What is IVF? An over view?
In vitro fertilization (IVF) is a process that involves fertilization of egg by sperm outside the body, in a glass. A woman's ovulatory process is monitored and stimulated to remove ovum from her ovaries which are then fertilized by sperm in a fluid medium in a laboratory. The fertilized ovum, also known as zygote, is cultured for a period between two to six days in a growth medium before implanting it into the uterus of the same or a different woman, with the intention of establishing a successful pregnancy
Who can go for IVF?
IVF is the best option for people suffering from these fertility problems:
- Damaged/blocked fallopian tubes
- Fallopian tubes problems that can prevent eggs released by the ovaries from reaching the uterus.
- Poor sperm movement or low sperm count
- Problems with sperm count or sperm quality can prevent sperm reaching the egg or fertilizing the egg in the fallopian tube.
- Unexplained infertility
- No cause can be found for about 1 in 5 cases of infertility. People with unexplained infertility who haven't had success with other fertility treatments may have success with IVF.
When should one opt for IVF?
It is recommended by the National Institute for Health and Clinical Excellence (NICE) that suitable couples receive up to three cycles of IVF if the woman is between 23 and 39 and the couple has had a problem with fertility for three years.Your doctor can tell you more about the IVF options open to you.
What are the risks involved?
- Multiple births may take place that can increase the risk of pregnancy loss, obstetrical complications, prematurity, and neonatal morbidity with the potential for long term damage.
- Spread of infectious disease through sperm
- Birth defects
What is the outcome and percentage of success?
The percentage of all IVF cycles that lead to a live birth is known as live birth rate. This does not include stillbirth or miscarriage and multiple-order births like twins and triplets are considered as single pregnancy. A summary compiled in 2009 by the Society for Reproductive Medicine shows live birth rate percentage for different age groups:
- 41.4% for <35 years
- 31.7% for 35-37 years
- 22.3% for 38-40 years
- 12.6% for 41-42 years
How is this done?
IVF is performed by collection of contents from a woman’s uterus or fallopian tubes after naturally stimulated ovulation. It is then mixed with sperm to get fertilized, before re-inserting it into the uterus. The probability of pregnancy would be extremely less if additional techniques are not applied. These include hyper stimulation of ovaries to generate multiple eggs, transvaginal oocyte retrieval directly from the ovaries guided by ultrasound and culture/selection of embryos to be transferred.
Stimulation of egg growth
Fertility drugs such as pergonal, puregon and humegon are used to increase the probability of pregnancy by recruiting the highest possible number of eggs because a cycling woman can ovulate just a single egg per month. Hormonal tests and ultrasound studies are performed repeatedly to closely monitor the eggs for its growth and development. Optimal ovulation timing is determined from these tests and ovulation is triggered by chlorigon or pregnyl that is followed by egg retrieval schedule.
Egg retrieval
It is scheduled after 36 hours from the ovulation induction. It is performed in a hospital through transvaginal route. It involves insertion of a needle into the ovaries through vaginal walls with the help of ultrasound imaging to puncture and aspirate the follicles containing the eggs. The eggs released are assessed for their developmental stage after transferring into the laboratory. The procedure takes not more than 10-15 minutes and the patient can be at home in a few hours.
Stimulation of egg growth
Sperm, obtained after masturbation, undergoes a series of procedures in the laboratory to get prepared for its interaction with the eggs. It is then added in a proper concentration to the dishes containing the eggs. These dishes are kept under favourable conditions in the incubator and monitored carefully. After a given duration of time, fertilization takes place that results in division of the fertilized egg into two daughter cells that continue to divide in a rapid manner.
Embryo transfer
After a period of 2-5 days post-fertilization, embryos that have divided satisfactorily are transferred to the uterus. A small plastic catheter, loaded with the embryos, is introduced gently through the cervix into the uterine cavity. The patient can return to home in the next couple of hours.
Follow-up
Although complete bed rest may be counter affective for the patient, it is recommended to refrain from physical exertion. Medications can be prescribed to support the young embryos hormonally based on the nature of cycle stimulation. Pregnancy presence can be indicated by secretion of Human Chorionic Gonadotropin (HCG) hormone by the placenta. Careful monitoring is required until ultrasound visualization of the foetus is possible.
What are latest technologies used for this process?
Advanced Artificial Reproductive Technology:
Advanced procedure has been developed for men who cannot produce quality sperms as those suffering from “male factor infertility”. The procedure known as Intra Cytoplasmic Sperm Injection (ICSI) can complete fertilization with a minimum sperm count. It has helped millions of childless couples to become parents.
Will the baby be healthy in the long term?
According to the world’s largest study into assisted reproductive technologies, most adults who have been conceived through in vitro fertilization and other ART are healthy compared to those conceived by natural means.
What are the precautions to follow?
For a safe pregnancy, these instructions should be followed:
• Vigorous activities should be avoided that involves forceful bodily movement
• Heavy workout and exercises should be avoided
• Stay away from cigarette smoke
• Caffeine must be avoided as much as possible
• Avoid indulging yourself in a sexual intercourse
• Do not lift heavy weights
• Avoid activities like aerobics
• Do not consuming alcohol or alcoholic products and drinks
• Avoid sunbaths and swimming
• Stay away from tough household work
• Avoid consuming OTC (over the counter) drugs
