Everything you need to know about IVF
What is IVF?
IVF, also known as In Vitro Fertilization, is an artificial method that assists women in getting pregnant. Currently, IVF is known as the most common and effective reproductive method.
The most popular reason for an IV procedure is the patient’s inability or unwillingness to naturally conceive a baby. It is, however, important to note that the possible reasons why a patient would choose an IVF are not limited to infertility alone.
How is IVF carried out?
While the actual techniques used in the process of IVF may differ between clinics and hospitals, 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.
The patient will also be given fertility drugs that contain 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. 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 for constant monitoring. This spermatic introduction is known as 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/ implantation
The final step of an IVF procedure is the implantation of the created embryo(s) into the patient’s womb. The number of implanted embryos is usually a matter of decision between the patient and their doctor.
In most cases, the doctor will only allow the implantation of more than one embryo 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 like a naturally conceived embryo.
Should I go for IVF?
There are numerous reasons for people to perform an IVF procedure. Such reasons include the following things:
- 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
- Other methods, such as fertility drugs and intrauterine insemination (IUI), do not work.
- 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).
IVF’s success rate
The success rate of IVF depends on various factors, including the age of the patient and the facility where the procedure is carried out. Generally, the success rate decreases as the woman grows older. Statistically, this rate is 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 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
It is important to keep in mind that there are differences between different IVF cases. Before the procedure, make sure to thoroughly consult your doctor about the success rate and whether or not you are suitable for the procedure.
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