IVF: What is it that nobody tells me?

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IVF is In-Vitro Fertilization, wherein fertilization of egg by a sperm occurs outside the body of woman.  A snapshot of steps in IVF is as follows.

  1. Ovaries are stimulated with hormones to produce more eggs
  2. Eggs released from ovaries are extracted by laparoscopy
  3. Under high power microscope, egg is injected with a good quality sperm from husband
  4. Fertilised egg is grown inside an incubator under controlled micro-environment
  5. In 2-3 days it grows into an embryo, which is transferred into uterus for implantation

Before embarking upon a wonderful journey of assisted parenthood, a couple should know realistic expectations, inherent advantages, disadvantages and risks of IVF.

Success rate of IVF cycle

This is the first question in a couple’s mind. Will I conceive with IVF? You might ask a question to your fertility specialist ‘what is the guarantee of IVF?’ Know that a fertility specialist claiming 100% success is lying. Although every IVF cycle cannot succeed, improved IVF technologies have shown significantly improved success rates. Women with favourable factors have IVF success rates of 40% or higher, while others have per-cycle success rates of 20-35%. Knowledge of realistic success rate prevents frustration. Variation in success rate is due to following determinants of IVF

  1. Wife, including poor quality of eggs
  2. Husband
  3. IVF Specialist
  4. Embryologist
  5. IVF Lab
  6. Quality Check of Lab

In addition to this, IVF cycle can fail due to stress, emphasising the need for strong moral and psychological support by husband, family, counsellor and fertility specialist.

How long does it take to get pregnant with IVF?

A couple undergoing IVF cycle will need about six weeks to complete. Woman needs to take daily injections of hormones for stimulation of ovaries for about 14 days. She may need to continue taking injection to facilitate implantation even after embryo has been transferred. She will also need to visit clinic for about half a day for extraction of eggs by laparoscopy. And another short visit after 2-3 days for transfer of embryos into the uterus. After 14 days of egg extraction, urine test is done to determine the success of IVF cycle. 2 weeks after this, a sonography confirms the pregnancy.

Advantages of IVF

A successful pregnancy and a healthy newborn are the biggest advantages of IVF. IVF makes parenthood a reality for a couple unable to bear child.

    • IVF is more successful than IUI (Intra Uterine Insemination) and other forms of assisted reproductive technology. IVF is recommended for a couple with more than 3 failed cycles of IUI to avoid any further loss of time, resources and ovarian reserve.
    • Blocked Fallopian tubes: IVF can bypass problem of blocked or damaged Fallopian tubes, allowing such woman to have a child using her own eggs.
    • Idiopathic infertility: In IVF fertilization is assisted in vitro, benefiting a couple with unknown cause of infertility (idiopathic), wherein most likely problem can be due to inability to sperm to fertilize the egg.
    • Older woman or woman with a low ovarian reserve: During stimulation phase, IVF focusses on quality of eggs, rather than quality. Hence IVF can maximise the chances of older woman or woman with low ovarian reserve to conceive.
    • Male infertility: ICSI (Intra Cytoplasmic Sperm Injection) allows for selecting good quality sperms to fertilise eggs. Hence IVF is good option for couples with a male infertility problem where child of husband is desired.
    • Poly Cystic Ovary Syndrome: PCOS is a common condition with hormonal imbalance leading to irregular menstrual cycles. IVF has proved successful for conception in PCOS patients not responding to medications.
    • Endometriosis: Patients with endometriosis, where endometrium layer of uterus grows outside it, may benefit from IVF
    • Premature ovarian failureWomen with premature ovarian failure or menopause can have IVF treatment using donor eggs, which typically has relatively higher success rates.
    • Single woman: For a single woman who wish to have a child, either IVF or IUI with donor sperm can help her fulfil her dream.
    • Same-Sex Couples: IVF or IUI with surrogate mother for a male couple and with donor sperm for a female couple can offer them a privilege of being parents.
  • Unused embryos can be donated to research or another infertile couple, duly after your consent.
  • To screen out inherited diseases: For individuals who are known carriers of genetic disorders such as cystic fibrosis, Huntington’s disease and muscular dystrophy, IVF with pre-implantation genetic diagnosis (PGD) is one of the most reliable ways to ensure that a child conceived will not suffer from the disorder

Risks with IVF cycle

  • Multiple births: In IVF cycle, most commonly 1 or 2 healthy embryos are transferred into the uterus.  IVF increases the risk of multiple births if more than one embryo is implanted in the uterus. A pregnancy with multiple fetuses carries higher risk of early labour and low birth weight than a pregnancy with single fetus. With no complications, multiple birth may be boon for some couples.
  • Premature delivery and low birth weight: IVF slightly increases the risk that a baby will be born early or with a low birth weight.
  • Ovarian Hyper Stimulation Syndrome (OHSS): Injection of hormones to induce ovulation can cause Ovarian Hyper Stimulation Syndrome (OHSS), in which ovaries become swollen and painful, which can rarely become serious. But this can avoided by an experience fertility specialist by tailoring the correct dose of hormones.
  • Miscarriage: Rate of miscarriage for women who conceive using IVF with fresh embryos is similar to that of women who conceive naturally (15 to 25 percent), but the rate increases with maternal age. Use of frozen embryos during IVF, however, may slightly increase the risk of miscarriage.
  • Complications during extraction of egg by laparoscopy: Bleeding, infection or damage to the bowel, bladder or a blood vessel can happen rarely.
  • Ectopic pregnancy: In 2 to 5 percent of women undergoing IVF cycle fertilized egg implants outside the uterus, usually in a Fallopian tube. An ectopic pregnancy needs to be medically terminated, since embryo can’t survive outside the uterus.
  • Ovarian cancer: Occurrence of ovarian cancer have been speculated due to stimulating hormones of IVF cycle, but recent studies refute this.
  • Stress: IVF can be financially, physically and emotionally draining. Support from counsellor, family and friends can help a couple cope up with the stress.
  • An IVF cycle may be unsuccessful: Women with favourable factors have IVF success rates of 40% or higher, but not everyone is fortunate to succeed in first attempt.

Continuous guidance by counsellor and fertility specialist is needed to take an informed decision to achieve your dream. Feel free to contact Currae IVF Hospital where trained counsellors and experienced Fertility Specialist equipped with international standard IVF Lab help resolve your doubts in a comfortable, relaxed setting and help you enjoy the bliss of parenthood.

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