So, what are the procedures involved in IVF?
First of all, the woman is given hormone injections to stimulate the ovaries to produce multiple eggs. This is done so that she has a better chance at fertilization of her eggs and typically takes about 2-3 weeks. Then, when the eggs are mature enough, they are extracted by a short procedure, usually done under sedation or anaesthesia. (Ovum Pick Up).A needle is inserted through the vagina into the ovary andthe eggsare aspirated. The eggs are combined with sperms of the husband or male partner in the laboratory and the resultant fertilized egg/embryo is placed back in the woman’s womb after 48-72 hrs (Embryo Transfer). She is then given medications for about 2 weeks and asked to test her urine at the end of this period. If she is pregnant, there is joy for all. She has to be taken care of through her pregnancy with regular antenatal check-ups. For the couple who does not get pregnant, there is disappointment and sorrow and the whole cycle starts again. Here, it must be understood that even modern-day IVF in the best of centres, cannot give 100% success. So, one must be mentally prepared.
What are the risks of IVF?
IVF increases the risk of multiple pregnancy (twins or triplets). This is because, to increase the chances of pregnancy, more than one embryo is generally placed in the womb. So, if it happens, all the risks of a multiple pregnancy may occur like premature labour, small babies, pregnancy associated Hypertension, premature rupture of membranes, etc.
Risks associated with high maternal age like genetic defects, Diabetes of pregnancy, Hypertension of pregnancy etc are often seen as most mothers opting for IVF are 35 years or older.
There are risks associated with the egg retrieval procedure (OPU) and risks of Anaesthesia.
Stress: The whole long process of going for daily hormone injections, daily ultrasound scans etc can be too stressful for some couples, and if not successful, it can lead to depression. Many couples stop the whole process of treatment for infertility if they are unsuccessful in the first attempt. Genetic defects and miscarriage can occur sometimes in the resultant pregnancy.
Are there different forms of IVF?
Apart from regular IVF, IVF can be done with donor eggs or sperm. It can also be done with a surrogate womb. When sperm counts or motility are very low, there is a process calledICSI which gives much better results. In this process, an individual sperm is held and injected inside the egg shell.
What are the causes of failure in IVF?
Maternal age is the commonest cause of failure. Women under 35 years have a 25% chance of having a healthy full-term pregnancy.
Obesity is another cause. So, overweight women who want to undergo IVF should try to lose a little weight. In fact, this is true for women who are trying for a spontaneous pregnancy also.
Chance of a successful IVF pregnancy also depend on the cause of infertility. For example, women with severe degrees of endometriosis or Pelvic TB have low chance of success even with IVF.
Lifestyle factors: Stress, alcohol intake or smoking is associated with lower rates of success.
Quality of the eggs/ sperms will affect the chances of having a healthy pregnancy.
Lastly, of course, the quality of the lab/clinic where the procedure is being done will also determine the success.