Infertility can be a difficult and emotional journey for couples hoping to conceive. Fortunately, there are a variety of treatment options available, one of which is in vitro fertilisation(IVF). IVF is a type of assisted reproductive technology (ART) that involves combining sperm and eggs in a laboratory setting before implanting the resulting embryo in the uterus. IVF has helped millions of couples conceive and has become simpler, safer, and more successful over time. While it's not usually the first treatment to be tried, IVF can be a viable option for those who have tried other fertility methods without success or who have certain medical conditions. In this guide, we'll explore the basics of IVF, including how it works, who it's for, and what to expect during the process. We hope this information will provide a helpful starting point for couples struggling with infertility.
IVF is a fertility treatment that helps people who are struggling to conceive. It involves combining sperm and eggs in a laboratory and then transferring the resulting embryo to the uterus. The process starts with medication to stimulate egg production. The eggs are then retrieved and fertilized with sperm in a lab. After fertilisation, the embryo is monitored for a few days until it is ready to be transferred to the uterus. Timing is crucial throughout the process, and close monitoring is necessary to ensure that everything goes smoothly. IVF can be tailored to meet the needs of different couples. It has helped many couples with fertility issues successfully conceive and may be a good option for those experiencing ovulation disorders, blocked fallopian tubes, or unexplained infertility.
The steps involved in an IVF treatment cycle
Step 1: Consultation and testing
Before starting IVF treatment, patients will undergo a thorough medical exam and fertility tests. The initial consultation will allow healthcare providers to discuss the details of the IVF process and answer any questions. Both partners will be examined and tested, including a uterine exam, up-to-date Pap test, mammogram (if over 40), semen analysis, and screening for sexually transmitted infections and other infectious diseases. Ovarian reserve testing, blood and urine tests, and genetic carrier screening will also be performed. Patients will receive instructions on how to administer fertility medications and sign consent forms. Finally, a uterine cavity evaluation will be conducted using hysteroscopy or saline-infused sonography (SIS). Results from these tests will inform the treatment plan and allow healthcare providers to tailor the IVF protocol to the patient's specific needs.
Step 2: Ovarian stimulation
The ovarian stimulation phase is a crucial step in an IVF treatment cycle. Its purpose is to encourage the simultaneous and full maturation of a group of eggs. This is achieved through the use of injectable hormone medications that are tailored to the individual based on their medical history, age, AMH level, and response to previous IVF cycles. The dosage and frequency of medications are adjusted based on the patient's response to ovarian stimulation, which is monitored through ultrasounds and blood hormone levels. Monitoring occurs daily or every few days over two weeks, and the size and number of growing ovarian follicles are measured. A trigger shot is given to finalise the maturation of the eggs in preparation for egg retrieval. The patient's response to medication is closely monitored, and adjustments to the dosage may be made to optimize the number and maturity of the eggs retrieved.
Step 3: Embryo fertilisation
During in vitro fertilisation(IVF), eggs are retrieved from the woman's ovaries using a minor surgery called follicular aspiration. The eggs are then mixed with sperm in a petri dish or injected with a single sperm using intracytoplasmic sperm injection (ICSI). ICSI is performed when the chance of fertilisation is low. The fertilised egg or embryo is then cultured in the laboratory for about 5 days, during which the embryologist regularly monitors its growth. Couples who have a high risk of passing a genetic disorder to their child may consider pre-implantation genetic diagnosis (PGD) to determine which embryos to implant. The suitable embryos are then transferred into the woman's uterus 3 to 5 days after egg retrieval and fertilisation. The embryologist determines which embryos are suitable based on their growth and quality.
Step 4: Pregnancy test (two weeks after the embryo transfer)
After the embryo transfer, a blood pregnancy test (hCG level) is performed to determine if the patient is pregnant. The test is usually done about 9 to 14 days after the transfer, depending on the clinic. The hCG hormone is produced by the placenta during pregnancy, and the blood test measures its levels. If the test is positive, the doctor will continue to monitor hormone levels and follow up with additional blood work and ultrasounds to ensure the pregnancy is progressing as it should. If the test is negative, it means the embryo did not implant, and the IVF cycle was not successful. It's important to note that not all pregnancies result in a live birth, but the majority of couples who experience a successful pregnancy after embryo transfer go on to have a healthy baby. Remember to take care of yourself during this two-week wait period and try to stay positive.
Step 5: Embryo freezing and genetic testing
Embryo freezing is a common part of the IVF treatment cycle. After the embryos are formed, they will spend 5-7 days in the laboratory before they are ready to be frozen or transferred back to the uterus. Frozen embryos tend to have better success rates. Extra embryos can be frozen and stored for several years, although not all will survive the freezing and thawing process. Genetic testing is often performed to check for any possible defects or hereditary conditions before embryo transfer. This is done through preimplantation genetic screening or preimplantation genetic diagnosis. Most patients choose to test embryos for genetic or chromosome abnormalities prior to embryo transfer. This method involves testing embryos, eggs, or sperm for later implantation. By testing the embryos, couples can avoid passing on genetic disorders to their children. It is important to speak openly with your healthcare provider to understand all the steps involved in the IVF process.
Step 6: Egg retrieval
The egg retrieval process in an IVF treatment cycle involves several steps. First, patients will receive mild IV sedation to sleep during the procedure. The doctor will use a transvaginal ultrasound probe to guide a needle to the ovaries and aspirate each follicle to remove the eggs. This is repeated for each follicle, with the doctor carefully removing each egg to be transferred to the embryology lab for the next step. On average, 8 to 15 eggs are retrieved during this procedure. The actual egg retrieval process takes only 20 minutes, but patients should plan to be at the office for around three hours that day. After the procedure, patients may feel crampy the day after and most women choose to take 1-2 narcotic painkillers the day of the egg retrieval. It's best to rest and relax at home for a day or two, but most women are back to their daily routine after a few short days. Risks associated with the egg retrieval process include bleeding, infection, and damage to surrounding organs. To prepare for the egg retrieval process, patients should arrange for someone to drive them home following the procedure and plan to rest for a day or two.
Step 7: Pregnancy management
During the pregnancy management phase of an IVF treatment cycle, couples will wait for the embryo to implant in the uterus. This is typically a two-week period, during which the doctor may prescribe progesterone injections or support to help maintain hormone levels that promote pregnancy. It's important to try to reduce stress during this time, as studies have shown that couples experiencing psychological stress may have poorer results with infertility treatment. Some women may experience light spotting, tender breasts, or light cramping, but the only way to detect pregnancy is with a blood test after about two weeks.
Once pregnancy is confirmed, couples will begin prenatal care with their doctor to monitor the health of the mother and growing fetus. Potential risks and complications during pregnancy may include ectopic pregnancy, gestational diabetes, preeclampsia, and preterm labour. However, with proper monitoring and care, these risks can be managed. Couples can expect regular prenatal check-ups, ultrasounds, and blood work to ensure the health of both mother and baby. It's important to communicate any concerns or symptoms with your doctor and to follow their recommendations for a healthy pregnancy.
Step 8: Infertility treatment plan
Having a clear infertility treatment plan in place before starting an IVF treatment cycle is crucial for increasing the chances of a successful outcome. The plan should include an evaluation of the couple's medical history, lifestyle factors, and any underlying causes of infertility. It should also outline the specific IVF treatment options recommended by the doctor based on the couple's age, health status, and personal preferences.
A clear plan can help the couple understand the steps involved in the IVF treatment cycle and prepare for each one. It can also help manage expectations, as fertility treatments can be emotionally and financially taxing. The plan should set limits on the number of procedures that are acceptable and consider alternative options, such as donor sperm or egg, gestational carrier, or adoption.
Overall, a clear infertility treatment plan can help reduce stress and anxiety, increase the chances of a successful outcome, and provide support for the couple throughout the IVF treatment cycle.
Step 9: Follow-up care
After an IVF treatment cycle, follow-up care is crucial for monitoring the progress of the pregnancy and ensuring its success. The first follow-up appointment will be around 9-12 days after the transfer, where a blood test will be conducted to detect pregnancy. If the test is positive, the doctor will continue to monitor hormone levels with additional blood work and ultrasounds to ensure the pregnancy is progressing as it should. It is important to report any symptoms, such as heavy bleeding or severe cramping, to the doctor immediately.
In terms of lifestyle changes, it is recommended to participate in activities or hobbies that bring joy, manage stress, and take care of the body through exercise, healthy eating, limited alcohol use, and plenty of sleep. It is also crucial to know your boundaries and have conversations with your partner about financial, personal, and emotional limits. Consider joining an infertility support group for additional emotional support. Remember, taking care of yourself and each other is a top priority during this vulnerable time.
Success Rates of IVF
IVF success rates can be influenced by several factors, including age, number of previous births, use of donor eggs, and the number of IVF cycles. Age is one of the most important factors in IVF success rates, with higher success rates in younger individuals. For example, the live birth rate for individuals under 35 using their own eggs is around 46%, while the birth rate for a 38-year-old using their own eggs is about 22%. Lifestyle factors such as weight and health conditions can also impact success rates. It's important to select a reputable fertility clinic and ask questions about their success rates, live birth rates, pregnancy rates, and cost of treatments. However, success rates vary from clinic to clinic and must be carefully evaluated. A doctor will evaluate your fertility history and recommend treatment options based on your age, health status, and personal preference. Overall, IVF can provide an opportunity for pregnancy that may not otherwise be possible for couples with fertility challenges.
The Cost of IVF
IVF treatment can be a costly process, and it's important to understand the different expenses that couples can expect to incur during the process. However, the exact cost of treatment will depend on various factors such as health history, insurance coverage, and the treatment center itself. Couples should check with their insurance company to see if any portion of the treatment will be covered, such as lab tests, medications, and ultrasounds.
In addition to consultation fees and the cost of the procedure itself, couples can expect to pay for laboratory fees, which include processing the eggs and sperm, embryo storage, and embryo transfer. It's important to note that there may be additional costs for multiple cycles or if additional treatments are required.
While IVF treatment can be expensive, there are ways to make it more affordable. Some clinics offer shared risk or IVF refund programs, and there are fertility scholarships and grants available. Couples can also consider raising funds from family and friends. With a success rate of 75% for women under 40 using their own eggs, IVF is one of the most effective assisted reproductive technologies available. It's important for couples to carefully consider the cost implications of IVF treatment and explore all available options to make it more affordable.
Preparing for IVF
Couples who are considering IVF treatment should be prepared for a complex and multi-step process. Before starting IVF, couples will undergo a thorough medical exam and fertility tests, including a uterine exam, semen analysis, and genetic carrier screening. They will also need to take fertility medications and receive regular monitoring from their healthcare provider. The cost of IVF can be high, so couples should also consider their financial options and whether their insurance covers the procedure.
During the IVF process, women will undergo ovarian stimulation to produce eggs, followed by egg retrieval and fertilization with sperm in a lab. The resulting embryos will then be cultured and transferred to the uterus. Possible side effects of IVF can include bloating, cramping, and mood swings. There are also risks associated with the procedure, such as infection and multiple pregnancies.
In summary , couples should expect a thorough medical evaluation and fertility tests before starting IVF. During the process, they will undergo ovarian stimulation, egg retrieval, fertilisation, and embryo transfer. Possible side effects and risks should be considered, and success rates should be discussed with a healthcare provider. Emotional support and follow-up care are also important aspects of the IVF process.
If you're struggling with infertility and wondering if IVF is right for you, don't hesitate to seek expert advice. Consult with a fertility specialist at Milann Fertility Clinic to discuss your options and determine the best course of action. Our caring team of experts can guide you through the IVF process and help turn your dream of parenthood into a reality. To schedule a consultation, visit our website www.milann.co.in. Don't wait any longer to start your journey towards parenthood. Contact us today!