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Nowadays we see a lot of advertisements daily about IVF or In vitro Fertilization, targeting infertile couples longing for their first child. However, a lot of questions arise in the mind of such couples. The following article, attempts to clarify the concepts of IVF for such couples.
Since long it’s been heard that due to problems in getting pregnant, the public/families just point out female. But why??
Inability to conceive, is often implicated as a disturbance in females. This may be true most of the times but not always. Advances in science has shed light to the factor that many times males lose their fertility. So, an answer was needed to control this rising cause of low production rate in many countries. The answer came in the form IVF or In vitro Fertilization. IVF was invented on 1978. Since then, IVF process has gained a vast popularity. Because of doctors and healthcare organizations, IVF is fast becoming an affordable, first choice of infertile couples. But it is important to understand the process. So, let’s come to discussion.
What is In vitro Fertilization?
IVF is an Assisted Reproductive Technology (ART). It is a unique medical procedure, which helps infertile couples to have their baby. However, it can be done only if other process like “Intra uterine Insemination“(IUI) or ICSI have failed. Around 34% to 42% couples have the chances of getting successfully pregnant with IVF. But, it very much depends on the age, lifestyle and supportive medication given to the couples. In general, the lower the age of females, higher the chances of getting pregnant by IVF.
Fertilization is a natural process in which an egg from mother and a sperm of father fuse together inside the body of a woman. It then develops into a baby inside mother’s womb. But, in IVF, the fertilization process is achieved in a laboratory by artificially fusing the mother’s egg with father’s sperm.
That’s why it’s called as In-vitro fertilization meaning fertilization outside body. Let us understand the basic of IVF procedure to have a better understanding of what you will go through if you go for it.
Steps involved in IVF procedure
IVF procedure is termed as an “IVF Cycle”. A patient has to undergo a complete IVF cycle. To have a success full IVF Cycle, there are a few stages a women have to go through to become pregnant.
- SUPER OVULATION- The IVF cycle starts with prescription of fertility drug. These drugs helps with egg production in expecting mother’s. In normal situation, only one egg is released per month but with fertility drug, ovaries produce more number of eggs. Women will then have to undergo regular ultrasound scans to check the ovaries and blood tests for examination of hormone level.
- EGG RETRIEVAL– After ovulation, the egg is taken from the ovaries with a surgical procedure. This process if generally painless and women don’t feel anything. A thin needle is inserted through vagina into the ovaries to retrieve the eggs.
- INSEMINATION & FERTILIZATION- After getting the eggs from the mother, the eggs are screened for any potential abnormalities. Here the good quality eggs are chosen and fertilized with sperms in process called Insemination. At this stage, generally, sperm selection is not done if male sperm count is sufficient. But, if a low sperm count is detected, then doctors may advise to go for ICSI where sperm is directly inserted into an egg.
- EMBRYO CULTURE- After fertilization, the fertilized egg develops into an embryo. Within 5 to 7 days, the embryo divides into several cells actively. If a couple have an increased risk of any hereditary disorder, then Preimplantation Genetic Diagnosis (PGD) is considered to discard embryos with genetic disorders. The PGD testing helps to decide which embryo is fit for implant and save a future child from having a disorder.
- EMBRYO TRANSFER– This is the last step. After, 3 to 6 days of fertilization, the selected embryo is placed into the womb of the woman. It is done by small tube and is painless procedure.
The IVF Cycle is successful if the implant embryo attaches itself to the walls of the uterus and starts developing. However, if for some reason the implant is not successful, the couple may have to repeat the cycle again.
If the couple does not undergo for Pre Implantation Genetic Screening for hereditary diseases, the couple would have to opt for Non Invasive Prenatal Screening in early stages to rule out any risks of developing any abnormalities.
Why to go for IVF treatment?
In vitro Fertilization is chosen by an infertile couple for whom other methods of having a child have been unsuccessful. It increases chances for women to conceive. It is recommended to infertile couples which may include one of the following reasons:
–Advance maternal age– Women with over 35 years are at less chances of getting pregnant naturally. So, they need some assistance from gynecologist. Sometimes, the problems are resolved by medications and in extreme cases, IVF is recommended.
–Blocked Fallopian tube– Women with Fallopian tube blockage are unable to release egg for fertilization. Their eggs are taken out surgically for IVF process.
–Prior reproductive surgery– Sometimes prior reproductive surgery makes women unable to fertilize. In such cases IVF is test of choice.
–Low sperm count and blockage– Men suffering from low sperm count or blockage are unable to fertilize women naturally. IVF assist them by collecting sperms and fertilizing eggs in lab
–Smoke, Alcohol & Drug users– Such people may loose or reduce their fertility to make them unable to conceive naturally. In such cases, IVF is only option.
–Endometriosis– a condition where uterus lining is affected and makes the uterus non favorable to implant
IVF treatment status in India
The IVF success rate percentage results in favorable consequences. However, this success rate depends on many factors. These include conceiving age, cause of infertility, embryo conditions, history of productive cycles, lifestyle status etc.
Assisted Reproductive Technology is growing day by day at a fast pace. India is not behind in the race of ART. In past few years, numerous IVF centers have opened nationwide. More number of Gynecologists are educating themselves with the knowledge of IVF. Few IVF centers have developed in a nationwide chain of IVF centers such as Indira IVF, Medicover Fertility, Apollo Hospitals Center for Assisted Reproduction, Bloom IVF etc.
The benefit of this boom in IVF sector has given a hope directly to the patient. Because, few years ago, the average cost of one IVF Cycle in India would cost on average more than 5 lakh rupees. It has now reduced to around 1 lac. This affordability has given a rise in people opting for IVF cycles.
The India IVF Services Market value currently values $256.0 million (2016), and is expected to reach value $829.5 million, 2023. (reference)
Pregnancy Rate of IVF
The pregnancy success rate is highly dependent on age of the women. The table below shows approximately the success rate depending upon the age.
Risks associated with IVF treatment
Every technology has its limitations. IVF is no different. With many of its benefits, IVF has some limitations as well:
- Success Rate: In spite of big claims by IVF specialists, the actual success rate is not more than 30-50%. Again, this factor is dependent on many factors.
- Undergoing IVF actually needs a lot of energy, plenty money, and lots of patience. Because, in most cases, single IVF cycle is not successful and couple may have to undergo multiple IVF cycles. So,it all adds to the cost, time and stress.
- There are some side effects from the IVF medications as well although these are not always the case. Woman taking fertility medicine may suffer from pain in abdomen, mood swings, headache etc.
- In many cases women takes fertility drugs which later on in some cases may cause a side effect called Hyper stimulation syndrome. (reference)
- Medical studies have shown the risk in egg retrieval which include bleeding, damage near the area of ovaries. (reference)
To conclude, it is certain that In vitro Fertilization is definitely a boon for childless couples. But unless there is a reduction in prices, this technology remain accessible to only the rich class. A lot of middle class salaried people and low income people are still unable to opt for IVF after 1st cycle has failed. They find themselves unable to bear the financial burden of repeated IVF cycles.
A lot can help in this regard with proper awareness among the people. Educated couple can better understand the risks and may not opt for IVF centers falsely claiming their success stories. A good doctor highly increases the In vitro Fertilization success rate while an inexperienced doctor may not set the procedure right from the start resulting in a failed cycle.
It a urgent need of doctors, IVF specialists, healthcare organization to come together and increase right awareness, strategic decisions to reduce the prices and spread its reach to everyone irrespective of geographical barriers or financial status.
Dear couples, if you have any question regarding this technology talk to you doctor today or contact us for more information