All you need to know about IVF

IVF is the most frequent and effective type of assisted reproductive technology for assisting people in becoming pregnant. When other treatments have failed, IVF can help you get pregnant.

An egg is fertilized outside the body, in a laboratory dish, and then implanted in a person’s uterus.

The most frequent and effective type of assisted reproductive technology is in vitro fertilization (IVF) (ART). ART is used to conceive roughly 2.1 percent of kids born in the United States each year, according to the Centers for Disease Control and Prevention (CDC). With IVF, there’s also a higher risk of multiple births.

The IVF procedure is discussed in this article. It covers everything from success rates to expenses to screenings and everything in between.

What is IVF

Overview of IVF

Louise Brown, the first baby born through IVF, was born in 1978. IVF is credited to Robert Edwards and Patrick Steptoe, who worked together on the treatment.

An egg grows and matures in the ovary during a normal pregnancy. The ovary releases the egg during ovulation.

The sperm go via the uterus and into the fallopian tube in search of the egg, which they pierce and fertilize. After that, the fertilized egg, or embryo, adheres to the uterus wall and begins to develop into a baby.

IVF, on the other hand, may be a viable alternative for the following reasons:

  • male factor infertititly or abnormal sperm parameters
  • a person’s fallopian tubes are blocked
  • a person is unable to get pregnant naturally
  • a person or couple is diagnosed with unexplained infertility

The IVF process

One IVF treatment cycle might take 3–6 weeks, according to the Human Fertilization and Embryology Authority in the United Kingdom. However, depending on their risk factors and the treatment’s effectiveness rate, a person may require more than one round.

Depending on the clinic, several techniques may be used. IVF, on the other hand, usually entails the following steps:

1. Superovulation

Controlled ovarian hyperstimulation is another name for superovulation. Luteinizing hormone or follicle-stimulating hormone are both found in fertility treatments. The ovaries create more eggs than usual as a result of these hormones. Transvaginal ultrasound scans can be used to track the ovaries’ growth and development.

A person can also use donated or frozen eggs as an option.

2. Retrieving the eggs

To extract eggs, doctors use a minor surgical technique known as “follicular aspiration” or “egg retrieval.”

A tiny needle is injected through the vaginal wall and into an ovary under ultrasound supervision. The needle is connected to a suction device that suctions out the follicular secretions and eggs. This procedure is carried out by doctors for each ovary.

3. Insemination, fertilization, and embryo culture

The obtained eggs are mixed with sperm and maintained in a temperature-controlled facility. The sperm should penetrate the egg after a few hours.

The sperm is sometimes put straight into the egg. Intracytoplasmic sperm injection is the term for this procedure (ICSI). Frozen sperm obtained via testicular biopsy could be used.

The fertilized egg divides into two and develops into an embryo. Many fertility clinics offer preimplantation genetic testing once the embryos have reached the blastocyst stage (PGT). An embryo is screened for chromosomal abnormalities or aneuploidies using this approach.

One or two of the best embryos are used in the transfer. The uterine lining is then prepared for the embryo’s implantation using hormones and other drugs.

4. Embryo transfer

The womb may receive more than one embryo at a time. It’s important to talk to your doctor about the amount of embryos you’ve transferred.

Typically, the doctor will only transfer one embryo at a time. Several risk considerations must be considered before deciding to transfer more than one embryo, which should be discussed with a clinician.

The embryo is transferred using a thin tube or catheter around 3–5 days after conception. It enters the uterus via the vaginal canal. A pregnancy begins when the embryo adheres to the uterine lining, a process known as implantation, and embryo growth proceeds.

IVF success rates

According to the CDC, the percentage of planned egg retrievals that resulted in live birth deliveries in 2019 was:

  • 52.7% among people aged under 35 years
  • 38% among people aged between 35–37 years
  • 24.4% among people aged between 38–40 years
  • 7.9% among people over the age of 40

These figures differ depending on where the procedure is performed.

Other considerations

The most important risk factor affecting the success rate of IVF is age.

However, there are a number of other elements that can influence your chances of success, including:

  • the cause of infertility
  • ovarian reserve test results
  • whether or not pregnancy or a live birth has occurred before
  • the strategy that will be used

IVF costs

In the United States, the average cost of an IVF cycle ranges from $10,000 to $15,000. Some insurance companies, however, fund infertility treatments like IVF. As a result, a person with health insurance may be able to save money on IVF treatment.

Coverage will be determined by the health insurance company and the state in which the individual resides. Currently, 17 states in the United States have laws requiring insurance companies to cover or offer coverage for infertility treatment.

Due date calculator for IVF

A due date calculator can be used to calculate an estimate of a person’s due date.

Many websites, including Flo Health, have a calculator that may be used to determine a person’s due date based on information such the embryo transfer date and the type of transfer they had. The calculators include the following:

  • Day 3 embryo transfer
  • Day 5 embryo transfer
  • IVF with own eggs
  • IVF with fresh donor eggs cycle
  • Fresh donor embryos cycle

Screenings

To establish the sex of the embryo and to rule out any genetic anomalies, screening and testing are available.

Preimplantation genetic testing (PGT) was originally a process used by clinicians to discover genetic diseases in the DNA of an embryo. These could cause a birth defect or a developmental problem.

Doctors are now using this approach to determine the sex of an embryo before it is implanted during IVF. Doctors can examine the embryo’s chromosomal make-up to predict whether it will be male or female.

Preimplantation testing is available at about 72 percent of contacted ART facilities, according to a 2018 survey.

IUI vs. IVF

Intrauterine insemination (IUI), commonly known as artificial insemination, is a method in which sperm is delivered directly to the uterine cavity via a catheter. This method shortens the time and distance that the sperm must travel to fertilize the egg.

This differs from IVF, which involves combining eggs and sperm outside of the body in a controlled setting.

IUI is typically used to treat couples with unexplained infertility and mild male factor infertility. In addition to IUI, a woman may be given medicine to help her ovulate. During the ovulation time, a doctor will inject the sperm into the uterus.

In comparison to IVF, IUI is a quick treatment that takes about 5–10 minutes. IUI is also less expensive than IVF. Without insurance, IUI costs between $300 and $1,000 on average.

IUI, on the other hand, is less successful than IVF.

The body’s natural processes will take over once the sperm is put into the uterus by doctors. Doctors can use IVF to check if an egg has been fertilized and choose the best embryo (s).

IUI has a success rate that is roughly a third of that of IVF.

In addition, IUI may not be an appropriate reproductive treatment in the following situations:

  • is in their late 30s or over 40
  • has low-quality eggs
  • has a low number of eggs
  • has blocked fallopian tubes
  • has severe endometriosis

If the reason for infertility treatment is severe male factor infertility, this treatment is equally ineffective.

Insemination vs. ICSI

ICSI is a fertilization procedure that involves injecting a single sperm into an egg.

ICSI is a frequent treatment for male factor infertility in couples. It may also boost the chances of fertilization in people who have had previous IVF failures. It’s also for preimplantation genetic testing-enabled cycles.

ICSI is linked to a slightly greater risk of birth abnormalities, according to the American College of Obstetricians and Gynecologists, including:

Side effects

During IVF, many people will have few to no adverse effects. Some people, however, may develop negative side effects. These may include the following:

  • irritability
  • nausea
  • headaches
  • fatigue
  • abdominal pain
  • sore breasts

These symptoms are most common during the IVF ovarian stimulation phase. The following side effects may occur in a small percentage of people:

  • vomiting or abdominal pain that requires hospital admission
  • dehydration
  • shortness of breath

Some people may have changes in mood as well.

Is it painful?

Although some people may suffer moderate discomfort throughout the IVF process, it is usually not painful.

There may be mild bruising and pain at the injection site because IVF involves the infusion of fertility drugs. Abdominal cramps, which can be unpleasant, is another possibility.

Because pain medication is provided before the procedure, the egg retrieval technique is usually painless.

Embryo transfer is frequently painless as well.

Risks with IVF

The following are some of the hazards connected with IVF:

Medication side effects

Some people may experience side effects from the drugs used during treatment.

The following are some of the probable negative effects of IVF drugs:

  • hot flashes
  • enlargement of the ovaries
  • difficulty sleeping
  • abdominal pain
  • nausea and vomiting
  • difficulty breathing
  • irritability

Ovarian hyperstimulation syndrome (OHSS)

The drugs used to stimulate the ovaries to generate eggs can cause OHSS in rare cases. This occurs when a person’s body overreacts to the prescriptions they’re taking, causing their hormone levels to rise.

OHSS people have a large number of developing follicles as well as high estrogen levels. This causes fluid to cause into the belly, causing bloating, nausea, and abdominal swelling.

The following symptoms may occur in people with severe OHSS:

  • dehydration
  • vomiting
  • blood clots
  • shortness of breath

Pregnancy loss

An abnormal number of chromosomes, known as chromosomal aneuploidy, is the major cause of pregnancy loss, whether in IVF or spontaneous conception.

An embryo is tested with PGT to look for aneuploidy.

Multiple births

When more than one embryo is transferred to the uterus, the chances of conceiving twins, triplets, or more infants increase.

Pregnancies with multiple fetuses can lead to:

  • significant increase in the mother’s blood pressure
  • double the mother’s risk of developing diabetes
  • preterm birth or low birth weight

In people who have a higher likelihood of conceiving twins, the doctor may prescribe that only one embryo be transferred.

Sources:

  • https://medlineplus.gov/assistedreproductivetechnology.html
  • https://www.cdc.gov/art/index.html
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5904054/
  • https://jneurodevdisorders.biomedcentral.com/articles/10.1186/s11689-020-09347-w
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7035132/
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6087828/
  • https://www.medicalnewstoday.com/articles/262798
  • https://www.hfea.gov.uk/treatments/explore-all-treatments/in-vitro-fertilisation-ivf/
  • https://www.cdc.gov/reproductivehealth/infertility/
  • https://www.pfcla.com/blog/intrauterine-insemination-success-rates
  • https://www.nhs.uk/conditions/ivf/
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3171154/
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4467930/
  • https://www.sciencedirect.com/science/article/pii/S2590161319300985
  • https://www.ncsl.org/research/health/insurance-coverage-for-infertility-laws.aspx
  • https://www.nature.com/articles/nrg.2016.97
  • https://www.plannedparenthood.org/learn/pregnancy/fertility-treatments/what-ivf