In-vitro Fertilization (IVF) involves uniting the egg and the sperm outside the body. It can be used to workaround common infertility problems such as sperm anomalies or irregular ovulation. During the procedure, a woman’s egg is surgically removed from the body and joined with the sperm in a laboratory. Once the team determines that the embryo is viable, it is then surgically returned to the uterus.
In 1978, Louise Brown of England was born into the world as the first baby to be conceived outside the womb. Back then, In-vitro Fertilization (IVF) was still a relatively unknown procedure, colloquially known as producing “test-tube” babies. Since then, over 8 million babies have been born with the help of IVF. Over 2.5 million IVF cycles are performed yearly, giving couples struggling with infertility a new lease on life.
The main goal of IVF is to bypass common infertility challenges. It is designed to result in a pregnancy that would otherwise be impossible. IVF also allows the woman to choose between using her/her partner’s own eggs and sperm or to look for a donor.
In-vitro fertilization gives new hope to couples living with infertility. During the treatment, a couple may discover that the problem lies in the interaction of their sperm and egg which results in a failed fertilization. Unlike the natural method, IVF can give an assurance of fertilization as it can be directly confirmed inside the lab.
Men who have undergone vasectomy or diagnosed with a low sperm count can benefit from IVF with Intracytoplasmic Sperm Injection (ICSI). IVF-ICSI is a method wherein sperm is inserted directly into the egg. This can counteract the problem of sperm motility or decreased sperm quantity.
In-vitro fertilization also allows couples to test the embryos for abnormalities before they are implanted back into the uterus. Most couples undergoing IVF are advanced in age, making them more susceptible to children born with genetic conditions such as Cystic Fibrosis or Down’s Syndrome. Pre-Implantation Genetic Diagnosis or Comparative Genomic Hybridization can give the couple such information beforehand.
As with all medical procedures, IVF comes with its own risks. Couples who are interested in IVF should be educated about the risks, benefits, and odds of the therapy at the beginning of the process.
Since the eggs will be extracted surgically, the woman is faced with the risk for infection, an untoward reaction to anesthesia and other perioperative complications. Success rates for IVF varies accordingly and is dependent among a number of factors. The viability of the egg and sperm, the embryo’s implantation site and a woman’s capability to carry the embryo to term all come into play. Less than half of couples in IVF therapy get pregnant, with only 25% resulting in a live birth.
Ovarian Hyperstimulation Syndrome (OHSS) is a condition that arises when the ovaries produce multiple eggs as a result of medication. While others may see this as a victory, multiple pregnancies can also give rise to challenges such as a high-risk pregnancy and financial troubles. Not all couples are ready to care for more than one child at a time. Some fertility clinics decrease the chances of multiple pregnancies by implanting one fertilized embryo at a time.
In-vitro Fertilization is an expensive medical procedure. It can cost anywhere from $12,000 to $20,000 per cycle depending on the treatment and medications needed. In some countries, IVF may be subsidized by insurance companies with substantial out of pocket costs.
If IVF turns out to be not a good fit, couples could explore other artificial reproductive methods available by consulting with doctors in the fertility clinic.
During the consultation period, your doctor will give you a rundown of what will happen on the day of your appointment. If you have any questions – no matter how silly you think it is – ask your doctor about it! It is important that patients and their partners feel at ease during the entire process.
PHASE 1: IVF PROCEDURE
Your doctor may opt to administer local anesthesia, intravenous anesthesia, or a combination of both. The choice of anesthesia should be discussed prior to the procedure, as a person’s tolerance for pain is highly individualized. The goal is to keep the patient as comfortable as possible while still being awake. Fasting is required 6 to 8 hours prior to the procedure.
Once you’re adequately sedated, the doctor will insert an ultrasound probe into your vagina and retrieve a suitable egg from your ovaries. This will take about 30 to 45 minutes. If you’re doing this with your partner, he will be asked to ejaculate in a separate room. The collected egg and sperm will then be taken to the laboratory to be examined. Once both are determined to be viable, the fertilization process will begin. The fertilized eggs will be put on observation for 2-3 days.
Meanwhile, the female will be given hormones via vaginal suppository or injections to prepare the womb to receive the embryo.
PHASE 2: EMBRYO TRANSFER
Once the fertilized egg becomes an embryo, it is now ready to be transferred into the uterus. This process does not require the use of anesthesia and usually takes around 30 minutes to complete. Embryo transfer can be done as soon as 3-5 days after egg retrieval.
Another option would be to let the embryo sit in the laboratory for more than 5 days. This is the period where the embryo develops into a Blastocyst. Blastocyst Transfer improves the chances of implantation and pregnancy.
One cycle of IVF takes about 4 to 6 weeks to complete. A pregnancy test is done 2 weeks after embryo transfer.
In-vitro fertilization involves both physical and psychological preparation. Once you’ve decided to go through with the procedure, you need to make sure that you’re at your physical best. This means eating a balanced diet, getting enough exercise and putting a stop to smoking. Alcohol and caffeine consumption needs to be put on hold for the meantime.
A complete physical exam will be done by your physician. A pelvic ultrasound will be done to observe follicle growth over a couple of days. Once the follicles are of the right size, medication will be given to stimulate ovulation. After 36 hours, the eggs are expected to be ready for harvesting.
As you can see, IVF requires a lot of effort and time. This is why it is important that both the patient and her partner are adequately briefed about the procedure, including the risks and common set-backs.
This is a relatively safe and quick procedure. Patients are kept inside the clinic for about 1-2 hours after the procedure just to make sure they’re stable before being sent home. Patients are advised to avoid stressful environments for 2 to 3 days. Strenuous activities such as vigorous exercise or heavy lifting are discouraged. Make sure to follow all the instructions given by the healthcare provider.
The woman may feel soreness in the lower abdomen/vaginal area after the procedure. Some experience cramping, especially if more than one egg has been retrieved. Some women also report seeing blood-tinged vaginal discharge. Pain medications are usually given post procedure to help control these symptoms.
Hormones may also be prescribed in order to encourage the pregnancy. If that’s the case, the woman may experience mood changes, bloating, and hot flashes during the course of treatment.
In rare occasions, the administration of hormones can lead to a condition called Ovarian Hyperstimulation Syndrome – a collection of symptoms brought about by an overactive ovary. Symptoms may include nausea, dizziness, weight gain, and stomach pain.
Who is suitable for this procedure?
IVF is recommended for individuals or couples that have been unsuccessful with other reproductive treatments. Typically, couples are encouraged to try all means available for 3 years before IVF is considered. It can help bypass common fertility challenges such as low sperm motility, endometriosis, and obstructed fallopian tubes.
Is there an upper age limit for IVF treatment? Does age affect the chances of pregnancy?
A woman’s chances of pregnancy decrease with age. A woman in her 40s is typically considered as someone who will have difficulty conceiving and carrying a baby to term.
The beauty of IVF is that it helps the woman overcome these biological barriers. She can opt to harvest her eggs while in her 20s or 30s and preserve them until she is ready to have a baby. IVF has been proven to be successful even for women in their mid-40s.
Does IVF treatment take long?
The entire IVF cycle lasts for about 4 to 6 weeks. This includes the preparation, procedure, and post-procedure care. The treatment itself begins on the third day of menstruation and lasts for about 2 weeks. A pregnancy test can be done 2 weeks after the embryo has been transferred into the uterus.
Is the egg retrieval procedure painful?
The goal of IVF is to ensure a comfortable experience for everyone involved. Local and intravenous anesthesia can be administered to ensure a painless procedure. IVF utilizes a thin ultrasound probe inserted through the vagina. The probe is guided to the ovaries where it retrieves the egg by using gentle suctioning. The entire procedure takes about 30 to 45 minutes.
Am I a candidate for IVF?
IVF may be indicated for couples who have had difficulty conceiving the natural way. It can also be prescribed for men with motility problems, low sperm count, or a vasectomy. Women with endometriosis, Polycystic Ovarian Syndrome (PCOS), and abnormal ovulation cycles can also benefit from IVF. Talk to your healthcare provider about your options.
How long does IVF take?
The entire process takes about 4 to 6 weeks. The procedure begins on the 3rd day of menstruation and ends after 2 weeks. Once the embryo has been transplanted, a pregnancy test can be attempted after 14 days.
It is important to understand that IVF may not be successful on the first try. It is quite common for IVF couples to go through more than one round of IVF before a successful pregnancy can occur.