VF: In Vitro Fertilization

In Vitro Fertilization or IVF is a complex series of procedures used to treat

fertility or genetic problems and assist with the conception of a child.

IVF is a type of assisted reproductive technology used for infertility treatment

and gestational surrogacy, in which a fertilized egg is implanted into a
surrogate’s uterus, and the resulting child is genetically unrelated to the
surrogate. Some countries banned or otherwise regulate the availability of IVF
treatment, giving rise to fertility tourism. Restrictions on availability of IVF
include costs and age to carry a healthy pregnancy to term. IVF is mostly
attempted if less invasive or expensive options have failed or are unlikely to
work. IVF is a choice for couples who are not able to conceive without
assistance.

Process of IVF
The process of IVF starts a few weeks before ovulation. Many women are
given a drug to control ovulation so that eggs can be more readily collected,
according to WebMD. The doctor will also monitor the eggs’ development over
the next few weeks. Once they are mature, they are harvested with a small
needle. Patients undergoing this procedure are usually sedated and given
pain medicine when they wake up. Soon after, sperm is collected, either by a
donor specified by the woman or from a sperm bank. The eggs and sperm are
then placed in a glass dish so that the sperm can fertilize the eggs. After two
to five days, the healthiest eggs are selected and set aside. Between one and
three eggs are then implanted into the uterus through the use of a catheter
inserted in the cervix. The remainder can be frozen for future attempts.
Success rates for women under the age of 34 are between 30 and 40 percent,
with rates dropping after age 35. Older women who choose to use IVF often
use donor eggs, which increases their chances of becoming pregnant despite
their own age.

Medical uses of IVF

IVF may be used to overcome female infertility where it is due to problems

with the fallopian tubes, making fertilisation in vivo difficult. It can also assist in
male infertility, in those cases where there is a defect in sperm quality; in such
situations intracytoplasmic sperm injection (ICSI) may be used, where a
sperm cell is injected directly into the egg cell. This is used when sperm has
difficulty penetrating the egg, and in these cases the partner’s or a donor’s
sperm may be used. ICSI is also used when sperm numbers are very low.
When indicated, the use of ICSI has been found to increase the success rates
of IVF. IVF is also considered suitable in cases where any of its expansions is
of interest, that is, a procedure that is usually not necessary for the IVF
procedure itself, but would be virtually impossible or technically difficult to
perform without concomitantly performing methods of IVF. Such expansions
include preimplantation genetic diagnosis (PGD) to rule out presence of
genetic disorders, as well as egg donation or surrogacy where the woman
providing the egg isn’t the same who will carry the pregnancy to term.

Advantages and Disadvantages of In Vitro Fertilization

Advantages

IVF helps 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:

Blocked tubes: For women with blocked or damaged fallopian tubes, IVF
provides the best opportunity of having a child using their own eggs.

Older patients/ patients with a low ovarian reserve: IVF can be used to
maximise the chance of older patients conceiving. At CREATE, we have great
expertise with older women and those with low ovarian reserve. We use
Natural and Mild IVF to focus on quality of eggs, rather than quantity.

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 liaise with an experienced urologist, Mr Vinod
Nargund.

Unexplained infertility: 1 in 6 couples will suffer infertility problems and

sometimes these remain undiagnosed after investigation. These patients may
benefit from intervention.

PCOS: Polycystic ovary syndrome is 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 respond appropriately to fertility
medication in isolation.

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.

Premature ovarian failure: Women with premature ovarian failure or

menopause can have IVF treatment using donor eggs, which typically has
high success rates.

Disadvantages

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. Currently just over 25% of all IVF cycles result in a live birth.
This naturally varies woman to woman, and a fertility specialist will be able to
give a more accurate and personalised likelihood of success. It is important to
be realistic but positive about the chances of success.

There may be associated side effects. 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 side effects is dramatically decreased or
eliminated. CREATE Fertility takes the possibility of side effects very seriously,
and as a result of our carefully constructed treatment protocols has never had
a patient admitted to hospital with severe OHSS.

Multiple pregnancy. In IVF treatments, there is often more than one embryo
put back into the uterus, and this leads to a higher likelihood of multiple
pregnancy; around 20-30% of IVF pregnancies are multiple pregnancies.
Multiple pregnancies do carry associated health risks to mother and baby:
there is an increased chance of premature labour, 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 pregnancy. At CREATE, we have a low multiple
birth rate and focus on the reduction of multiple births.