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In Vitro Fertilization (IVF) is defined as fertilizing the woman eggs with a male sperm outside the woman body in a lab environment. The fertilized eggs are then transferred into the uterus of the woman for implantation and thus initiating pregnancy.
Originally, IVF was used for women with damaged fallopian tube but now it is being used for almost all types fertility or genetic problems. IVF has now become a treatment of choice for couples who are facing medical issues that disable them to conceive naturally.
The doctor will recommend In Vitro Fertilization in following cases:
IVF will not be applicable when
IVF is emerging as big respite for couples facing pregnancy issues but its high cost, potential pregnancy risks like premature babies or ectopic pregnancies, and chances of multiple gestations like twins and triplets are factors that are making people think twice. It may even require more than one cycle of IVF for success.
Several tests and screenings are conducted before IVF. Common tests include
You will be put on birth control pills which may reduce your risk of ovarian hyper-stimulation. Doctor will also use either basal body temperature charting or ovulation predictor kit to detect when you ovulate. Once, the doctor knows this you will be put on a hormonal medication so your ovulation can be controlled.
If you’ve irregular cycles, you’ll be prescribed medicines to bring your periods on time.
The day you get your period is when your treatment will officially begin. On the second day, you’ll be asked for blood tests to check the oestrogen levels in your body.
Ultrasound to check the size of ovaries and detect the presence of any ovarian cysts which may interfere with the treatment. In case there are ovarian cysts, doctors will either allow them to dissolve in a week’s time or take them out with needle.
Under natural conditions, one egg is released by the ovaries every month. However, to increase the chances of success in IVF treatment will be given to produce multiple eggs. Doctors will give injectable hormonal medication for 1 to 2 weeks for stimulating ovaries and produce multiple eggs.
You will be asked to come at least 8 to 9 times for monitoring appointments which will involve:
Based on the monitoring results about the size of your follicles and oestrogen level, doctor will decide when to give you a trigger shot that will fully mature the ovaries and pave way for ovulation. Timing is very important in this stage because just before ovaries are going to ovulate egg has to be retrieved.
Roughly, 2 to 3 days after trigger shot you’ll be called to the lab for retrieving the egg. An anesthesia medication will be given to you and a needle will be inserted into each ovary to remove the egg along with the follicular fluid. This will be a small outpatient surgical procedure which will take around 30-45 minutes.
In case your ovaries are inaccessible through trans-vaginal procedure, then an abdominal surgery will be performed.
Your partner’s sperm will be collected and stored either earlier or on the same day of insemination.
If you are planning to use your partner's semen, then your partner will be asked to provide semen sample through masturbation. Surgical methods like testicular aspiration might be used in some cases.
Sperm is seperated from the semen in the laboratory.
Insemination & Fertilization
Egg retrieval and insemination occurs on the same day. Mature eggs and sperm are mixed and incubated overnight.
If there is a problem with quality of the semen, sperm injection (ICSI) may be used. A single healthy sperm will be isolated and then injected into the egg. This is done in the embryology lab of IVF clinic.
Once fertilization is complete, embryos began to develop. The growth of these embryos or blastocyst is closely examined by a specialist for at least 1 week.
Nearly on the fifth day after the egg retrieval, your appointment will be scheduled for embryo transfer. Depending on the quality of the embryos, your age and previous medical treatments, either one more embryos will be transferred. For females less than 37 years of age, undergoing first IVF cycle and with good quality blastocysts, doctors may opt for elective Single Embryo Transfer (eSET).
A catheter is used to insert embryo into the uterus.
You’ll have to wait for at least two weeks before pregnancy can be confirmed. You’ll be called for a blood test to check the hCG levels. If more than 25mIU/ml it is considered positive. Still, to be doubly sure doctor may ask for a beta test 2-3 days. If the level of hCG becomes twice after two days, it indicates a healthy pregnancy.
After 6-8 weeks, a vaginal ultrasound may also be done to check for foetal heartbeat and amniotic sac to confirm the positive development of your pregnancy.
For many females, the pregnancy may come out to be negative which would be very disappointing especially after so many weeks of efforts and enthusiasm but don’t let it cloud your hope. Discuss with your IVF specialist who will guide you on next steps.
Your doctor will recommend you to avoid any strenuous activity after the embryo transfer and before pregnancy test.
Complications in IVF
Be assured - IVF does not make one vulnerable to cervical cancer, ovarian cancer, endometrial cancer or breast cancer. Birth defects resulting from IVF
Millions of women are turning to IVF for getting pregnant and completing their families. Birth defects may occur but the incidence are not alarming as compared to babies which are conceived naturally.
In general population, the risk of birth defects in a child born through IVF is only 2-3%. The use of intracytoplasmic sperm injection (ICSI) may cause inherent sex chromosomal abnormalities especially in the male offspring like improper development of penis or sperms.
Other common birth defects seen in babies born through IVF are cerebral palsy which interfere with normal development of motor and physical development of the infants; cleft lip, heart defects or hip dysplasia. Research studies are being carried out to monitor the long-term health of babies born through IVF. The excessive doses of hormones during IVF procedure cause dangers of birth defects. Maternal age and causes of infertility also play a greater role in causing birth defects.
To reiterate what was said earlier, the chances of complications and birth defects are not a cause of worry for those undergoing IVF treatment because they may happen in case of natural births also. With advances in the medical science technology the incidence of such cases have been on decline. IVF-born babies are as much healthy and happy as those though natural conception. You can discuss your concerns and doubts with an IVF specialist or counselor.