In Vitro Fertilization (IVF): What You Need to Know..
In Vitro Fertilization is an assisted reproductive technology (ART) commonly referred to as IVF. IVF is the process of fertilization by extracting eggs, retrieving a sperm sample, and then manually combining an egg and sperm in a laboratory dish. The embryo(s) can then be frozen for storage or transferred to a woman’s uterus. One full cycle of IVF takes about three weeks. Sometimes these steps are split into different parts and the process can take longer.
Why is IVF used?
IVF is offered as a primary treatment for infertility in women over age 40, and can be used to treat infertility in patients of, blocked or damaged fallopian tubes, male factor infertility including decreased sperm count or sperm motility, women with ovulation disorders, poor egg quality, problems with the uterus or fallopian tubes, premature ovarian failure, uterine fibroids, endometriosis, women who have had their fallopian tubes removed, individuals with a genetic disorder or unexplained infertility.
What is involved with in vitro fertilization?
One cycle of IVF can take about two to three weeks, and more than one cycle may be required. There are five basic steps in the IVF and embryo transfer process:
Step 1: stimulate egg production. Multiple eggs are desired because some eggs will not develop or fertilize after retrieval.
Step 2: eggs are retrieved through a minor surgical procedure that uses ultrasound imaging to guide a hollow needle through the pelvic cavity to remove the eggs.
Step 3: male is asked to produce a sample of sperm, which is prepared for combining with the eggs.
Step 4: In a process called insemination, the sperm and eggs are mixed together and stored in a laboratory dish to encourage fertilization. The eggs are monitored to confirm that fertilization and cell division are taking place. Once this occurs, the fertilized eggs are considered embryos.
Step 5: The embryos are usually transferred into the woman’s uterus three to five days following egg retrieval and fertilization. A catheter or small tube is inserted into the uterus to transfer the embryos. This procedure is painless for most women, although some may experience mild cramping. If the procedure is successful, implantation typically occurs around six to ten days following egg retrieval.
About 12 days to two weeks after egg retrieval, your doctor will test a sample of your blood to detect whether you're pregnant.
Side effects of in vitro fertilization:
Some side effects after IVF may include: Passing a small amount of fluid (may be clear or blood-tinged) after the procedure, mild cramping, mild bloating, constipation or breast tenderness. The chance of a multiples pregnancy is increased with the use of fertility treatment.
Risks of in vitro fertilization:
Multiple births; IVF increases the risk of multiple births if more than one embryo is transferred to your uterus. A pregnancy with multiple fetuses carries a higher risk of early labor and low birth weight than pregnancy with a single fetus does.
Premature delivery and low birth weight; Research suggests that IVF slightly increases the risk that the baby will be born early or with a low birth weight.
Ovarian hyperstimulation syndrome; Use of injectable fertility drugs, such as human chorionic gonadotropin (HCG), to induce ovulation can cause ovarian hyperstimulation syndrome, in which your ovaries become swollen and painful.
Miscarriage; The rate of miscarriage for women who conceive using IVF with fresh embryos is similar to that of women who conceive naturally — about 15% to 25% — but the rate increases with maternal age.
Egg-retrieval procedure complications; Use of an aspirating needle to collect eggs could possibly cause bleeding, infection or damage to the bowel, bladder or a blood vessel. Risks are also associated with sedation and general anesthesia, if used.
Ectopic pregnancy; About 2% to 5% of women who use IVF will have an ectopic pregnancy — when the fertilized egg implants outside the uterus, usually in a fallopian tube. The fertilized egg can't survive outside the uterus, and there's no way to continue the pregnancy.
Birth defects; The age of the mother is the primary risk factor in the development of birth defects, no matter how the child is conceived. More research is needed to determine whether babies conceived using IVF might be at increased risk of certain birth defects.
Stress; Use of IVF can be financially, physically and emotionally draining. Psychological stress and emotional problems are common, especially if in vitro fertilization (IVF) is unsuccessful.
How successful is in vitro fertilization?
The success rate of IVF clinics depends on a number of factors including reproductive history, maternal age, the cause of infertility, and lifestyle factors. It is also important to understand that pregnancy rates are not the same as live birth rates.
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
How many embryos should be created or transferred?
The number of embryos transferred typically depends on the number of eggs collected and maternal age. As the rate of implantation decreases as women age, more eggs may be implanted depending on age to increase the likelihood of implantation. However, a greater number of eggs transferred increases the chances of having a multiples pregnancy.
References:
1- https://americanpregnancy.org/infertility/in-vitro-fertilization/
2- https://www.mayoclinic.org/tests-procedures/in-vitro-fertilization/about/pac-20384716