In vitro fertilization (IVF) Treatment

In vitro fertilization (IVF) is assisted reproductive technology. It is a procedure of choice to help couples conceive a baby when other modalities have failed.In the IVF clinic, the fertility doctor collects mature eggs from your ovary and fertilizes these eggs with sperm in a laboratory. The doctor then implants the fertilized egg or eggs into the uterus. One IVF cycle usually takes twenty days.The embryologist can use the couple’s eggs and sperm or use eggs and sperms from a donor. The success of any IVF procedure depends on two critical factors, viz. the age of the female and the cause of infertility.

Indications of IVF:

In vitro fertilization (IVF) is usually an infertility treatment when other less invasive treatment options fail to give any result. IVF can be a primary option for women aged more than 40 years. Your doctor may consider IVF as an option if you or your partner has one of the following conditions:

  1. Fallopian tube blockage or damage: Any damage or blockage of the fallopian tube may act as a barrier for fertilization of egg or movement of an embryo into the uterus
  2. Ovulation disorders: Problem with ovulation may cause fewer or no eggs available for fertilization.
  3. Endometriosis: Endometriosis occurs when the tissue lining of the uterus grows outside the uterus. This condition may affect the functioning of the ovaries, fallopian tubes, and uterus.
  4. Uterine fibroids: Uterine fibroids are benign tumors commonly occur in women in their 30s and 40s. The presence of fibroids in the uterus can prevent the proper implantation of the fertilized egg.
  5. History of tubal sterilization or tube removal: In tubal ligation, the surgeon cuts or blocks the fallopian tubes to permanently prevent pregnancy. For women who want to conceive after tubal ligation, IVF can be an option.
  6. Sperm-related abnormalities: Low sperm concentration, poor sperm mobility, abnormalities in sperm morphology can prevent proper fertilization of sperm and egg. IVF can be a procedure of choice in such cases.
  7. Unexplained infertility: Sometimes, the reason for infertility remains unknown. Your doctor may then recommend IVF.
  8. A genetic disorder: Sometimes, genetic disorders in parents can pass to their children. If you have such a condition, the fertility doctor may recommend eggs or sperm from a donor.

What are the potential risks of IVF?

Multiple births:

An IVF can lead to multiple births if more than one embryo develops and gets implanted into your uterus. Multiple fetuses usually carry a higher risk of premature and low birth weight than pregnancy with a single fetus does.

Premature delivery and low birth weight

According to some research, IVF may increase the risk of preterm delivery or low birth weight.

Ovarian hyperstimulation syndrome or OHSS:

Your doctor may prescribe human chorionic gonadotropin (HCG) hormone to induce ovulation. This hormone may cause painful and swollen ovaries called ovarian hyperstimulation syndrome. Some of the common symptoms of OHSS are

  • Mild
  • abdominal pain
  • Bloating
  • Nausea
  • Vomiting
  • Diarrhe
Miscarriage:

Women who conceive using IVF may have more chances of miscarriage than women who give birth naturally. But we should also remember that chances of miscarriage increase with maternal age


Complications related to procedure:

The use of an aspirating needle to retrieve female eggs can cause complications like
  • Bleeding
  • Infection
  • Damage to the bowel
  • Damage to the bladder
  • Damage to the blood vessel
Ectopic pregnancy:

It happens when implantation of the fertilized egg occurs outside the uterus, causing the termination of pregnancy

Stress:

IVF not only puts a financial burden, but it is also physically and psychologically draining. A detailed discussion with the counselors and family before and during the procedure can help you sail out through this stressful journey.


What you can expect:

IVF involves five steps

  • Ovarian stimulation
  • Egg retrieval
  • Sperm retrieval
  • Fertilization
  • Embryo transfer

One IVF cycle typically takes two to three weeks.

Ovulation induction (OI):

OI involves the use of synthetic hormones to stimulate the ovaries. The stimulated hormones produce multiple eggs, rather than a single egg that typically develops during the monthly cycle. Multiple eggs increase the chances of successful fertilization during IVF.

Egg retrieval

Your fertility doctor will do the egg retrieval procedure approximately 35-36 hours before ovulation. During egg retrieval, the doctor will guide an ultrasound probe into your vagina and identify follicles. The fertility expert then inserts a thin needle into an ultrasound guide, reaches the vagina, then into the follicles, and retrieves the eggs.

Sperm retrieval

In the IVF clinic, the doctor takes a semen sample from the male partner on the morning of egg retrieval

Fertilization

Fertilization between eggs and sperms can happen in two ways: Conventional insemination: It involves mixing and overnight incubation of sperm and eggs. Intracytoplasmic sperm injection (ICSI): In ICSI, a fertility expert injects a single healthy sperm directly into each mature egg. Your doctor may recommend ICSI when poor semen quality or sperm number leads to failure of previous IVF cycles.

Embryo transfer

The embryo transfer procedure is the final step of the IVF cycle. The success of IVF depends on the precise placement of the embryos in the middle of the endometrial cavity. The doctor should complete the procedure with minimal trauma of the endometrium.

After the procedure

After the embryo transfer, you may feel some discomfort due to painful and swollen ovaries. You can resume your daily activities as soon as you feel normal.

Results

Your doctor will do a blood test for pregnancy, typically 12 to 14 days after the egg retrieval process. If the result is positive, the doctor will refer you to an obstetrician for further care. If you’re not pregnant, you’ll likely get your period within 5 to 7 days after stopping medications.