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Who should go for IVF ?
IVF is the most commonly known ART technique which is used to help couples who are primarily affected with male infertility, or structural blockages in the reproductive tracts. It is further recommended for:
Fallopian tube blockage
IVF should be considered in the cases where the fallopian tubes are badly damaged and tubal surgery may have decreased chances of success than IVF or in most cases where tubal surgery has already been unsuccessful. IVF can be considered if both fallopian tubes are blocked or damaged. It's a tubal factor infertility that prevents natural conception. During IVF, the ovaries are stimulated to produce several eggs, which are then retrieved. The eggs are then fertilized in the laboratory, and fertilized embryos are placed into the uterus where they can implant and grow, so In vitro fertilization (IVF) can bypass the fallopian tubes altogether.
Ovulation Disorders
Certain women face problems with ovulation, but produce eggs when stimulated with fertility drugs without conceiving. In such cases, specialists opt to stimulate the ovary to produce many ova and then select the best for fertilization and transfer.Ovulation disorder generally happens for women over 40 when hormone levels might be irregular because there are few eggs left to ovulate. For women under 40, premature ovarian failure is when ovaries stop working normally. In such cases, IVF may be suggested by the doctors.
Endometriosis
Endometriosis is a disorder wherein tissue similar to the tissue lining the uterus grows outside the uterine cavity.Such women with endometriosis may also benefit from the IVF procedure.You may need some special monitoring and careful management of fertility medications because they can temporarily trigger symptoms of endometriosis, but your chances of success are good. So if you have endometriosis and you wish to start a family, IVF is a good solution.
Impaired Sperm Production or Function
IVF is a good option for partners with low sperm count who have been trying to conceive naturally for at least 2 years.When the sperm of the male partner has low motility, count or certain structural abnormality but may still have the potential to fertilize an ovum, in such cases carefull preparation by embryologists and an IVF procedure may help such couples to conceive.
Female partners with ‘hostile’ cervical mucous
Certain women have thickened cervical mucus which may present as an inhospitable environment for sperms to pass through. In such cases IVF is recommended as it bypasses the cervical region.
For couples facing several fertility issues together or Unexplained Infertility
In cases such as poor male fertility and tubal disease in the couple, IVF may help to overcome the fertility issues and proceed for conception.Also, when infertile couples or individuals have undergone all appropriate tests and no cause for their infertility is found, they are diagnosed with unexplained infertility. In such cases, IVF might help them to conceive, overcoming any unknown infertility factor.
Genetic Disorder
IVF along with other genomic procedures may be recommended to couples who have or had previous children with genetic disorders.and for people who already know, they are at risk for passing on a genetic disease. However, for most of the babies born with genetic disorders, there is not much-known family history. Through IVF and technical advancement, it has become quite feasible to detect genetic disorders, and accordingly, healthy embryos can be curated by eliminating any problematic genes causing genetic birth defects.
Fertility Preservation in case of Cancer or any other health conditions
In case either of the partners is suffering from cancer and would like to opt for gamete preservation prior to chemotherapy or radiotherapy, IVF is recommended at a later date with such cryopreserved gametes.Freezing embryos or embryo cryopreservation is to help preserve fertility for certain females with cancer. Mature eggs are removed from the female and put in a sterile lab dish with sperm following the IVF or (IVF-ICSI) procedure.
IVF Process
Couples recommended for IVF are required to go through a number of investigations and procedures:
IVF treatment may be cumbersome physically and emotionally for the couple. Counselling with Crysta Counselors help couples understand their treatment regime and voice their concerns which is important prior to the start of the procedure.
Ovarian stimulation leads to maturing of follicles. The growth of these follicles is monitored over 10-12 days. The ovarian response is measured through blood investigations and ultrasound at regular intervals. This process helps to control the size, quality and quantity of the maturing follicles.
Medication and final stimulation leads to the release of the mature ovum. The ovum is collected in the clinic and is done by ultrasound guidance under sedition. The collected ovum is then sent to the embryologist for processing in the ART laboratory.
The male partner is asked to provide a fresh semen sample on the same day. If required, sperm may be extracted from the testes or epididymis by a surgical procedure.
The prepared sperm and ovum are fertilized under laboratory conditions to form the embryo. Several such embryos are prepared by the embryologist and based upon the quality is transferred to the uterus of the female partner on the day 3 or day 5 stage of the embryo.
Post transfer of the embryo, the ART specialist may prescribe medication and other routine care to enhance the chances of implantation. After a particular period of time, pregnancy tests may be recommended to confirm pregnancy.
Success and IVF
The success of an IVF procedure is around 30-35%, however in women younger than the age of 35 years the success rate is around 40%. The success of an IVF procedure depends upon a number of factors such as:
Age of the female partner
Duration of infertility
Type of infertility
Cause of infertility
Quality of the sperm, ova (eggs), and embryo
Development of the endometrium
Myths around IVF
A. Infertility only affects female partners.
Fact: Infertility may be encountered by either the male or female partner. In case of the inability to conceive after 1 year of unprotected intercourse, it is recommended both partners get evaluated for treatment and or ART procedures.
B. IVF procedures assure 100% success.
Fact: The success of IVF procedures is around 30-35% and may increase to 40-50% in women younger than 35 years of age. The success of this procedure is based upon a number of factors such as the age, type of infertility, cause and quality of the gametes. Most couples get dejected after the failure of the first cycle and do not continue with treatment. It is advisable that couples undergo around 2-3 IVF cycles for better chances of success.
C. Chances of congenital anomalies increase in children born through IVF.
Fact: There is no significant increase in the risk of congenital anomalies in children conceived through IVF than the ones conceived naturally. However, there may be an increased risk of genetic disorders in children conceived by women greater than the age of 35 years. In such cases, ART procedures along with genetic testing such as Pre-implantation Genetic Testing- PGT-A, PGT-M, and PGT-SR may be suggested to help select healthy embryos.
D. IVF involves the use of donor gametes only.
Fact: IVF is usually done using the sperm and ovum from the husband and wife respectively. However, in case of severe fertility issues in either the male or female partner, donor gametes may be used.
E. IVF procedures lead to twin pregnancies.
Fact: IVF procedures may lead to multiple pregnancies. However with advanced ART procedures, it is possible for elective single embryo transfers.