In Vitro Fertilization (IVF)
In Vitro Fertilization, or IVF for short, is just one of the many methods employed to help infertile couples conceive the child that they so desire. IVF has become an extremely popular and successful choice for couples seeking to have a baby. As a matter of fact, in 2008 alone there were 10,000 babies conceived by IVF and subsequently born in Australia. The overall success rate of IVF is 25% with almost 41,000 IVF cycles being performed each year in Australia. Unfortunately, there are many misconceptions about IVF; how it is performed, what is within the limits of IVF, and how effective it truly is. Therefore, this article will address the specifics of IVF and the success that it provides.
IVF is the process of uniting a sperm and an egg together in a dish at a laboratory. Once the egg and sperm are united, they will be injected into the uterus via the cervix in the hopes that a pregnancy will occur. Although this sounds rather simple, it really is not. IVF is performed in cycles and each cycle involves 6 steps. Each time these six steps are completed, it is considered one cycle and one cycle is considered to be one attempt at achieving a pregnancy. Here are the six steps:
Step 1: Controlling the Menstrual Cycle – This is done by prescribing birth control pills that should be started on the same day that the menstrual cycle starts. These pills should be taken until Lupron, the medication that keeps the pituitary gland at rest, can be introduced.
Step 2: Stimulate and Develop Healthy Eggs – After completing step 1 and a menstrual cycle has begun, an ultrasound will be performed to ensure that the pituitary gland has been suppressed and to confirm that the ovaries are ready for stimulation. At this point, fertility drugs will be introduced to encourage the ripening of the eggs. This step is also known as ovulation induction.
Step 3: Monitoring – For 5 to 7 days after taking the fertility drugs, more tests must be done to check follicle growth. Many times the follicles won’t be ready to harvest so the drugs will need to continue for another 1 – 3 days. Once the follicles reach a certain size, the fertility drugs are discontinued and an injection of Human Chorionic Gonadotropin (HCG) is given. Approximately 40 hours after this injection is given, the follicles will begin to rupture and release their eggs.
Step 4: Egg Collection – This step involves an actual surgical procedure in which the woman is given anesthesia to avoid any discomfort or pain that is common during this phase of the process. A hollow needle is guided by ultrasound into the top wall of the vagina and into the fluid filled sacs in the ovaries that house the eggs. This specific action is called follicular aspiration. The entire retrieval process takes only 15 minutes and the patient is usually able to return home 60 to 90 minutes later. Although there is no pain during the procedure, women have reported cramping and a feeling of fullness or pressure for a few days after.
Step 5: Insemination – This is the step where the eggs and sperm (which were previously collected from the male partner) are placed in an incubator so that fertilization can occur. They are closely monitored to ensure that fertilization and cell division has occurred. If it hasn’t occurred on its own, then another step may be needed in which the sperm is manually injected directly into an egg.
Step 6: Embryo Transfer – One to six days after insemination, the fertilized eggs, which are now embryos, are ready to be transferred into the woman’s uterus. Unlike the retrieval process, this step is extremely easy, doesn’t cause any pain, and doesn’t require anesthesia. It is similar to a normal pelvic exam in which a speculum is inserted into the vagina so that the cervix is exposed. A set number of embryos are suspended in fluid and then carefully inserted into the cervix with a catheter.
It is important to note that sometimes a seventh step occurs. This is the step when the embryos that have not been transferred are frozen in order to preserve them. This is a good step to consider because if the initial IVF cycle fails, you can skip the first few steps and just have the frozen embryos transferred. However, not all embryos can be frozen for future use. If they are not of a high quality or if there are not enough remaining, it may not be worth the cost of this step.
Once all 6 steps have been completed, it then becomes a game of waiting. A woman will be told to rest and will be watched for symptoms of early pregnancy. If a pregnancy results, then the IVF cycle is considered to be successful. However, if a pregnancy does not occur, the cycle has failed and may be attempted again at a later date.
Many women wonder how long they should wait between IVF cycles and unfortunately, there is no magic answer. Depending on your age, health, and specific fertility issue some women are told to wait several weeks or months before beginning another IVF cycle. On the other hand, some women can begin another IVF cycle immediately after learning that a pregnancy has not occurred. This is something that should be discussed with your doctor.
Despite the high success rate of IVF and the safety of this procedure, there are still minor risks associated with IVF. Risks include failure of the procedure, adverse reactions to the fertility drugs used, ovarian hyperstimulation syndrome, and multiple births. This last risk may not seem like a risk at all but in reality, multiple births can cause a severe risk to the health of both mom and babies.
Too many people are under the impression that babies born as a result of IVF are not as healthy as their naturally born counterparts – This is completely untrue! Another common misconception is that babies born via IVF are genetically altered to be a specific sex or other physical attributes. Again, this is completely untrue.