An egg and sperm are normally fertilized inside a woman’s body. If the fertilized egg attaches to the womb lining and grows, a baby is born nine months later. This is known as natural or unassisted conception.
In vitro fertilization (IVF) is a type of assisted reproductive technology (ART). It indicates that special medical procedures are used to help a woman in becoming pregnant. It is usually tried after other, less expensive fertility treatments have failed.
What is in-vitro fertilization?
IVF or In Vitro Fertilization is a complex series of procedures for the conception of a child. It involves the retrieval of mature eggs from ovaries and their fertilization in a laboratory by the sperm. A successful procedure allows the fertilized embryo to get placed in the uterus of the prospective parent or a surrogate. There are two types of surrogates, the traditional and the gestational surrogate. The conventional surrogate act as the carrier and the egg donor, implying that she is the child’s genetic mother. In contrast, a gestational surrogate has no genetic link to the child and is only acting as a carrier for the implantation and growth of the baby.
IVF is usually opted by couples who face infertility or wish to freeze their embryo for future pregnancy or need donor eggs or sperm to conceive.
How does IVF work?
Here are a few screening tests and procedures that need to be done when planning to go ahead with IVF:
1. Ovarian stimulation: Fertility medications and additional hormones such as DHEA, estrogen, and progesterone are administered in the mother’s body to stimulate the ovaries to produce mature eggs. These steps increase the chances of pregnancy.
2. Patient monitoring: A transvaginal ultrasound examines a woman’s uterus, ovaries, tubes, cervix, and pelvic area and thus helps to determine the hormone levels in the blood.
3. Maturing eggs: Human chorionic gonadotropin (HCG) is a hormone that promotes normal egg development in the ovary and stimulates egg release during ovulation. This hormone is injected two days before the collection of the eggs to trigger their maturation.
4. Egg retrieval: The matured eggs are extracted from the body through a minor surgical procedure. This is a 30 minutes long procedure that involves the use of special needles and ultrasound imaging. If the ovaries cannot be reached via transvaginal ultrasound, an abdominal ultrasound may be used to guide the needle.
5. Sperm collection: The sperm is collected from the male donor, separated from the semen fluid in the lab, and prepared for the next step.
6. Egg fertilization: The extracted eggs and sperm are combined during an insemination procedure to allow them to fertilize. Mature eggs are incubated in a nutritive liquid or a culture medium. Eggs that appear to be healthy and mature are combined with sperm to develop embryos. But, not all eggs are fertilized successfully.
Intracytoplasmic sperm injection is injected in some cases where the sperm is directly injected into the egg to increase the chances of fertility. Healthy sperm and mature eggs are mixed and incubated overnight during conventional insemination. The eggs are then monitored to ensure that cell division and fertilization occur as expected to become an embryo.
1. Embryo transfer: After 3-5 days, the embryos are transferred into the carrier’s uterus for implantation. The doctors insert a catheter, which is a long, thin, flexible tube, into the vagina, through the cervix, and into the uterus. A syringe with one or more embryos suspended in a small amount of fluid is attached to the catheter’s end. The doctor inserts the embryo or embryos into the uterus with a syringe.
2. Pregnancy test: After two weeks, the carrier is supposed to take a pregnancy test. If the results are positive, which suggests a pregnancy, an ultrasound is done after another two weeks. The progesterone medications will have to stop if the effects are negative, and periods will arrive within a week. In case of no periods, the doctor has to be informed. Further medical options need to be discussed with the health professionals, and IVF can be repeated to improve the chances of successful fertilization.
What are the side effects or risks of IVF?
There is a risk, as with most medical procedures, but it is minimal. The majority of side effects are minor and disappear soon after the procedure is completed and any additional hormone medications are discontinued.
Women who have had embryo transfer have a large number of growing follicles in their ovaries, as well as high estradiol levels. This causes fluid to leak into the stomach, causing bloating, constipation, mild cramping, and breast tenderness.
The medications also result in side effects such as headaches, mood swings, hot flashes, abdominal pain, and bloating issues.
A rare risk associated with IVF is a medical condition called ovarian hyperstimulation syndrome that can occur very rarely and requires medical attention. Careful medical team monitoring, as well as a customized fertility medication schedule, dramatically reduces the risks. Some of the symptoms include decreased frequency of urination, breathlessness, severe stomach pain and bloating, nausea, vomiting, and sudden weight gain, to name a few.
How successful is IVF?
Factors like age, reproductive health, lifestyle habits, and the reason behind infertility determine the rate at which IVF can happen successfully. IVF success rate in India ranges from 30 to 35 per cent, depending on the factors listed above. It is also essential to consult the best health professionals and ensure that the correct scientific technique has opted for the procedure.
Discuss with the doctor the factors that apply and how they may affect successful pregnancy. The doctors will advise on the available fertility tests, treatments, and programs most suitable for the couple.
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