IVF has come long way from days when its medical miracle. First IVF baby was born in 1978. Since as per European Society of Human Reproduction and Embryology, total of 5 million such births have bought joy to parents across globe. This has also created scenario where many couples turn to this procedure without understanding its implications. Small, unsupervised clinics prey on lack of knowledge and non specialist doctors sell as “Fertility experts”. An IVF procedure without proper adherence to rules create grave risks for child and mother.
What is In Vitro Fertilisation?
In vitro fertilization is a biological process which has been made to occur in laboratory vessel, test tube or other controlled experimental setting. At simple terms, in vitro fertilization is a fertility treatment where eggs and sperms are combined in a laboratory to form embryos and placed inside the uterus through cervix to enable conception of an IVF baby. Nowadays, IVF treatment is considered to most commonly used fertility treatment, accounting for more than 99 percent of assisted reproductive technology procedures.
IVF Treatment Procedure Step by Step
This revolutionary procedure is used to treat fertility or genetic problems and helps in conception of child. You can go for less invasive treatment options before attempting IVF. These including take up medications to increase production of eggs or intrauterine insemination.
But if you are one of those couples who failed to conceive through all other treatments and want to move for IVF treatment then you must be aware of procedures to be required to follow at the course of treatment. First you must know procedures done using your own eggs and your husband’s sperm. This may involve eggs, embryos or sperms from an anonymous donor. There are cases where gestational carrier-a woman who has embryo implanted in her uterus might also be used.
Before moving to IVF treatment, both partners must have to undergo following screening tests.
1. Evaluation of Ovarian Reserve
In order to know the quantity and quality of your eggs then you have to take certain tests in knowing the concentration of follicle-stimulating hormone, oestrogen and anti-mullerian hormone into your blooding at the first few days of your menstrual cycle. Tests might be combined with an ultrasound of ovaries to predict ovaries response to fertility medication.
2. Semen Analysis
Your partner may be asked to take semen analysis tests before starting treatment. This test analyze health and viability of sperm including number, movement and shape. Both of you might also have take screening tests for infection diseases including HIV.
3. Uterine Cavity Exam
This test helps doctor to examine your uterine cavity or space inside uterus. Healthy uterine cavity is essential to conceive and maintain pregnancy. There are important points considered as couple and discuss them with doctor before taking plunge through IVF treatment cycle. Some of these things are:
4. Embryos for Transfer
Normally, number of embryos transferred during treatment depends on age and number of eggs. Since rate of implantation is lower for older women (above 35 years of age), more embryos are transferred to increase likelihood of conception. This happens except in cases where donor eggs are used.
5. Multiple Pregnancies
You should also know that if more than one embryo transferred to your uterus, IVF treatment which can lead multiple pregnancies. Avoid these situations at some cases, people opt for foetal reduction. This can help woman minimize the chances of complications and give birth to healthy baby. This could be major decision with emotional, ethical and psychological consequences.
6. Extra Embryos
What you do with extra embryos during the treatment? You can choose to discard unused embryos, you should also know that they can be frozen and stored for future use. There is no assurance that all embryos to endure freezing. Its recommended to discuss with doctor and follow expert advice.
7. Other Issues
You also need to consider chance of complications arising out of donor eggs, embryos and sperm from gestational carrier. For this, you must consult trained counselor with expertise donor issues who can thoroughly explain legal rights of donor. You may need attorney to file court papers to help you become legal parents of implanted embryo.
How Does The In Vitro Fertilisation Process Work?
There are various stages that couple has to pass through before able to conceive. Lets look for the procedure step by step to understand complexities of process.
1. Ovulation induction
This is stated to be the first phase of treatment. If you are using your own eggs then you must be treated with synthetic hormones to stimulate the ovaries for producing multiple eggs instead of single egg normally develops each month. Its important that multiple eggs produced as some ggs which may not fertilize or develop after fertilization.
For this doctor must prescribe medication at various stages of treatment.
- Ovarian stimulation. For stimulation of ovaries you are generally advised to take injections containing follicle-stimulating hormone, a luteinizing hormone or combined both. This helps to produce more than one egg at a time.
- Oocyte maturation. After eggs are formed and follicles ready for egg retrieval then you are prescribed medications to help egg mature.
- Premature ovulation. You are asked to take medications which could prevent the body from releasing the developing eggs too soon.
- Lining of your uterus. Another set of medications might be prescribed on the day of egg retrieval or at the time of embryo transfer. You are given progesterone supplements to prepare the lining of uterus, and make it receptive for implantation.
Your body might take one or two weeks for ovarian stimulation before eggs are retrieved. During the course of medications then you have to be checked each and every two or three days for blood hormone levels and get ultrasound for measurement of ovaries. This helps to track growth of follicles-fluid filled sacs where egg mature and determine eggs are ready for collection.
You must know that IVF cycle at this stage might be cancelled for reasons such as insufficient number of follicles developing, premature ovulation or too may follicles creating risk of ovarian hyperstimulation syndrome. If your cycle doesnt progress for reason then doctor might recommend changing medication or doses to support better response in future cycles.
2. Egg extraction
After follicles are ready, you given trigger shot-an injection will help eggs to mature fully and prepare them for fertilization. Eggs are ready for retrieval from 36 hours after shot is given.
3. Transvaginal Ultrasound Aspiration
Before you undergo transvaginal ultrasound aspiration you will be first sedated through medication. Normally this procedure an ultrasound probe is inserted into your vagina to identify follicles which is then followed by thin needle into ultrasound guide to go through vagina and into follicles to retrieve the eggs.
Mature eggs collected are kept in nutritive liquid and incubated. Eggs appear healthy and mature which is said to be infused with sperm to create embryos.
4. Sperm Retrieval
Now its your partner turn where he is asked to provide semen sample as same morning when egg retrieval is expected to be carried. At rare cases and methods such as testicular aspiration, the needle or surgical procedure is done to extract sperm directly from testicle. Sperms are then separated from semen fluid in laborartory.
Now your eggs will go through most important phase-fertilisation. This can be carried out through two popular methods. First is insemination in which healthy sperm and mature eggs are mixed and incubated overnight. Other is intracytoplasmic sperm injection (ICSI) where single healthy sperm is injected directly into each mature egg. ICSI is often used when semen quality or number is an issue or fertilization attempts during previous IVF cycles have not yielded fruitful results.
6. Embryo or Blastocyst Transfer
The next critical stage at the three day mark when some fertilized eggs is said to transform into multi celled embryos. Within two or more days, further metamorphose into blastocysts. At this stage, they develop a fluid filled cavity with tissues will ultimately spate into baby and placenta.
After you have passed on above stages, you reach stage where embryo can finally transferred into your womb. It is done after two to six days from egg retrieveal. Here again you must be given mild sedative. The procedure is painless for patient. Doctor is said to insert a long thin, flexible tube called catheter into the vagina, through cervix and into your uterus. Syringe containing one or more embryos suspended in a fluid is attached to end of catheter. If successful, an embryo is said to implant into your uterus about six to 10 days after egg retrieval.
Why is Fertility Treatment Good for You?
If you are trying to conceive for couple of years now and your efforts gone in vain then its time to go for IVF treatment, Even those who have not been able to conceive due to problems such as ovulation or egg quality, blocked fallopian tubes, endometriosis, uterine fibroids, unexplained infertility and more can take the treatment. It is one of the best medical procedures available today, which will help you to get pregnant. It is offered as primary treatment to treat infertility in women who have crossed over 40 years age. If your partner is said to have low sperm count or if you are using donor eggs to become pregnant then its one of the best treatment at hand.
What is IVF Treatment for Pregnancy?
IVF has become one of the best treatments for couples with fertility issues or genetic problems. Both partners must take the treatment depending on the problems diagnosed and go on to become a parent.
How does IVF help in Treating a Woman?
It is main to determine the cause of fertility problems in a woman before the treatment to begin. At some cases, the reason or cause must be completely unknown. Find out some of the causes of infertility problems in women and their treatment:
1. Ovulation Issues
If you have problems with ovulation which are been detected with polycystic ovary syndrome then some medications would be prescribed to stimulate your ovaries to release eggs or treat PCOS.
2. Unexplained Infertility
Any treatment that has failed to determine the cause of infertility so far then you might be treated with medications such as Clomiphene, hormone injections and more.
3. Blocked/Damaged Fallopian Tubes or Fibroids
At the case a blocked or damaged fallopian tubes, treatment might include tubal surgery. If mild to moderate endometriosis which has been detected as primary reason for infertility then treatment must include laparoscopic surgery to remove endometrial tissue growth. Endometriosis is result of growth and implantation of uterine tissue outside uterus. This affects function of uterus, fallopian tubes and ovaries. You could have uterine fibroids which are bengin tumors’ in wall of uterus and could be interfering with implanation of fertilized egg.
How Does IVF Help in Treating a Man?
In men, below average sperm count, weak movement of sperm or abnormalities in sperm size and shape can pose challenge for sperm to fertilise an egg. If problems are found then you could be recommended to try insemination first wherein your sperms are said to be collected and then concentrated to raise up healthy sperm required for insemination.
How Long Does It Take to Get Pregnant through IVF?
This takes about four to six weeks to complete one cycle of IVF. Typically 12 days to two weeks after the procedure of egg retrieval is done, you must be asked to take blood tests for determining pregnancy.
What is The Success Rate of IVF?
For any couple decided to take IVF route to starting a family, primary question is how successful is IVF. Its difficult to get conclusive answer to question as success rate of IVF treatment varies depending on various reasons including age and infertility. Younger women have healthier eggs and higher success rates. As per recent study, birth rates resulting from single cycle of IVF using women’s own eggs are about 30% to 40% for women aged 34 and younger. Rates decreased once you cross 35 yrs of age. Embryo status, reproductive history, lifestyle factors such as obesity and smoking are factors contribute to success of IVF.
Advantages or Disadvantages of In Vitro Fertilisation
There are various concerns whenever you have to undergo a medical procedure. So, anxiety before taking the IVF treatment is also natural. Hence its important to understand the pros and cons before you proceed.
Pros of IVF?
- Scientifically Proven and Popular: In vitro fertility treatment is the oldest assisted reproductive technology procedure and has been validated by researchers through extensive studies on children conceived using this method.
- Improved Procedures: Its invention, there are efforts by researchers to improve techniques. For instance, with genetic screening so called as preimplanation genetic diagnosis or preimplanation genetic screening then you can ensure the foetus used during treatment is free from genetic markers.
- Control: Because of highly controlled, medically supervised procedure, IVF allows parents it with strict demands on their time due to professional or personal commitments to select up the timings of the baby’s conception and birth.
Cons of IVF?
- Unsuccessful Cycle: Even after you decided to go through treatment don’t pin all your hopes on it being successful. Success of IVF treatment is not guaranteed and you might end up going through more than one cycle treatment before getting result.
- Expensive Procedure: IVF is said to be an expensive procedure at a monetary terms. The best thing is to go ahead with a clear idea of all the costs attached to the treatment.
- Lead to Stress: whole process of testing and administering fertility medications can be emotionally and physically taxing, as you need to visit the doctor several times for the IVF cycle.
What are The Risks of IVF Treatment?
There are various certain risks associated with the IVF treatment such as the following:
1. Multiple Pregnancies
If more than one embryo is placed in uterus then there are chances of having twins or more. This might seem ideal for some couples wanting to conceive twins, please note that multiple fetuses increases riks of miscarriage and many other complications such as preterm labour.
2. Ectopic Pregnancy
You must be aware that the IVF procedure carries risk of ectopic pregnancy. This is said to occur when fertilized egg attachés itself to a place other than inside uterus. As fallopian tubes cant properly hold an embryo then fertilized egg can’t develop properly. Risk of an ectopic pregnancy increases in women with damaged fallopian tubes.
3. The Risk of Ovarian Hyperstimulation Syndrome (OHSS)
OHSS will happen when a woman’s body shows a severe response to fertility drugs and produces too many eggs which will be leaving ovaries swollen and painful. At rare cases, it could also be life threatening, and the woman is said to require intensive monitoring.
4. Potential Risks for Baby
There is said to be a belief that babies conceived through IVF might be more likely to be born prematurely or have a low birth weight. However, experts don’t have more evidence to prove whether the risk stems are from infertility issues such as age, or from the treatments.
Side Effects of IVF Treatment
The IVF treatment is not fully devoid of side effects. Expecting parents to be informed about potential side effects caused by treatment. You might pass a small amount of clear or bloody fluid soon after procedure. This is said to happen due to swabbing of cervix before IVF embryo transfer.
You might have tender breasts because of high oestrogen levels with mild bloating, constipation and cramping.
Use of inkectable fertility drugs for ovulation inducation cause OHSS which ovaries become painful and swollen. You might witness mild abdominal pain, nausea, bloating, vomiting and diarrhea.
What is The Cost of IVF Treatment?
IVF costs is between Rs 60,000-Rs 1 lakh. This could go beyond as per cycle, including doctor’s fees, injections and medication costs. The chances of IVF working the first time are only about 46% in women under the age of 30 and only 12% in women between the ages of 40 and 43, the final cost will depend on the treatment program you chose and the items included in it.
How to Use IVF Calculator for Pregnancy?
There are many online IVF calculators which can help in calculating due date more precisely in IVF. You can now simply type in the information that could be the first day of the last menstrual period, the day of ovulation, egg retrieval, or insemination, the date of the 3-day embryo transfer, or the date of the 5-day embryo transfer.