Reality of IVF

What is IVF? 

In vitro fertilization (IVF) is a complex series of procedures used to help with fertility or prevent genetic problems and assist with the conception of a child.

During IVF, mature eggs are collected (retrieved) from ovaries and fertilized by sperm in a lab. Then the fertilized egg (embryo) or eggs (embryos) are transferred to a uterus. One full cycle of IVF takes about three weeks. Sometimes these steps are split into different parts and the process can take longer.

IVF is the most effective form of assisted reproductive technology. The procedure can be done using your own eggs and your partner’s sperm. Or IVF may involve eggs, sperm, or embryos from a known or anonymous donor. In some cases, a gestational carrier — a woman who has an embryo implanted in her uterus — might be used.

Your chances of having a healthy baby using IVF depend on many factors, such as your age and the cause of infertility. In addition, IVF can be time-consuming, expensive, and invasive. If more than one embryo is transferred to your uterus, IVF can result in a pregnancy with more than one fetus (multiple pregnancies).

How does it help?

In vitro fertilization (IVF) is a treatment for infertility or genetic problems. If IVF is performed to treat infertility, you and your partner might be able to try less-invasive treatment options before attempting IVF, including fertility drugs to increase the production of eggs or intrauterine insemination — a procedure in which sperm are placed directly in your uterus near the time of ovulation.

Sometimes, IVF is offered as a primary treatment for infertility in women over age 40. IVF can also be done if you have certain health conditions. For example, IVF may be an option if you or your partner has:

  • Fallopian tube damage or blockage

Fallopian tube damage or blockage makes it difficult for an egg to be fertilized or for an embryo to travel to the uterus.

  • Ovulation disorders
    If ovulation is infrequent or absent, fewer eggs are available for fertilization.
  • Endometriosis
    Endometriosis occurs when the uterine tissue implants and grows outside of the uterus — often affecting the function of the ovaries, uterus, and fallopian tubes.
  • Uterine fibroids
    Fibroids are benign tumors in the wall of the uterus and are common in women in their 30s and 40s. Fibroids can interfere with the implantation of the fertilized egg.
  • Previous tubal sterilization or removal
    If you’ve had a tubal ligation — a type of sterilization in which your fallopian tubes are cut or blocked to permanently prevent pregnancy — and want to conceive, IVF may be an alternative to tubal ligation reversal.
  • Impaired sperm production or function
    Below-average sperm concentration, weak movement of sperm (poor mobility), or abnormalities in sperm size and shape can make it difficult for sperm to fertilize an egg. If semen abnormalities are found, your partner might need to see a specialist determine if there are correctable problems or underlying health concerns.
  • Unexplained infertility
    Unexplained infertility means no cause of infertility has been found despite evaluation for common causes.
  • A genetic disorder
    If you or your partner is at risk of passing on a genetic disorder to your child, you may be candidates for preimplantation genetic testing — a procedure that involves IVF. After the eggs are harvested and fertilized, they’re screened for certain genetic problems, although not all genetic problems can be found. Embryos that don’t contain identified problems can be transferred to the uterus.
  • Fertility preservation for cancer or other health conditions
    If you’re about to start cancer treatment — such as radiation or chemotherapy — that could harm your fertility, IVF for fertility preservation may be an option. Women can have eggs harvested from their ovaries and frozen in an unfertilized state for later use. Or the eggs can be fertilized and frozen as embryos for future use.

Women who don’t have a functional uterus or for whom pregnancy poses a serious health risk might choose IVF using another person to carry the pregnancy (gestational carrier). In this case, the woman’s eggs are fertilized with sperm, but the resulting embryos are placed in the gestational carrier’s uterus

What are the pros of IVF?

IVF helps many patients who would be otherwise unable to conceive
The ultimate advantage of IVF is achieving a successful pregnancy and a healthy baby. IVF can make this a reality for people who would be unable to have a baby otherwise:

  1. Blocked tubes: For women with blocked or damaged fallopian tubes, IVF provides the best opportunity of having a child using their own eggs.
  2. Older patients/ patients with a low ovarian reserve: IVF can be used to maximize the chance of older patients conceiving. At CREATE, we have a great experience with older women and those with low ovarian reserve. We use Natural IVF to focus on the quality of eggs, rather than quantity.
  3. Male infertility: Couples with a male infertility problem will have a much higher chance of conceiving with IVF than conceiving naturally. We have a number of laboratory techniques to facilitate this including intra-cytoplasmic sperm injection (ICSI). We also have an experienced consultant urologist to advise men with fertility problems.
  4. Unexplained infertility:1 in 6 couples will suffer fertility problems and sometimes these remain undiagnosed after investigation. These patients may benefit from intervention.
  5. PCOS: Polycystic ovary syndrome is a common condition in which there is a hormone imbalance leading to irregular menstrual cycles. IVF has proved very successful in patients with PCOS, who will not conceive with ovulation induction.
  6. Endometriosis: Patients with endometriosis, where parts of the womb lining grow outside the womb, may like to try IVF, as it has proved successful in this group.
  7. Premature ovarian failure: Women with premature ovarian failure or menopause can have IVF treatment using donor eggs, which typically has high success rates.

It has been used for a long time and has a safe track record
The first ‘IVF baby’, Louise Brown, was born using natural IVF in 1978. Since then, the technology has advanced, and techniques refined in order to create a safer and successful treatment. We use only the safest forms of IVF with fewer drugs in order to reduce the risk of side effects such as Ovarian Hyperstimulation Syndrome (OHSS).

IVF can be more successful than IUI and other forms of assisted reproductive technology
IVF success rates have been increasing since its conception, thanks to technological advances. Although IUI and other forms of assisted reproduction technology can be successful for some patients, on the whole, they have not undergone the same level of improvement, and do not currently have as high success rates. IUI with donor sperm can, however, be a useful first option in single women and same-sex couples.

It can help single women and same-sex couples
For single women or same-sex couples who wish to have a child, IVF can provide a great opportunity for helping them to become parents if IUI has not been successful. IVF with donor sperm can help potential patients achieve this goal.

IVF can help to diagnose fertilization problems
In some cases of unexplained infertility, there could be a problem with fertilization. Cases such as these may not be diagnosed until fertilization is attempted in the laboratory. Although this would be a disappointing outcome, it is useful to be able to uncover such problems so that solutions could be reached for future treatment with ICSI.

Unused embryos can be donated to research or another couple
If you are lucky enough to have embryos to spare, these can be used to help other people and even save lives. With the permission of the biological parents, unused embryos can be donated for research purposes, or to another couple to enable them to have a child. 

Embryos can be used to screen for inherited diseases
For individuals who are known carriers of genetic disorders such as cystic fibrosis, Huntington’s disease, and muscular dystrophy, IVF with pre-implantation genetic diagnosis (PGD) is one of the most reliable ways to ensure that a child conceived will not suffer from the disorder. Pre-implantation genetic screening (PGS) can improve the chances of a successful outcome, as it screens embryos for chromosomal disorders such as Down’s syndrome. Both of these techniques are available at our clinics.

What are the cons of IVF?

An IVF cycle may be unsuccessful.

The success of IVF is not guaranteed, and patients often have to undergo more than one cycle of treatment before they are successful. This naturally varies from woman to woman, and a fertility specialist will be able to give a more accurate and personalized likelihood of success. It is important to be realistic but positive about the chances of success.

There may be associated side effects and risks

As a medical treatment, IVF comes with a small chance of developing side effects, the most severe of these being severe ovarian hyper-stimulation syndrome (OHSS). Fortunately, the use of fewer or no drugs in natural and mild IVF cycles means that the already small likelihood of developing unwanted risk of OHSS is dramatically decreased or eliminated.

Multiple pregnancies

In IVF treatments, there is often more than one embryo put back into the uterus, and this leads to a higher likelihood of multiple pregnancies; around 20-30% of IVF pregnancies can result in multiple pregnancies. Multiple pregnancies do carry associated health risks to mother and baby: there is an increased chance of premature labor, miscarriage, need for caesarean, stillbirth, and infant health problems with multiple pregnancies. It is important for all fertility clinics to have robust single embryo transfer policies, to avoid the risks of multiple pregnancies.

There is a slightly higher chance of ectopic pregnancy

With IVF treatment, the risk of an ectopic pregnancy doubles, to 1-3%, particularly in women with damaged fallopian tubes.

There is evidence that high oestrogen levels associated with high stimulation IVF can increase the risk of prematurity and low birth weight in babies

There is growing evidence that giving high stimulation during IVF increases the chance that a baby is born prematurely and with lower birth weight. This has been linked to long-term health problems for the child. It is theorized that high oestrogen levels can affect the intra-uterine environment. With drug-free and low drug approaches, it has been observed that babies born are more likely to be born at full term and with a higher birth weight than those born through high stimulation IVF associated with high oestrogen levels.

IVF treatment can take an emotional/psychological toll

Going through IVF treatment can be a highly emotive and stressful experience. For patients undergoing treatment, it can be physically and emotionally demanding. For partners, it can be difficult to watch a loved one go through a stressful experience. It is important to prioritize your psychological health, and this is also good for the health of the body. Our short, lower-drug protocols should help to minimize the amount of stress.

IVF treatment can be expensive

IVF treatment is not cheap, and after paying for medication and blood tests, the costs can quickly mount up. It is good to have a clear idea of the costs involved before starting treatment and to have your finances in order before beginning.

Some patients may be concerned about ethical issues

The idea of selecting some embryos and potentially discarding others may not sit well with everybody. Before starting treatment, consider your own stance and what you would be comfortable with. If you are uncomfortable with the creation of multiple embryos, we can support your choice by using Natural Cycle IVF, or by freezing additional eggs rather than fertilizing them to create embryos.

 

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