What You Need to Know About In-Vitro-Fertilization (IVF)

In Vitro Fertilization (IVF) is a proven and effective infertility treatment. Because of its long record of success and well-earned reputation, the method is often the first option that comes to mind when a person or a couple is facing any infertility issue. But what is IVF exactly? And what should ‘parents-to-be’ know first about IVF? Today, Superior A.R.T. has the answers.

What is IVF?

In Vitro Fertilization, more commonly referred to as IVF, is a method to help people who are unable to conceive naturally (internal fertilization) to be able to have a baby safely via external fertilization. In this assisted reproductive technique, a doctor will collect a woman’s eggs from her ovaries, before bringing them to be fertilized, with sperm retrieved from the man, in a laboratory dish. Once the eggs are fertilized, they will be grown to become good quality embryos. Then doctor will then transfer some of them back into the woman’s uterus, with the hope that at least one of them will be able to implant and grow to become a fetus.

When is In Vitro Fertilization (IVF) usually used?

The conditions most often leading to IVF includes:

• Where a woman suffers from pelvic adhesions,
• Where a woman suffers from chocolate cysts,
• Where a woman suffers from blocked or damaged fallopian tubes,
• Where a woman suffers from ovulation disorders due to some general or personal medical conditions,
• Where a man suffers from infertility issues such as a low sperm count, low sperm motility, abnormal sperm morphology, etc.

How is In Vitro Fertilization (IVF) done?

The IVF process essentially comprises four steps as follows:

1. Stimulate egg production

In the first step, on the second or third day of your period, your doctor will prescribe injectable medications to stimulate your egg production. If your ovaries produce too few eggs, the doctor may add further suitable fertility medications to help the follicles (each containing an egg) on your ovaries to grow. However, before the stimulation a doctor will check first whether your body is ready. This is done through monitoring your hormone levels via blood tests, and by checking your ovaries via ultrasounds. If everything shows good signs, then the stimulation can begin. You will be given a single dose of injection every day for 8-12 days. What kind of injectable medications you will receive depends on your hormone levels, your numbers of potential eggs, and your medical history of infertility treatment (if any).  After 8-12 days, the follicles on the ovaries, each follicle contains an egg, will normally grow to 18-20 millimeters and be ready to be harvested and eggs retrieved. To retrieve all of your eggs, your doctor will also usually prescribe another injectable medication, known as a trigger shot, to make your ovaries and eggs ready for the retrieval process.

2. Retrieve eggs and sperm

36 hours after your trigger shot, your eggs will be retrieved through a minor surgical procedure, in which a doctor will use ultrasound imaging to guide a thin needle through your pelvic caivity to remove or retrieve your eggs. If it sounds painful don’t worry, as you will be sedated, given pain medications, and the whole process usually only takes 15-20 minutes.

Around the same time as your eggs are being retrieved, your partner’s sperm will also be collected. Then, the eggs and sperm will be mixed together, and allowed to fertilize on their own in a laboratory dish.

However, before this fertilization process can begin it is important to check the sperm by semen analysis to see if they are qualified. Good quality sperm must show signs of good sperm concentration (number), good sperm motility (strength), and normal sperm morphology (shape). This semen analysis is important because in IVF a sperm must be strong and healthy enough to swim to meet an egg and then, after it meets an egg, penetrate through an eggs wall to fertilize the egg.

If the quality or number of semen is below standard, the egg  and sperm may be fertilized via an alternative fertilization process called ICSI. In ICSI, instead of letting the eggs and sperms fertilize on their own in a laboratory dish as in IVF, healthy sperm are specially selected and a single sperm is injected into each mature egg to achieve fertilization. Because you can inject only one egg at a time, and the egg is prone to damage, ICSI normally takes a longer time and requires an experienced fertility scientist.

Once fertilization occurs, the fertilized eggs are considered embryos.

3. Finding the perfect embryos

After the eggs and sperm are fertilized and become embryos, they will be cultured for 5 – 6 days in the laboratory so that some will grow and survive to the blastocyst stage, ready to be implanted in the lining of your uterus. Those that cannot become blastocysts are considered basically too weak and incompetent, and will not be transferred back to your uterine cavity.

4. Transferring the embryos

Finally, following the embryo culture process, and after your uterus is ready, blastocyst embryos will be transferred into your uterus. We then wait for about 10-11 days, hoping one of them shall be strong enough to implant in your uterus and begin to develop as a fetus, before doing a pregnancy test.

How many embryos will be transferred?

A woman’s physical condition and the quality of embryos will determine how many embryos can be transferred. Only one embryo, for example, can be enough if that embryo has been genetically tested and shows all the signs of good quality and success, as advised by our scientists and doctor.  To reduce the risks and problems associated with multiple pregnancies, usually no more than two embryos will be transferred

How safe is In Vitro Fertilization (IVF)?

In Vitro Fertilization is considered a safe medical procedure but, like all medical procedures, there are risks and in a few cases complications may occur. Complications during the treatment, and in any subsequent pregnancy, can include Ovarian Hyperstimulation Syndrome (OHSS), internal bleeding or infection after egg retrieval, multiple pregnancies, birth defects, and miscarriage. It is therefore important that you carefully select an IVF clinic with a good reputation and excellent medical staff.  A good doctor will be able to provide an IVF treatment that is suitable for each individual’s physical conditions and reduces the risk of complications.

How successful is In Vitro Fertilization (IVF)?

Globally the success rate of In Vitro Fertilization will vary widely between clinics from below 40% to as high as 70%+. Again it is important to select a good clinic. In addition, success rates will vary between women, based mainly on their reproductive history, age, and the cause of infertility. As well, lifestyle factors such as smoking, obesity, stress, etc. may contribute to a reduced success rate. While younger women are generally more successful with IVF, increasingly there are many successful cases with patients of more advanced maternal age.  The earlier you seek a direct consultation with an experienced IVF doctor, the greater your chance of success. The doctor will also be able to assess your fertility potential and give you a more precise and accurate indication of your potential success rate following IVF treatment.

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