In vitro fertilization or IVF is a widely used fertility treatment that helps couples imagine when other methods fail. Know who needs IVF, how the process works, and potential risk factors.
Infertility is a challenge faced by many couples and can affect both men and women. There are many reasons for infertility, including hormonal imbalances, lower sperm counts, and blocking the fallopian tubes. When other treatments such as medications and intrauterine insemination (IUI) fail, many of them turn to in vitro fertilization (IVF). IVF is the process by which eggs are fertilized outside the body, and the resulting embryos are embedded in the uterus. Success can depend on factors such as age and overall health, but it is one of the most successful fertility treatments today. IVF brings hope to people suffering from infertility, but it’s important to know everything about the process before trying it out.
What is in vitro fertilization (IVF)?
In vitro fertilization or IVF is a popular reproductive technique (ART) used to help couples suffering from infertility. This involves collecting eggs from a woman’s ovaries and fertilizing them with the sperm outside the body. The resulting fertilized egg, called an embryo, is stored or embedded in the female uterus to become pregnant. IVF is usually recommended after a year of unsuccessful attempt to conceive. It also helps prevent genetic disorders from being passed down to children. One IVF cycle typically takes up to 2-3 weeks. IVF is the most successful infertility treatment, but its success depends on factors such as age and the underlying cause of infertility.
Why is IVF completed?
In vitro fertilization (IVF) is often used to help individuals with infertility or genetic disorders who want to have a pregnancy or baby or who want to have it. Because IVF is expensive and invasive, couples usually try other treatments first, such as fertile medications or intrauterine fertilization (IUI). According to Mayo Clinic, IVF may be required for several reasons for infertility, including:
- Women over 40 years old who have a decline in fertility rate
- Blocked or damaged fallopian tubes
- Ovulation disorder or impaired ovarian function
- Endometriosis
- Uterine myoma
- Infertility in men (low or abnormal sperm count)
- Infertility of unknown cause
- Genetic disorders
- Maintaining fertility due to cancer and other health conditions
- Polycystic ovarian syndrome (PCOS)
IVF provides a solution if other options are not successful.
How is IVF performed?
According to Johns Hopkins’ medicine, IVF has five steps.
1. Stimulation (Super ovulation)
Women usually produce one egg per cycle, but IVF requires multiple eggs to be most likely to succeed. Fertility medicines are prescribed to stimulate the ovaries and produce more eggs. At this stage, women undergo regular blood tests and ultrasound to monitor their hormone levels and check for ovarian development. This ensures that the eggs are growing properly.
2. Egg collection
Egg collection or follicle aspiration is a minor surgical procedure performed under anesthesia. The doctor uses an ultrasound cane to guide it through the vagina and into the ovaries. The needle absorbs the egg from the follicle. After that, the woman may experience mild convulsions or fullness. This usually disappears within a day. The recovered eggs are placed in a special liquid to help mature and prepared for fertilization.
Read again: Stop believing these general IVF myths
3. Insemination and fertilization
The male partner will provide a semen sample and combine it with eggs from a lab Petri dish. This process is known as insemination. The fertilization process occurs naturally when sperm enters the egg within a few hours. If fertilization is unlikely, a technique called intracytoplasmic sperm injection (ICSI) can be used when a single sperm is injected directly into the egg. The fertilized eggs are stored in a controlled environment for proper development.
4. Embryo culture
When fertilization occurs, the embryos are monitored and confirmed to be properly divided and grown. Over the next few days, the embryo develops into several cells. By day 5, the healthiest embryos will be formed and ready for transfer.
5. Embryo transfer
Once the embryo is fully developed, one or more are selected to move into the female uterus. This procedure is usually performed 3-5 days after fertilization. A thin tube called a catheter is inserted from the vagina to the cervix into the uterus, where the embryo is gently released. The number of embryos transferred depends on a variety of factors, especially the age of the woman. Multiple embryos can lead to the possibility of twins, triplets, and more.
If the IVF process is successful, the embryo is implanted into the endometrium approximately 6-10 days later. A blood test will check if you are pregnant.
How can I prepare for in vitro fertilization (IVF)?
Preparing for in vitro fertilization requires a thorough medical evaluation and fertility test prior to IVF. Both you and your partner will be tested. Important preparations include:
- IVF consultation to discuss the process
- Uterine tests, PAP tests, and mammograms (for those over 40)
- Semen analysis
- Screening for Sexually Transmitted Diseases (STIs) and Other Diseases
- Preliminary ovarian tests, blood and urine tests
- Instructions regarding administration of fertility drugs
- Gene carrier screening
- Sign the consent form
- Uterine cavity assessment (hysteroscopy or saline injected ultrasound) Additionally, providers recommend starting folic acid supplements at least 3 months prior to embryo transfer.
Is IVF a fertility solution?
The success rate of IVF varies based on several factors. According to the American Pregnancy Association, the birth rate for women under the age of 35 is approximately 41-43%. However, for women over the age of 40, this rate drops to 13-18%. Key factors that influence your success include:
- Causes of infertility, such as endometriosis and low egg counts
- Where you are performing the steps
- Is the egg fresh or frozen?
- Are the eggs yours or donated?
- Your age
Young women tend to have a higher success rate. IVF is usually not recommended for women over the age of 42 as it is unlikely to be successful. Maintaining a healthy weight and avoiding alcohol, smoking and caffeine can improve IVF results.
Why do IVF treatments fail?
IVF treatment can fail for several reasons, including:
- Early egg respiratory
- Eggs are not developed
- Too many eggs
- The egg is not fertilized by sperm
- The quality of the sperm is poor
- The embryo is not grown or embedded
- Egg collection or embryo transfer problems
Each step in the IVF process can affect the outcome, and failures can occur at any stage. Your healthcare provider will review the process with you to identify the cause and determine the best course of action for future treatment.
What are the complications associated with in vitro fertilization?
IVF, like any medical procedure, presents risks and potential complications, suggesting National Health Services. These include:
- Multiple pregnancies that increase the risk of low birth weight and preterm birth
- Early delivery or miscarriage
- Ectobiotic pregnancy, eggs trapped outside the uterus
- Rare complications such as bleeding, infection, and damage to the intestines and bladder
- Ovarian hypersensitivity syndrome (OHSS) is a condition caused by excess fluid in the abdomen and chest
Additionally, side effects from the procedure may include cramps, bloating, nausea, soft chest, headaches and hot flashes. In rare cases, bleeding, infection, or organ damage can occur from the egg collection needle.
Related FAQs
What is the difference between IVF and IUI?
IVF fertilizes the eggs on the outside of the body and transfers the embryo to the uterus. IUI (intrauterine insemination) involves placing sperm directly into the uterus during ovulation, increasing the chances of fertilization. IVF is usually recommended for more complex infertility issues, but IUI is often used for less severe fertility issues.
Does infertility affect women only?
No, infertility can affect both men and women. Women can face problems like hormonal imbalances, while men may have problems like low sperm counts and sperm quality.
Is IVF harmful?
IVF is generally safe, but like other medical procedures, there are several risks, including ovarian hypersensitivity syndrome (OHSS), multiple pregnancies, or infection. However, they are closely monitored to minimize complications.
Can IVF cause birth defects?
Although IVF does not directly cause birth defects, it may be at a slightly higher risk in certain conditions, especially in older women and multiple pregnancies. However, most babies born through IVF are healthy.
