In vitro fertilization

What is in vitro fertilization (IVF)?

In vitro fertilization (IVF) is a assistive reproductive technology (ART). In IVF, eggs are retrieved from the ovaries of a woman and then fertilized with sperm to form an embryo. The embryo is then transferred to the womb of a woman or stored for later use.

Based on what the circumstances are, IVF can employ donated embryos, donor eggs and donor sperm, donor eggs and your partner’s sperm, your eggs and donor sperm and your eggs and your partner’s sperm. If you or your partner are not in a condition to have a pregnancy, your doctor can also implant the embryos in a surrogate who is a female who carries your baby for you.

What is the process of in vitro fertilization?

The process of IVF is divided into five steps: stimulation, egg retrieval, insemination, embryo culture and transfer.

Stimulation

During stimulation, a woman is given fertility drugs to increase the number of eggs her body produces. Your blood test will be done, and you’ll have an ultrasound done on you for monitoring the production of eggs and for your doctor to know when it is time for retrieval.

Egg retrieval

A needle guided by an ultrasound wand will be inserted in the vagina, into the ovary and into an egg containing follicle. The eggs and fluid will be suctioned by the needle.

Insemination

The sperm sample given by the male partner will be mixed with the eggs in a petri dish. If embryos aren’t created, ICSI may be performed.

Embryo culture

The dividing and developing embryos will be monitored. You may get genetic testing done on them for presence of genetic conditions.

Transfer

Embryos are implanted into the uterine cavity when they are big enough. In implantation, a catheter (thin tube), is inserted into your vagina, past the cervix and into your uterus. The embryo is released into the uterus. Pregnancy happens when the embryos get implanted to the uterine wall. It can take 6-10 days. Your blood may be tested to see if you’re pregnant.

What are the risks associated with pregnancy achieved with in vitro fertilization?

The risks of IVF associated with pregnancy occur mainly during embryo transfer after fertilization and its implantation in the wall of uterus. The main risks of IVF associated with pregnancy are as follows:

Preterm pregnancy: Premature births occur in babies born with IVF treatment. It happens on account of high levels of a hormone called relaxin that forms in corpus luteum.
Miscarriage: In twenty percent cases of IVF, biochemical abortions take place, usually in the initial weeks. But the risk of a miscarriage occurring is not more in IVF pregnancy than the normal pregnancy. Biochemical abortions, however, do occur more in IVF pregnancies than the normal pregnancies.
Ectopic pregnancy: Instead of getting implanted in the uterus, the embryos is implanted elsewhere, for instance, in the fallopian tubes. The risk of it occurring in an IVF pregnancy (2-5%) is more than that in a natural pregnancy (1%).
Multiple pregnancy: Multiple pregnancies result in more problems than a single pregnancy. ARTs have seen an increase in the numbers of double or triple pregnancy. This along with the increased age of the women trying to get pregnant with IVF, makes the risks greater for the mothers and their babies.

In infants, IVF conceptions are linked to a several obstetric and perinatal problem, like low weight at birth, prematurity, congenital defects, low weight for gestational age, admission to neonatal intensive care unit, C section and premature breaking of membrane.

What are the advantages and disadvantages of in vitro fertilization?

Infertile individuals can’t conceive through natural methods. However, using IVF, they can become parents. The advantages of IVF are as follows:

Increased chance of having a healthy baby: People who have a family history of genetically linked diseases can have healthy babies as the fetus is screened to make sure it is free of any genetic markers.
Decreased risk of miscarriage: The genetic viability of an embryos can be checked beforehand to avoid miscarriage due to the mother’s genetic problems.
Authority over planning: IVF facilitates a general control to individuals who are centered around their vocations. They can freeze and store their eggs or embryos when they want to and use them later when required.
Ability to utilize given eggs or sperm: IVF can be useful in circumstances where doctor’s recommendation is to, using the given eggs or sperm, prepare the eggs in the facility and utilize a subsequent, practical fetus for IVF. This increases the chances of becoming pregnant for the first or second time.
IVF is helpful when other treatments fail: It works when other treatments for fertility fail. IVF is very helpful in infertility conditions, such as blocked fallopian tubes, reduced ovarian reserves, severe male infertility factor and/or advanced maternal age (>38 years).
Increased chances of conception: IVF along with PGT has the greatest success rate compared to other assisted reproductive technologies. You can go through multiple cycles to increase your odds of fertilization, a healthy pregnancy and live birth.

The disadvantages of IVF are as follows:

Cost: It is not a cheap procedure and isn’t always covered by insurance. Multiple cycles can increase the overall cost of IVF.
Varied success rates: Based on the age and medical condition, the success rates of IVF vary widely. On average, just over 25% of IVF cycles lead to live births.
Side effects: The side effects of IVF include problems due to ovarian stimulation to create more eggs, risk of ectopic pregnancy, etc.

Conclusion

It can be very complicated to decide whether you should go through IVF treatment or how to try again when it has failed. It can be a very costly process and can take a toll on you. You should consult with your doctor to find out the best options for you and if IVF is the right choice for your and your family.

FAQs

Does IVF increase the risk of preterm labor?
Several research studies have shown that there is a slightly increased risk of preterm delivery in IVF pregnancies when compared to the natural pregnancies.
What other problems can arise during IVF treatment?
Physical problems can arise during IVF, as well as psychological and emotional problems. A person or a couple may experience intense episodes of stress and anxiety while receiving a diagnosis or a negative result. Financial problems can also arise due to high cost of IVF treatment.
Does in vitro fertilization have any risks for the baby?
There are research studies that show that children born through IVF have slightly increased risk of congenital malformations. But it is unknown whether it is due to the infertility issues of parents or IVF itself.
What are the risks associated with embryo transfer?
Women may get mild cramps when the catheter is put inside the vagina. They may experience vaginal spotting after the procedure. Rarely, infections may develop which can be treated with antibiotics.
If I conceive with IVF, will my pregnancy be more complicated than a natural pregnancy?
Multiple pregnancy is more likely in IVF which carries multiple significant risks: maternal hemorrhage, gestational diabetes, preterm labor or delivery, delivery by cesarean section, and high blood pressure related to pregnancy.
Are there greater risks when IVF treatment is done on older women?
Yes, with an increase in age, the risks increase for both the mother-to-be and fetus. Also, the possibility of achieving a pregnancy is reduced.
Will I be awake during egg retrieval in IVF?
A sedative is given to help you relax but you will remain awake during the procedure. A local anesthetic will be injected to numb the vaginal and cervical areas.
Can I get pregnant naturally after egg retrieval?
While uncommon, it is possible to get pregnant naturally after egg retrieval of IVF.
Can IVF babies have babies?
Yes, IVF babies can conceive when they reach adulthood.
When is a woman most fertile?
A woman is most fertile in her 20s.