.2020.00027.7