In-vitro Fertilization or IVF is a ‘test-tube’ baby technique. It is an Assisted Reproductive Technology (ART) which is used for infertility treatment and gestational surrogacy, which include implantation of a fertilized egg into female’s uterus. For women who cannot produce their eggs due to advanced age or other causes, IVF can be done using donor eggs.This method can be used to overcome a range of fertility issues and give couples a chance of having a baby.
In-vitro Fertilization is a treatment option if:
- any woman’s fallopian tubes are blocked and can’t be repaired
- any woman has endometriosis
- any the man has low sperm counts
- artificial insemination has not been successful
- any woman has had an unsuccessful tubal ligation reversal surgery
Process of In-vitro Fertilization
Step 1: Ovulation induction:
The preparation for an assisted reproductive procedure using any woman’s eggs requires hormonal treatment to control her egg production from an ovary (ovulation).
This is done so that unpredictable ovulation can be prevented. This is done by the use one of two similar types of hormones – Gonadotropin-releasing hormone analog – GnRH agonist or GnRH antagonist.
Step 2: Sperm collection:
Sperms are collected using masturbation or by taking sperm directly from a testicle through a small incision.
This procedure is usually used when there is a blockage that is preventing sperm from being ejaculating or when there is an issue with sperm development.
Sperm can also be collected and frozen earlier. Then thaw the sperm on the day when the eggs are collected
Step 3: Fertilization and embryo transfer:
The eggs and sperm collected are placed in a glass Petri dish and incubated carefully at a controlled temperature, infection free atmosphere for 48-120 hours.
Then about 2 to 5 days after the fertilization, the best fertilized eggs are selected.
One to three fertilized eggs is placed in the uterus with the help of thin flexible tube (catheter) that is inserted into the uterus through the cervix. The rest fertilized eggs can be frozen (cryopreserved) for future attempts.
The implanted embryos may result in pregnancy, and therefore, the birth of one or more infants takes place.
How does it work?
It begins with hormone therapy to stimulate the development of follicles in the ovary, then these eggs are collected, and then they are fertilized in a test-tube, to create several embryos.
After incubating these embryos for 2-5 days, one or two of these embryos are transferred to the uterus through the vagina, where implantation normally occurs, and pregnancy begins.
In IVF, unlike natural conception, not all embryos implanted become a successful pregnancy that is why extra embryos are frozen so that more transfer might be tried if the first trial fails.
The most common ‘side effect’ associated with IVF has increased chances of multiple pregnancies.
There is also a possibility that some women (1-2%) may over-react to the hormone drugs which is used to stimulate the ovaries, i.e., Ovarian Hyperstimulation Syndrome (OHSS). So, the doctor uses ultrasound and does hormone monitoring during this phase to ensure that the reaction can be observed and the side effect can be avoided.
Other side effects that can be seen are bloating, headache, breast tenderness, upset stomach, hot flashes, skin irritation, and mood swings.
Are there risks involved in IVF?
- Ectopic pregnancy – This occurs when an embryo is implanted outside the uterus most commonly in the fallopian tube. It can happen in the ovary.
- Multiple births – the birth of twins, triplets or more kids
- Drug reaction
- Birth defects
- Ovarian hyperstimulation syndrome (OHSS)
In 2017 women having In-vitro Fertilization (IVF) using fresh embryos created with their fresh eggs, the percentage of cycles started that resulted in pregnancy was:
With age, the ability of a woman to conceive a child through In-vitro Fertilization reduces significantly. If one is using her eggs, on average, the younger she is, the higher would be the chances of success.