There is nothing more wonderful than holding your precious, little bundle of joy in your arms. To bring a baby into this world is not an easy job and yet a mother goes through so much pain to make it happen and a father stands by her side, holding her hand. While many couples are able to conceive easily within a few months of trying, there are some who have to face difficulties and deal with infertility. Thanks to advanced science, there is this amazing process known as IVF (In-Vitro Fertilization) which can make your dreams of parenthood true. Let’s find out What is IVF (In-Vitro Fertilization) and learn All about the Process, Success Rate, Side Effects, and Risk Factors.
What is IVF (In-Vitro Fertilization)? All about the Process, Success Rate, Side Effects, and Risk Factors
There are many fertility treatments available for hopeful parents such as medications like Clomid (clomiphene) or Femara (letrozole) and intrauterine insemination (IUI) which is also known as artificial insemination in which sperm is placed in the uterus and then conception happens in its natural course. But sometimes these options are futile for some couples, say for a same-sex couple or the couples who didn’t find any success in these treatments. In such cases, IVF comes in as a blessing.
What is In-Vitro Fertilization (IVF)?
The process of In-Vitro Fertilization involves fertilization of the eggs and sperms outside the body in a laboratory. In simple words, mature eggs are extracted from the ovary and a sample of sperm is retrieved and then the egg and sperm are manually combined in a laboratory dish. Then the embryo or embryos (fertilized eggs) is transferred to the uterus.
Earlier known as “test-tube babies,” In-Vitro Fertilization (IVF) has become the most effective form of assisted reproductive technology (ART). The first IVF baby, Louise Brown, who was conceived outside her mother’s womb, was born in England in 1978. Now, more than 200,000 IVF cycles are performed in the USA since its introduction in 1981.
What Causes of Infertility Can IVF Treat?
IVF becomes the most effective option when a couple is having the following infertility issues:
- Male factor infertility including decreased sperm count or sperm motility
- Blocked or damaged fallopian tubes
- Women who have had their fallopian tubes removed
- Women with ovulation problems, premature ovarian failure, uterine fibroids
- Antibody problems that harm sperm or eggs
- The inability of sperm to penetrate or survive in the cervical mucus
- Individuals with a genetic disorder
- Infertility problems due to age
- An unexplained fertility problem
Generally, IVF is never suggested by the doctors as the very first option, mostly because IVF is an expensive and complex procedure. But in certain cases such as severely blocked fallopian tubes, men with insurmountable sperm deficiencies, same-sex couples or couples using donor eggs, IVF remains as the only possible way to conceive.
What Is The Process Of In-Vitro Fertilization (IVF)?
When other less expensive fertility treatments turn out to be a failure, IVF is the procedure that is considered as the best bet. There are five basic steps in the IVF and those are:
Step 1 – Stimulation or Super Ovulation
Fertility drugs are prescribed to stimulate eggs production. Normally, a woman produces one egg per month but multiple eggs are required because there is a chance that some of the eggs will not develop or fertilize after extraction. These fertility medications boost egg production and regular transvaginal ultrasounds are performed to examine the ovaries and blood tests are taken to monitor hormone levels.
Step 2 – Extraction of Eggs
A minor surgical procedure known as follicular aspiration is done to extract the eggs from a woman’s body. Medication is provided to the woman so she does not feel any pain or any discomfort during the procedure. A thin needle is inserted into the pelvic cavity with the help of ultrasound images as a guide. There may be some cramping after this procedure but it only lasts one day.
Step 3 – Insemination and Fertilization
While the process of egg retrieval is taking place, the man is asked to produce a sample of sperm and is prepared to combine with the eggs. The sperm and eggs are then mixed together which is called insemination. In a controlled environmental chamber, the sperm and eggs are stored and after a few hours of insemination, the sperm fertilizes (enters) the egg. In some cases, where the probability of fertilization is low, the eggs are fertilized using an intracytoplasmic sperm injection (ICSI). In this process, the sperm is directly injected into the egg. Even though when things appear normal, ICSI is done on some of the eggs for a higher rate of success.
Step 4 – Embryo culture
The eggs are monitored to confirm that fertilization and cell division are taking place. When the fertilized egg is divided, it becomes an embryo. An embryologist then monitors each embryo over the next three to five days to make sure it is growing properly. Couples who have a high risk of passing a genetic disorder to the child can opt for pre-implantation genetic diagnosis (PGD) in which a single cell is removed from each embryo to screen it for genetic disorders. This allows parents to decide which embryo to implant.
Step 5—Embryo transfer
Usually, after three to five days of egg retrieval and fertilization, the embryos are transferred to the woman’s uterus. A catheter or a small tube containing the embryos is inserted into the uterus. If the embryo sticks (implants) to the uterine wall then the procedure is said to be successful and pregnancy occurs. More than one embryo may be placed into the womb at the same time which results in multiple pregnancies.
Success Rate of IVF
One cycle of IVF generally takes about two weeks and sometimes more than one cycle is needed. In that case, the whole IVF process takes about four to six weeks to finish.
Factors that affect the success of the IVF are age, how long you have been trying to conceive, the cause of infertility, type of embryo transfer, quality of the sperm and whether self eggs or donor eggs were used. The success rate is higher in younger women, especially women under 35. It is also higher when frozen embryos are used as opposed to the fresh embryos as the embryos that survive the thawing process will be more robust and have more chances of pregnancy. Irrespective of the age of the patient, a live birth rate of around 30% is considered as a gold standard around the world. In the United States, the live birth rate for each IVF cycle started is approximate:
- 41-43% for women under age 35
- 33-36% for women ages 35 to 37
- 23-27% for women ages 38 to 40
- 13-18% for women ages over 40
Side Effects of In-Vitro Fertilization
It is better to take it easy for a few days after the embryo transfer to minimize the chance of uterine contractions which might prevent the embryo from implanting. But after some days, women can return to their normal activities. Some of the side effects of IVF are:
- Nausea and vomiting
- Passing a small amount of fluid (may be clear or blood-tinged) after the procedure
- Breathing trouble
- Mild cramping
- Difficulty sleeping
- Mild bloating
- Enlargement of the ovaries
- Host flashes
- Breast tenderness
- Abdominal pain
On the occurrence of heavy vaginal bleeding, pelvic pain, blood in the urine or a fever over 100.5 °F, one must immediately consult to the doctor. Plus, all the hormonal changes happening inside makes it more of a roller coaster ride.
Risk Factors of IVF
Like any other medical procedure, there are some risks of IVF as well. One of the most widely reported risks is a multiple-birth pregnancy (twins or more). Multiple birth pregnancy can cause issues such as pregnancy and labor complications, premature delivery and developmental problems for children. The fertility drugs can cause Ovarian Hyperstimulation Syndrome (OHSS) but this happens very rarely. OHSS causes the ovaries to become swollen and painful due to the excess of eggs development in the ovaries. In such cases, a woman should right away call the doctor. Other risk factors include:
- Nausea or vomiting
- Decreased urinary frequency
- Feeling light-headed
- Shortness of breath
- Severe stomach pains and bloating
- Ten-pound weight gain within three to five days
- Ectopic pregnancy
- Egg-retrieval procedure complications
How Much Does IVF Cost?
Like I mentioned earlier, IVF tends to be pretty expensive. A single IVF cycle can cost up to $15,000 or more. One cycle of IVF includes medicines, procedures, anesthesia, ultrasounds, blood tests, lab work, and embryo storage. And keep in mind that you might need more than one cycle of IVF. So the bill can jump higher pretty quickly. There are a few insurance companies that cover some or all of the costs of the infertility treatment. Some clinics offer to come up with financing plans which make the treatments affordable for couples. There are also IVF fundraising crowdsourcing campaigns being launched by couples which you can look into.
Before you decide to go for IVF, make sure that you have all the fine details of this treatment from a fertility specialist. You can also opt for surrogate if your OB/GYN suggests so! If you have been longing for a baby of your own, IVF can be the answer to your prayers. It might be a bit hazy and crazy journey, but have hope and soon you will be holding your little baby in your arms.