In Vitro Fertilization is commonly known as “test-tube baby”, is an Assisted Reproductive Technology (ART) fertility procedure which is done manually by combining ovum and sperm in an IVF laboratory and after the fertilization ‘embryo’ is placed back in the female uterus. This ideal procedure is for those who have damaged or removed or blocked fallopian tubes, or may have tried other methods such as fertility drugs, surgery, and artificial insemination but haven’t worked.
What Causes of Infertility Can IVF Treat?
IVF is a huge boon for a woman whose fallopian tubes are blocked, damaged or removed. The other can be many such as Endometriosis, Low sperm counts, uterus problem, ovulation problem, hormonal problem, cervical problems, sperm penetration problem, sperm survival problem, unexplained fertility problem, age, and genetics. Male partner fertility problems can be poorer-quality sperm, low motile sperm, azoospermia, Hormone problems, genetics, ejaculation problem, absent sperm pipeline, obstruction in male reproductive system, anti-sperm antibodies and Varicoceles.
What to Expect with IVF Treatment
Initially in the IVF clinic, the specialist will ask a couple about previous medications and history of failed pregnancy or pregnancies. Later according to the history, a reproductive endocrinologist will discuss and plan out best IVF plan. Doctor will likely perform vaginal ultra sound and blood tests to determine the number and quality of ovarian eggs. One IVF cycle consists of ovulation induction, egg retrieval, sperm retrieval, fertilization and embryo transfer, which takes about 2 weeks and can require more than one cycle.
A female body generally produces single egg a month but that won’t work because it may or may not fertilize. Therefore in ovulation induction, doctor prescribes synthetic hormones or certain medicines to stimulate ovaries for producing multiple eggs. Different medications can be for ovarian stimulation, for oocyte maturation, to prevent premature ovulation and to prepare the lining of your uterus.
IVF cycle is cancelled if any of the below is the case and doctor prescribes other medicines;
- Development of poor number of follicles
- Premature ovulation
- Excess follicles development which isa risk of ovarian hyper stimulation syndrome
- Other medical issues
Egg retrieval is done 35 to 36 hours before ovulation and after the final injection. Sedation is given and with Transvaginal ultrasound aspirationor abdominal surgery or laparoscopy eggs are retrieved. You may experience slight cramping or feeling of pressure. The mature eggs are carefully placed in culture mediumand incubated. These are mixed with the healthy sperms for the creation of an embryo.
For sperm retrieval procedure, male partner has to submit semen sample. In case of absent male partner, donor’s semen sample is used. Sperms are separated from the semen in the laboratory.If sperm count is less, then IVF is combined with intracytoplasmic sperm injection.
Common Methods of Fertilization
- Insemination: In which sperm & mature eggs are combined and incubated for a whole night.
- Intracytoplasmic sperm injection (ICSI): in which single healthy sperm is injected into each mature egg with the help of needle. This method is generally done when there is a problem in quality or number of sperms. Even used due to failed IVF cycles.
In some cases doctor may recommend assisted hatching or Pre implantation genetic testing methods before embryo implantation. In assisted hatching, an embryo “hatches” from surrounding zonapellucida membrane about 4-6 days after fertilization.A slight hole is made in the embryoand thenimplanted into theuterus lining.This method is recommended for much older woman or who have experienced multiple attempts of failed IVF.
Embryo transfer usually takes place two to six days after egg retrieval. A long tube called catheter is inserted in the vagina through cervix directly into uterus, and 1 or more embryos are suspended. You can resume normal everyday activities but should avoid laborious activities. The embryos used in first cycle can be frozen for later use for another cycle for cost-effectiveness. The left over embryo can later be donated to infertile couple.
The side effect of IVF can be:
- Breast tenderness
- Mild bloating & cramping
- Bloody fluid discharge due to swabbing of the cervix before the process
After about two weeks of embryo transfer, doctor will perform pregnancy test by taking a blood sample.
What is the Success Rate for IVF?
The success rates of IVF are 99.99%. In a report, out of 10 women, eight conceived in an average of all cyclesaverage (depending on various factors like age, genes etc.), live births are 80-85% successful. Woman’s age plays a major role in successful outcome. There is a 45% chance of having baby for a woman who is under age 35 while woman above 40 has 11.5% chance.
Are There Other Issues With IVF to Consider?
Sometimes, IVF doesn’t result in pregnancy. Patient should continue with another cycle for successful outcome. There is an increased chance of twins or triplets, or premature and underweight baby, drug used to stimulate ovaries may increase risk of ovarian hyperstimulation syndrome OHSS or any infection.
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