Many women don’t know what IVF is all about. It is a kind of Fertility treatment: It means In Vitro fertilization (IVF). In Vitro Fertilization (IVF) is a fertility treatment in which Sperm and Eggs are combined in a laboratory. The resulting embryos are assessed for quality, and one or more are placed in the uterus through the cervix.
IVF is by far the most commonly used high-tech fertility treatment, accounting for more than 99 percent of Assisted Reproductive Technology (ART) procedures. About 1.5 percent of babies born in the United States are conceived using ART. The member too is on the increase in Nigeria. Below are the usual questions woman ask when they are in search of pregnancy.
IS IVF FOR ME?
IVF can help you get pregnant if you have problems with ovulation or egg quality, blocked fallopian tubes, or endometriosis; if your partner has problems with sperm count or motility; or if you’re using donor eggs to become pregnant.
IVF may also be an option if your doctor can’t pinpoint the problem (this is called “unexplained infertility”) or if other treatments have been unsuccessful.
HOW DOES IVF WORK?
The timeline for IVF treatment usually goes something like this: Ovary stimulation. For eight to 14 days near the beginning of your menstrual cycle, you take a gonadotropin, a type of fertility drug that stimulates your ovaries to develop multiple mature eggs for fertilization (instead of just one). You also need to take a synthetic hormone like leuprolide or cetrorelix to keep your body from releasing the eggs too early.
Follicle development. While taking these medications, you visit your doctor’s office or clinic every two to three days to have your blood hormone levels checked and ultrasound measurements of your ovaries done. This allows your healthcare provider to monitor development of the follicles – the fluid-filled sacs where eggs mature.
The trigger shot. When the follicles are ready, you get a “trigger shot,” an injection that causes the eggs to mature fully and become capable of being fertilized. About 36 hours after your trigger shot, your eggs are ready to be retrieved.
Gathering the eggs. Your doctor gives you an anesthetic and inserts an ultrasound probe through your vagina to look at your ovaries and identify the follicles. A thin needle is then inserted through the vaginal wall to remove the eggs from the follicles. Eight to 15 eggs are usually retrieved. You may have some cramping and spotting for a few days afterward, but most women feel better in a day or two.
Fertilization. An embryologist (a scientist who specializes in eggs, sperm, and embryos) will examine your eggs before combining them with your partner’s sperm and incubating them overnight. Fertilization usually happens during this time, but eggs that aren’t normal may not be fertilized. (If sperm quality is poor, or if fertilization was unsuccessful during previous IVF cycles, your doctor may recommend using a technique called intracytoplasmic sperm injection (ICSI). With ICSI, a single sperm is injected directly into each mature egg.)
INSIDE PREGNANCY: FERTILIZATION
Sperm make an impressive journey through the woman’s body. See the moment of conception.
*Developing Embryos. Three days after the egg retrieval, some of the eggs that were successfully fertilized become six- to 10-celled embryos. By the fifth day, some of these embryos will become blastocysts with a fluid-filled cavity and tissues that are beginning to separate into placenta and baby.
*Embryo Selection. The embryologist selects the most viable embryo or embryos to place in your uterus three to five days after the egg retrieval. Extra embryos, if there are any, may be frozen and used for future IVF cycles.
*Planting the Embryos. Depending on your age and diagnosis, your doctor places between one and five embryos in your uterus by inserting a thin tube (a catheter) through your cervix. You might feel some mild cramping, but you won’t need anesthesia.
Successful Implantation. If the treatment works, an embryo implants in your uterine wall and continues to grow into a baby. Keep in mind that if more than one embryo is transferred, your chance of pregnancy is higher, but so are the odds of having a multiple pregnancy – about 20 percent of babies born through IVF are twins, triplets, or more.
You can take a pregnancy test about two weeks after the embryos are placed in your uterus.
HOW LONG WILL IVF TAKE?
It takes about four to six weeks to complete one cycle of IVF. You have to wait a few weeks for your eggs to mature. Then you and your partner spend about half a day at your doctor’s office or clinic having your eggs retrieved and fertilized. You have to go back again three to five days later to have the embryos inserted into your uterus, but you’ll be able to go home that same day.
WHAT’S THE SUCCESS RATE FOR IVF?
The outcomes of IVF vary dramatically, depending on each couple’s reasons for infertility and their ages. Younger women usually have healthier eggs and higher success rates. Based on recent national data, the percentage of IVF cycles resulting in a live birth (in which one or more babies are born) is about:
40 percent for women age 34 and under, 31 percent for women age 35 to 37, 21 percent for women age 38 to 40, 11 percent for women age 41 to 42, 5 percent for women age 43 and over.
WHAT ARE THE PROS OF IVF?
Successful Track Record. IVF is the oldest assisted reproductive technology (ART) procedure on the block – it’s been around since 1978. IVF has been used long enough for researchers to have done extended health studies on the children conceived using this method. So far, no medical problems have been directly linked to the procedure.
No Link To Cancer. Recent studies have shown no connection between ovulation-inducing fertility drugs and cancer. Early studies suggested that exposure to fertility drugs might lead to a higher risk of ovarian cancer or other cancers of the female reproductive system.
Improved Techniques. Researchers continue to refine and improve IVF procedures. For example, advances in embryo cryopreservation (freezing) have resulted in IVF pregnancy rates that are about the same for frozen and fresh embryos.
WHAT ARE THE CONS OF IVF?
Costly and Time-consuming. Fertilizing your eggs outside of your body requires costly lab work and medications. Monitoring your response to fertility drugs also requires a lot of time, with frequent trips to the doctor’s office for blood tests and ultrasounds.
Odds of multiples. Because more than one embryo may be placed in your uterus, your chance of having twins or more is about 20 percent. Though many couples consider this a blessing, multiple fetuses increase your risk of miscarriage and other complications, such as preterm labor. Some doctors will advise you to consider selective reduction if three or more embryos implant successfully. This is a serious decision with major emotional and psychological consequences. IVF researchers are working on techniques to prevent multiple fetuses.
RISK OF ECTOPIC PREGNANCY
Women who have difficulty getting pregnant have an increased risk for ectopic pregnancy, regardless of how they conceive. And all assisted reproductive technology treatments, including IVF, also make an ectopic pregnancy more likely. An ectopic pregnancy occurs when an embryo implants in a fallopian tube or the abdominal cavity rather than in the uterus. It’s treated with the medication methotrexate or by surgically removing the embryo to prevent it from severely injuring the mother by continuing to grow.
RISK OF OVARIAN HYPERSTIMULATION SYNDROME (OHSS)
OHSS can happen when women respond too well to fertility drugs and produce too many eggs. About 10 to 20 percent of women who take gonadotropins develop a mild form of OHSS, a condition marked by weight gain and a full, bloated feeling. Some also have shortness of breath, dizziness, pelvic pain, nausea, and vomiting. If you have OHSS, your ovaries swell to several times the normal size and produce fluid that accumulates in your abdominal cavity. Normally this resolves itself with careful monitoring by a physician and bed rest. But in rare cases it’s life threatening, and you may have to be hospitalized for more intensive monitoring or treatment.
POTENTIAL COMPLICATIONS FOR BABY
Babies conceived with high-tech treatments for infertility such as IVF may be more likely to be born prematurely or have a low birth weight. They may also have a slightly higher risk of birth defects. But experts aren’t sure whether that’s from the factors that cause infertility (such as age) or the treatments.
It may not work. Up to 20 percent of IVF cycles may be cancelled before eggs are retrieved, usually because not enough follicles developed. Reducing the risk of OHSS is another reason for cancellation.
WHAT DOES IVF COST?
In the United States, expect to spend an average of $12,400 for one cycle of IVF if you’re using your own eggs and your partner’s sperm. The amount you’ll pay depends on how much medicine you need, where you live, and whether your state mandates insurance coverage for fertility treatments. If your insurance doesn’t cover them, you’ll probably have to pay the entire cost up front. In Nigeria too, the cost is high. It runs into millions.