IVF or in vitro fertilization has undoubtedly altered countless lives for the better by helping couples conceive and fulfill their dream of giving birth to and bringing up a child of their own. In recent times, hormonal imbalance and health-and lifestyle-related issues have increased infertility rates globally among men as well as women. IVF Success rates have considerably improved in different parts of the world at far more affordable rates.
In the event, more and more couples want to opt for IVF treatment. However, it is important to be fully aware of what IVF is, how the treatment is done, and who is a likely candidate for IVF. One of the most frequently asked first questions is about the best age for IVF. People also ask where and when to go for IVF treatment and about the best type of IVF treatment to opt for. We look at these details as well as the success rate and the types of IVF treatment available to help make an informed decision.
Candidates for IVF
Women who have tried for a long time to get pregnant but have been unable to do so may be advised to opt for injectable drugs, intrauterine insemination (IUI) or other alternatives. If these conventional therapies do not work to help a woman conceive, IVF is advisable; particularly if there are certain underlying conditions responsible for the difficulty in getting pregnant. Women with ovulation dysfunction, blocked Fallopian tubes, PID (pelvic inflammatory disease), PCOS (polycystic ovary syndrome), endometriosis, uterine problems or problems relating to cervical mucus are typically advised to opt for IVF if they fail to conceive.
Couples with male factor infertility issues such as low sperm count also undergo IVF when they fail to conceive. Hence, it is important to arrive at a definitive diagnosis for the reasons behind the difficulty of getting pregnant and then choose the right course of action.
How is IVF performed?
If you are contemplating undergoing an IVF procedure, you should understand exactly how this works. This helps you get a realistic idea of the chance of success of the IVF process; which involves several steps. Here is what you can expect:
It is the first step of the IVF process. This involves monitoring of the ovaries, the release of the egg and its timing. The fertility doctor will ensure that the hormone levels are at optimal levels. It is seen that the ovaries are producing eggs as needed. If the ovaries are not producing requisite eggs, fertility-boosting medications help stimulate the ovaries to ovulate and produce eggs. With the help of this, the ovaries produce several eggs within a short period.
Egg retrieval is the second step. After administering pain medication, a thin needle is inserted into the vaginal wall. With the help of ultrasound, fluid is extracted and then the egg (oocyte) is isolated from that fluid. This is transferred to a culture dish and then to an incubator.
Fertilization and embryo culture
Now it is time for the fertilization of the egg with the sperm. The sperm sample may be from a partner, volunteer or a sperm donor. The most active sperm is brought into contact with the egg either in a special chamber or by direct injection into the egg.
The subsequent process of embryo formation is closely monitored. The quality of the embryos is assessed to rule out any disorders or abnormalities. The healthiest and strongest embryos are identified for transfer.
The last step of the IVF procedure is embryo transfer and implantation. The sturdiest embryos are then transferred via the cervix into the uterus for implantation. This is followed by a complete bed rest to give the woman the best chance at conception.
Types of IVF Treatment
There are various types of IVF treatments. Each case is assessed independently to decide on the best course or a combination of treatments based on the underlying cause of infertility. Different types of fertility treatments are recommended. The decision is made considering the medical condition, the age, and health of the couple, as well as certain lifestyle factors.
The types of IVF cycles
The natural cycle is the simplest type of IVF cycle. It does not stimulate the ovaries for egg production. The ovaries produce eggs as they would in the natural course, which are collected and mixed with sperms to create embryos. This is a good option if there are no abnormalities in the ovaries or the Fallopian tubes and the woman is ovulating normally each month.
However, if this is not the case, ovarian stimulation may be required. This uses hormonal medications to stimulate the ovaries to produce several eggs to increase the chances of conception. Only mild stimulation may be used in cases where there is the apprehension of ovarian hyperstimulation syndrome (especially among women who have already undergone IVF treatments previously).
Different types of fertility treatments
IVF with Laser-Assisted Hatching
In IVF, laser-assisted hatching is used in cases where the hatching of the egg is difficult; typically due to thicker than usual embryo walls. This procedure is used to help the fertilized egg attach to the walls of the uterus. Acid or mechanical hatching procedures are some other procedures that may be used in some cases.
IVF with Egg Donation
In the case where a woman is unable to produce eggs or cannot produce eggs of a sufficiently healthy quality, IVF with egg donation may be opted for. The eggs from a donor woman are combined with the sperm of the man. The resultant embryos are implanted into the uterus of the woman who is undergoing IVF treatment. Therefore, in this case, the woman would carry a child this that is not biologically her own. The sperm could be sourced from her own partner or a donor. She would nurture the embryo in her uterus and carry the fetus to term.
IVF with ICSI
IVF with Intracytoplasmic Sperm Injection (ICSI) is typically used when the male partner displays male factor infertility. The main difference here is the method of fertilization. In IVF, the egg and sperm are merged in a petri dish and fertilization is achieved naturally. With ICSI, however, a single sperm is injected into the cytoplasm of the egg using a very fine needle. In cases of very severe male factor infertility, the sperm of a donor is used. That is, the child would not biologically be that of the male partner.
IVF with ICSI and Optical Spindle View
IVF and ICSI assisted with Optical Spindle View may be recommended to increase the chances of a successful pregnancy. Here, the mitotic spindle within the woman’s egg is examined to gauge quality. The spindle helps in the chromosomal division of the egg. The embryos are minutely examined to detect any possible abnormalities. It also helps ensure that there is no damage around the site of the injection.
IVF with ICSI and Testicular Biopsy
IVF and ICSI with testicular biopsy are yet another of the different types of fertility treatments that may be recommended if the male partner’s testicular function is a problem. In cases where the quality of the male sperm is seen to be deteriorated or of poor quality, the sperm is surgically extracted (as opposed to being collected via ejaculation) and then merged with the egg. Different types of IVF cycles and various permutations and combinations may be used depending upon each couple’s particular set of circumstances.
Success Rate of IVF
While it is advisable to opt for IVF treatment at age 35 or earlier to have the highest chance of success, this is not to say that older women are ill-advised to go in for IVF. IVF success rates over age 35 are now much higher than before. In fact, women above the age of 35 can improve their chance of conception significantly with the help of IVF and advanced age of a woman is one of the primary reasons to opt for this treatment.
The best chance of an IVF treatment leading to living births is for women aged below 35 years; when the chances of success are about 40 percent. This success rate drops to 31% percent for women between 35 and 37 years of age. The success rate is about 21 percent for women aged 38 to 40 and 11 percent for women aged 41 to 42. This rate drops to just 5 percent for women aged 43 and above.
One of the secrets to IVF success is to thoroughly investigate the underlying cause of infertility and then use the best and targeted method for conceiving a baby. Lowering stress and anxiety, eating healthy and exercising regularly – in other words, leading a healthy lifestyle can also help improve the chances of IVF success.
The success rates of IVF can be assessed using a specially formulated IVF success rates calculator. This can help predict one’s chances of conception and successful pregnancy. The calculator takes various factors into consideration. It considers maternal age, underlying medical conditions, history of alcohol abuse, smoking status, BMI (body mass index) and lifestyle habits into consideration to predict the chances. Such an IVF calculator can also help decide upon the best course of treatment or combination of IVF treatments to help couples conceive.
It isn’t enough to simply know about the different types of IVF treatments and the success rates. It is also important to know about the possible side effects of the procedure. Couples should also know that the chances of multiple births (twins and so on) are significantly higher with assisted reproduction because fertility specialists typically insert more than one embryo into the uterus of the woman to increase chances of success.
Couples would have to be mentally, emotionally and logistically prepared for the high possibility of multiple births. There are significant chances of IVF cycles not producing the desired results. This can be stressful and traumatic as well.
It is also important to know that treatments are expensive. The costs vary greatly depending upon where the treatment is performed and what exactly couples opt for. Treatments are available at significantly lower costs in some countries as opposed to others. Still, couples can expect the same high level of medical expertise, the latest procedures, and quality of care. Various local factors impact costs. Therefore, couples should do their due diligence and then decide where and what type of IVF procedure to opt for.
In the end, the success rates for IVF hinge upon a number of personal factors that will vary widely from one to another couple. The ideal candidates for IVF are those who decide to improve their chances of conceiving by improving overall health and living a healthy and active lifestyle devoid of harmful habits.
The types of IVF treatments to opt for will also vary widely; so it is important to seek the advice of a highly experienced specialist who can take a holistic view of the situation and suggest the best possible course of action.