What is IVF?
IVF, also known as in vitro fertilization, is an artificial method that helps women become pregnant. Currently, IVF is known as the most common and effective reproductive technology that can achieve this feat.
The most general reason for getting IVF stems from the inability or unwillingness to naturally conceive of the patient. It is, however, important to note that the possible reasons why a patient would choose an IVF are not limited to infertility alone.
What does IVF consist of?
While the actual techniques used in the process of IVF may differ between clinics, the entire procedure of an IVF will typically include the following steps:
♦ Suppression of the natural menstrual cycle
The natural menstrual cycle of a woman plays an important role in her reproductive abilities. An IVF, however, will require this natural cycle to be suppressed before the procedure can take place.
This suppression is usually achieved with the use of a certain drug (i.e. suppressant), which is usually administrated via daily injections for approximately 2 weeks.
♦ Super ovulation
The patient will also be given fertility drug(s) that can supply them with a fertility hormone known as the follicle stimulating hormone (FSH). This hormone, in turn, causes the ovaries of the patient to produce more eggs than it otherwise would. During this process, the patient’s ovarian activities can be monitored by vaginal ultrasound scans.
♦ Retrieving the egg
After the eggs (i.e. ova) have been produced, they are then obtained via a minor surgical procedure known as the follicular aspiration. This procedure involves inserting a very thin needle, which has been connected to a suction device beforehand, into an ovary of the patient through their vagina.
Once the suction device has been inserted, it will draw the egg cells out of the ovary. This entire process has to be repeated for each ovary that the patient has. In some cases, frozen or donated egg cells can also be used in place of the patient’s eggs.
♦ Insemination and fertilization
Posterior to the collection of the ova, the egg cells are then introduced to and placed together with the sperms of a male in a chamber whose environment is constantly monitored. This spermatic introduction is known as an insemination. In most cases, the sperms will enter the egg cell on their own a few hours after the start of insemination.
There are, however, also cases in which the sperms have to be directly injected into the egg. This injection is known as an intracytoplasmic sperm injection (CSI). The sperms used for insemination and, subsequently, fertilization, can be either frozen sperms obtained from a testicular biopsy or fresh sperms.
At the end of this phase, the fertilized egg divides and becomes an embryo.
♦ Pre-implantation genetic diagnosis (PGD)
Prior to the actual embryo transfer, the patient may also choose to have a pre-implantation genetic diagnosis if their health center offers it. The primary purpose of PGD is to diagnose any genetic disorder that the baby may have. However, the use of PGD remains controversial and is, therefore, not always preferred.
Specifically, PGD is capable of providing results regarding the embryos’ characteristics (e.g. gender, disorders) and allowing the parent(s) to “select” their desired embryo. The controversy surrounding PGD largely stems from the unethical discarding of the deselected embryos after they have been created, especially if the reason for it is gender preference.
♦ Embryo transfer, also known as embryo implantation
The final step of an IVF is to actually implant the created embryo(s) into the womb of the patient. The number of implanted embryo(s) is usually decided between the patient(s) and their doctor.
In most cases, the doctor will only allow the implantation of more than one embryos if there is no ideal embryo available. The transfer itself involves the use of a thin tube or catheter, which connects to the womb via the vagina. Once the embryo has adhered to the lining of the womb, it will begin to grow as a naturally conceived embryo would.
Should you go for IVF?
Patients will choose to have an IVF if:
- The patient and/or her male partner has been diagnosed with (unexplained) infertility. Possible causes of infertility include:
- Endometriosis (i.e. the development of the uterine-lining tissue outside the uterus)
- Low sperm counts of the male partner
- Problems related to the uterus or the fallopian tubes
- Ovulation-related problems
- Antibody-related problems that affect the reproductive cells of either or both partners
- The inability of sperm to penetrate or survive in the cervical mucus
- The patient does not respond to other techniques such as the use of fertility drugs and intrauterine insemination (IUI)
- The patient’s fallopian tubes have been blocked
- The patient does not wish to naturally conceive (i.e. engage in sexual activities with a man)
Success rate of IVF
The success rate of IVFs depends on many factors, including the age of the patient and the facility in which the IVF is carried out. In terms of age, the general trend is that the higher the age of the patient, the lower the chance of a live birth. Statistically, the success rate of IVFs in different age ranges has been estimated to be:
- 32.2% for women under 35 years old
- 27.7% for women between 35 and 37 years old
- 20.8% for women between 38 and 39 years old
- 13.6% for women between 40 and 42 years old
- 5% for women between 43 and 44 years old
- 1.9% for women between 44 years old
Other factors that may affect the success rate of IVFs include:
- The amount of time prior to the IVF which the patient has been trying to get pregnant
- The underlying cause of infertility (which is not always diagnosable)
- If the patient has been previously pregnant or has given a live birth
- The actual procedure of the IVF
- Vitamin D levels, though this has only been suggested
It is important to keep in mind that every case of IVF is unique and has its own characteristics. Before choosing to have an IVF, make sure you thoroughly consult your doctor about its success rate and whether or not you are a suitable candidate for the procedure.
GO.CARE does not provide medical advice, diagnosis or treatment.