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In Vitro Fertilization: What You Need to Know

If you and your partner have been trying to get pregnant but without success, it can be a really difficult and stressful time for you both. You’ve been trying for ages, have exhausted all the common methods to try and conceive, but that pregnancy test still comes up negative. Many people often spiral into emotional turmoil at this point, because trying, trying and trying again without getting the result you want can be debilitating even for the strongest of couples. But before looking at surrogacy or adoption as a viable option, scientific advances over the last few decades have meant that there is still another way that you can carry your own baby.

It might not be conventional, it might not be everybody’s cup of tea, it might be a long, painful and an invasive process, but it will enable you to carry your baby and experience the miracle of giving birth. This process is In Vitro Fertilization, commonly referred to as IVF. We will delve into everything you need to know about IVF, and aim to inform you about the procedures involved, why you may consider it and the potential risks and side effects associated with IVF treatment.

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15 History

The year 1978 saw the birth of IVF and the world’s first so-called test tube baby as a result of the treatment, Louise Brown. English physiologist, Sir Robert Geoffrey Edwards pioneered the revolutionary treatment in combination with surgeon Patrick Steptoe and the duo were the first to treat infertile patients and train other medical professionals. It all began in the 1960s at the world-renowned Cambridge University where Edwards successfully cultured an early human embryo on media in the lab. Surgeon Steptoe operated on an infertile woman to obtain her oocytes – egg cells. The two combined their research and eighteen years later made medical history when Louise Brown was born at Oldham General Hospital in Manchester, UK. Nowadays their methods have been developed and built upon extensively, still using the same general principal of egg retrieval, lab fertilization and implantation. A staggering scientific breakthrough for which Edwards received the Nobel Prize in Physiology in 2010 – a well-deserved recipient of the prize as I’m sure you’ll all agree.

14 Why use IVF?

The primary usage of IVF is to get around the crushing pain and heartache of being infertile. Many people resort to IVF treatment when they’ve exhausted all other methods; tried using fertility drugs, other invasive techniques such as intrauterine insemination – a process where sperm is inserted into the uterus – listened to their doctor’s advice, but without the desired results. These are instances in which IVF is commonly used:

  • Infertility, including age-related infertility.
  • Complications with ovulation – If you’re not ovulating at all, or infrequently, it means that less eggs are being produced for fertilization.
  • Ovarian failure – Many women stop ovulating around the age of 40. But for some women, ovulation can stop prematurely, well before this age, often due to hormonal problems.
  • Endometriosis – Tissue that are meant to grow inside the uterus, grow outside, affecting vital functions necessary for conceiving.
  • Unexplained causes – sometimes the reasons as to why a couple can’t conceive is an utter mystery. You’ve tried and tried, had all the medical tests in the world, but you’re still none the wiser.

13 The Process

An entire book can be written on the process of IVF, so here we’ll just cover the basics, the need-to-know facts:

  • A woman’s eggs are collected, either after natural ovulation or by using additional techniques such as ovarian hyperstimulation.
  • In the lab, the eggs are then prepared by isolating them from the other tissues collected – effectively stripping off the other cells so that you only have the eggs.
  • When obtaining the eggs, multiple eggs are usually collected, so the eggs then undergo testing in order to ascertain their suitability for the IVF procedure.
  • Semen is prepared – it’s usually been quarantined in a freezer and has to be thawed, ready for use.
  • On a culture media in the lab, the sperm and egg are incubated together and left to be fertilized – this usually occurs within a day.
  • The fertilized egg then gets passed through a growth medium and is left for two days for the cell to begin dividing.
  • The egg is now an embryo and is implanted into the cervix using a thin catheter.

12 Infertility Isn’t Uncommon

The science of IVF can help an infertile couple have children, but there are still those who are against the treatment, religious groups who believe that it’s God’s will that you aren’t meant to have children, or those who believe that there are certain unethical protocols involved with IVF. But if you’re struggling to conceive and are dead set on using IVF or are considering it, you’re not alone. In fact, 1 in 6 couples are judged to be infertile, so it’s a common phenomenon, more common than you may have imagined. Of this 1 in 6, 40% of the problems relating to infertility stem from the woman and 40% from the man with the remaining 20% representing couples in which both the man and the woman contribute problems relating to infertility. Nowadays, even fertile individuals are utilizing IVF - all this data collates to mean that 1 in 50 couples now using IVF, so if you’re considering going down this road, there are plenty of others who have walked and are walking the same path. It may be a rocky path, but at the end of it, the potential rewards will surely be worth it.

11 Age is a Huge Factor

You age at the time of IVF has a huge factor in terms of its success rate. The younger you are the more likely IVF will work for you. As a woman your fertility declines the older you get and starts to drop off rapidly as you enter your 30s – the likelihood of infertility increases and the chances of you getting pregnant drops. Many people think that IVF will work regardless of age, but that’s certainly not the case. The thing is, as you get older your fertility declines and that also means you produce less eggs. Since eggs are required in IVF treatments – if you want to use your own eggs that is - this poses a problem for women in their late 30s considering IVF. A man’s fertility levels remain more stable, although sperm counts do also decline with age. If you’re in your mid-late 30s, or older, and want to get pregnant, all is not lost. The age of people using IVF is rising, although bear in mind that when you get into your 40s, the chances of getting pregnant will be greatly reduced, IVF or not.

10 Embryonic Waste

During IVF and the transvaginal oocyte retrieval process – when eggs are retrieved from the ovaries – it’s not uncommon to obtain between 10 and 30 eggs during the 30-minute procedure. Obtaining multiple eggs means that they can be graded and undergo a careful selection process, in order to judge their quality and optimize potential pregnancy. Multiple eggs – the best eggs – are then cultured and fertilized before being implanted into the uterus. This also means that many eggs – the majority of eggs that don’t pass the screening process, are discarded and thrown to waste. This gets many people riled up as people argue it shows a reckless disregard for potential human life. Some eggs that aren’t used are donated to fertility clinics or frozen or used in scientific research, but the majority go to waste. Contemplate this for a sec: is it justifiable for IVF to destroy potential life for the sake of creating a life? Many people don’t think it is, but on the other hand, for those using IVF to get pregnant this is rarely a consideration. What are your thoughts?

9 IVF Side Effects

IVF involves the use of various medications, usually hormonal medications that include FSH (follicle stimulating hormone) in order to stimulate the ovaries to produce more eggs. As I’m sure many of you know, hormonal changes, among other things, can lead to an array of different side effects, many of which will occur naturally anyway as you get older and approach menopause.

  • Hot flashes – these occur without warning, characterized by a sudden onset of heat that spreads throughout the body. This can also cause excessive sweating, palpitations, red flushes – blushing.
  • Feeling stressed out, down in the dumps and an increased sense or irritability.
  • Headaches, ranging from tension headaches – constant ‘everyday’ type headaches, to migraines and cluster headaches.
  • Restlessness – this may be due to the drugs or the psychological effects and worries of the IVF process.
  • Ovaries may become large and painful and may increase egg production – ovarian hyper stimulation.

8 Risks

IVF is a complicated scientific procedure that involves manipulating hormones and natural bodily functions, it’s invasive and time-consuming, so there’s no saying how a person’s body will react to the rigours of IVF treatment.

  • There has been data suggesting that IVF could increase the risk of birth defects.
  • Painful ovaries due to swelling and fluid accumulation in the abdominal cavities. This could lead to heartburn, stomach pain, nausea and vomiting.
  • Complications arising from egg retrieval and implantation. It’s a highly invasive procedure that may damage surrounding structures such as the bowel or bladder.
  • Nerve damage could occur during laparoscopy.
  • There could be allergic reactions to IVF medications.
  • Ectopic pregnancy – embryo attaches outside the uterus which tragically means the pregnancy will have to be terminated.
  • Multiple births – this may be great but brings with it a lot of complications. It increases pregnancy loss and the risk of giving birth prematurely, in addition to other long-term damaging effects on the babies.

7 The Process Can Be Very Time-Consuming

IVF isn’t going to get you pregnant overnight. In most cases it’s a long, laborious process, but obviously well worth it if it means you could get pregnant at the end of it. A conventional IVF procedure could last between 1-3 months, depending on the women’s body and the type of medication that’s involved. The process of ovarian stimulation is the first stage and takes about a month. Medication needs to be taken to stimulate the ovaries into producing and releasing multiple eggs, then there needs to be a number of scans/check-ups before the egg retrieval procedure can take place. Once fertilized, the egg needs to be inserted back into the uterus, which is actually one of the shortest procedures and only lasts about 40 minutes or so. Then there’s pregnancy tests, blood tests etc. so be prepared for a long and lengthy process.

6 Common Misconceptions

Firstly, lets mention infertility – what does infertility really mean? Well infertility doesn’t mean you can’t have a baby and will never be able to, it just means you won’t be able to do so naturally. It’s important to note that IVF doesn’t cure infertility. It’s a way around infertility, a way to help infertile couples get pregnant and mothers to carry their own children. So if you have a medical or physical condition that prevents you from conceiving, IVF is not a cure and your condition won’t be treated with IVF- it’s not a treatment. The purpose of IVF is so you can get pregnant and hopefully give birth to a normal, healthy baby. When you receive IVF your fertility won’t be miraculously restored, even if the process works. You’ll still need help if you want to get pregnant in the future, and sort out any underlying medical issues.

5 It’s Costly

If you’re looking to get pregnant you’re likely to throw everything into it and spend whatever it takes to make it happen. But IVF costs thousands of dollars, so the cost factor is something that must be considered, and there’s no guarantee of success at the end of it. Those looking into IVF do their research and find out about the costs, but many overlook the fact that the cost of the cycle won’t be the only payment on their bill. Many treatment centres often quote the cost of the cycle and not the entire treatment – they’re crafty like that and somewhat despicable because they know that costs will rarely be the main consideration for patients undergoing IVF. The cost of the entire treatment is different to cycle costs and far more expensive. Treatments are put together and tailored to suit your circumstances so these vary from patient to patient. So don’t get suckered in to thinking that the cycle cost prices are all you’re going to have to pay!

4 Success Rates

This is the thing with IVF. You spend all that money, all those sleepless nights tossing and turning waiting to get pregnant, then you receive the positive result, the result you’ve been wanting for years and years and then there’s joy and jubilation and a sense of completeness, of utter happiness. Now to put a dampener on things – IVF doesn’t mean the pregnancy will necessarily be a success. In fact, because you’re likely to be older when you have IVF, or have complications to begin with, the chances of giving birth to a healthy baby aren’t anywhere near 100%. However, it’s important to note that  many clinics have their own statistics that could relate to the success of fertilization, pregnancy or giving birth – therefore statistics vary considerably between treatment centres. This isn’t to deter you from IVF. Just ensure you look at what’s being measured when comparing the statistics of different labs and clinics.

3 Consider Freezing Your Eggs?

Nowadays many women under the age of 35 are taking to freezing their eggs and storing them away for safe keeping with the intention of possibly using them later in life. If you’re not ready to start a family right now but are definitely contemplating doing so in the future, this would be perfect, because the age-related risks of IVF would be greatly reduced. That’s because frozen is just as good as fresh when it comes to eggs. When they’re thawed out for use, the eggs will remain healthy and viable, in the same condition as when you had them frozen. A lot of women have gone down this route in recent years. There have been numerous instances of older women, menopausal and postmenopausal who have gotten pregnant as a result of freezing their eggs when they were younger and using them for IVF. By freezing your eggs, it also cuts a lot of time out of the IVF procedure, because you won’t have to take a lot of the hormonal medications or go through the ovarian stimulation or egg retrieval procedure.

2 Additional Techniques 

IVF is rarely as simple as egg retrieval, fertilization then implantation. Often there’s a whole heap of other stuff that goes along with it – additional techniques that may or may not be used depending on the woman’s unique set of circumstances. Some may call these techniques add-ons, additional services that can be carried out to increase success rates such as the ERA (endometrial receptivity array) test and PGS (pre-implantation genetic screening) to screen an embryo for chromosomal abnormalities. A common procedure that’s often carried out is the use of the embryoscope. This is an incubator that provides a live camera feed so that embryonic development can be carefully monitored without removing the embryo from its ideal environment. These methods are often carried out on patients who want to stay on top of the process as much as possible and know what’s going on, but they may only be relevant depending on your specific circumstances.

1 This Technology May Destroy Traditional Notions of Parenthood

Parenthood is more than just about giving birth, it’s about the physical bond shared between a man and women who love each other leading to a family – that’s the old-fashioned notion of parenthood, a view that still holds true for many people to this day. Much of the IVF process is carried out in a lab and can get complicated – sperm banks may be used, egg donors, surrogates may be involved etc. – a traditionalist’s nightmare scenario. But if you’re a woman who’s infertile or struggling to conceive,  this is unlikely to be a consideration. But consider the effects it may have on any children you give birth to from IVF. IVF babies are far more likely to struggle with depression or substance abuse later in life and data shows they struggle to find an identity, even if donors aren’t used.

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