Anirban Das

Batch IVF is a basically well-planned process of recruitment and synchronization of the menstrual cycle followed by ovarian stimulation in one sequence of infertile couples, a group of infertile couples to facilitate the completion of a process that is oocyte retrieval, IVF/ICSI, embryo transfer in a well-designated period of time.

How to investigate IVF patients?

Endocrine disorders to be picked up by doing insulin and thyroid prolactin for everyone.  If the woman is above the age of 35, Pap smear and sonography, mammography is a must with blood sugars.  For males, semen analysis, collection difficulties to be noted, viral markers and it is about 35 one has to look at the sugars.  Optimization of patients is something that is very, very important. Sperm optimization depending upon the count, the FSH, the testicular size you decide whether the patient needs varicocele or the patient needs antioxidant therapy and antibiotics. Generally prefer in a natural cycle evaluation when the size of the follicle is 16 to 18 mm. If the endometrium is more than 9 mm triple line endometrium with power Doppler blood flow showing reaching zone IV then the endometrium is good.

Disadvantages of Batch IVF

The disadvantage of the batch is fix and rigid timeframe so some patients get period early, some patients get period delayed so all that things need to be looked at. On day 10 when the trigger was supposed to be given, some follicles may not be ready at all. So, you might have to cancel the cycle or some patients may not respond to the same treatment, respond very poorly because of the stress, maybe the dose calculation, HMG cold chain, lots of things.  So they don't respond well, we have to cancel the cycle so cycle cancellation sometimes can be very high.  Now there are special care patients like recurrent implantation failure, thin ET patients where you require to do something extra like doing intrauterine GCSF or giving intra-lipids or giving prolonged estrogen therapy for thin ET patients so these all things will require to be learned over a period of time in a batch IVF.

A few other questions to be answered include:

• how many numbers of couples to be included for IVF?
• what happens when the patient gets a period earlier?
• When you start and stop the OC pills?
• What was the antral follicle count, AMH, age of the patient, weight of the patient?
• What types of triggers to be given?
• how many cases a batch should be started?

For detailed answers to these and other questions you might have on the Batch IVF from "Inception to Conception, enroll for live lecture Dr. Kedar N Ganla MD (Gynecology) here https://docmode.org/batch-ivf-from-inception-to-conception-dr-kedar-n-ganla/