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Everything You Need to Know Before Going Through In Vitro Fertilization (IVF)

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This article is Medically Approved by Dr. Edward Salko

It’s a known fact that not everyone can conceive a child through conventional methods. 

When fertility issues become too complicated for common treatments, couples who wish to have a baby turn to assisted reproductive technology (ART).

The most well-known of these methods is in vitro fertilization (IVF).

According to the report US Society of Assisted Reproductive Technology (SART), about 1 million babies have been born through procedures such as the IVF from 1987 to 2015. 

Moreover, in a 2018 report, the CDC stated that about 50% of women who undergo IVF procedures lead to live births.

The stunning results and increasing success rates of IVF encouraged many couples who struggle with fertility to give it a try.

However, not everyone can undergo IVF treatment, let alone have a successful one all the time. 

First, there’s the issue of costs. The procedure is known to be expensive. Then, there’s also the matter of approval in terms of eligibility. You will have to satisfy the prerequisites of IVF before you can avail yourself of the treatment.

Nonetheless, if you’re strongly considering IVF or have come to a firm decision to take this method, it is best to learn everything there is to know so you can ensure a smooth process.

What Is In Vitro Fertilization?

ivf fertility doctor visit

In vitro fertilization or simply known as IVF, is an assisted reproductive technology involving fertilization that is manually performed on a dish.

The word in vitro is Latin for within glass. Hence, in vitro fertilization literally means conception inside a test tube or culture dish.

In terms of natural conception, fertilization takes place on the fallopian tube, wherein the egg cell waits for the sperm cell to penetrate the multiple layers of the ovum. This occurs during ovulation, where the egg cell has already been released from the ovary. Otherwise, the sperm cells would have spun for nothing.

The same goes when the sperms themselves have physical and chemical abnormalities failing to completely break the barriers that cover the egg cell – or when the sperm is in the low count.

Nonetheless, before couples are advised to consider IVF, other treatments are explored in favor of natural conception. These include medications for specific disorders such as erectile dysfunction, polycystic ovarian syndrome (PCOS), insulin resistance, etc.

In some cases, surgery is performed, such as removing varicocele and blockage in the ejaculatory duct.

Why Do Couples Use In Vitro Fertilization?

For some couples, in vitro fertilization is their last resort, while others go for it the minute they find out about their infertility. 

But whether they choose it first or last, it is clear that couples turn to IVF to conceive a child but fail to do so naturally. So it is rarely a personal choice to undergo IVF if you are perfectly fertile unless the couple plans for surrogate pregnancy.

Nevertheless, if you’ve been diagnosed with the following reproductive problems, you can consider IVF:

  • Ovulation disorders
  • Endometriosis
  • Fallopian tube blockage or damage
  • Uterine fibroids
  • Poor egg quality
  • Low sperm counts
  • Sperm abnormalities
  • Production of anti-sperm antibodies
  • Inhospitable environment in the cervix, uterus, or fallopian tube
  • Genetic disorder
  • Unexplained fertility issues

What Are the Requirements to Get IVF?

Unfortunately, IVF is not for everyone since there are health requirements both you and your partner or spouse need to satisfy. 

Likewise, if you’re planning for a surrogate pregnancy, the same prerequisites have to be met.

Check out some of the standard requirements for in vitro fertilization (IVF).

Age: Women have to be at least in their early forties during the procedure. The younger you are, the higher the success rate of live birth. In the case of egg donors, the age requirement ranges from 21 to 35 years old.

Health Condition: The surrogate or female partner must be fit without critical health conditions that could lead to high-risk pregnancies. For example, women who are obese need to shed some pounds before going through IVF.

Smoking: Nicotine affects sperm and egg quality. Hence, it only makes sense to quit smoking if you plan to go through IVF or pregnancy altogether.

Substance Abuse: Drugs and alcoholism are never good news, but they are even more detrimental when it comes to fertility. IVF and conception require sobriety to ensure its success.

Emotional Health: IVF can be a frustrating process, and the waiting period can be longer than you’d hope. Although the ART has been improving over time, the experience for each couple may vary from time to time. Therefore, mental stamina and the right emotional state are needed to withstand the negative emotions that come along with the complex procedure.

You have to meet these requirements without exceptions due to two primary reasons. 

The first is to ensure a healthy pregnancy. The second is to guarantee that the baby will develop and be born healthy. With the latter, age plays an important role. 

For example, women who carry the pregnancy terms in their 40s have a higher chance of giving birth to babies with genetic defects.

What Tests Are Done Before IVF?

couple at ivf fertility clinic

Aside from the primary eligibility requirements for IVF, couples also have to undergo several laboratory tests to evaluate their fertility and reproductive health condition. 

If problems are identified in the process, they would have to resolve the issue or consider other options.

Here are the basic tests you need to comply with before going through in vitro fertilization.

Ovarian Reserve Screening 

This test assesses if the number of viable egg cells in your ovary matches the standard quantity for your age. To get the results for this test, hormone blood levels are measured.

           Anti-Mullerian Hormone (AMH) Test: AMH is a hormone produced by the ovarian follicles, which indicates the normalcy of ovarian reserve. A fertile woman will have AMH between 1.0 to 4.0 ng/ml. Any lower than this range means decreased egg count in the ovary.

           Follicle-Stimulating Hormone (FSH) Test: FSH is responsible for stimulating the maturation of the egg cells. With men, the same principle applies to the growth and development of sperm cells. Hence, it is vital to know if there are issues revolving around FSH production by the pituitary gland.

Male Infertility Test (Semen Analysis)

Semen analysis is performed to learn about sperm count and their physical form as well as speed. These factors are essential in evaluating if the sperm that will be used for IVF are viable.  

Sexually Transmitted Diseases (STDs) Tests

Infectious diseases can diminish the success of IVF. Pathogens that cause the infection can degrade the uterine walls and sperm quality. Hence, before going through IVF, make sure that you and your partner are not infected with an STD.

Pelvic Exam

This test is performed to check the female reproductive parts physically. In the case of IVF, the main focus is usually the uterine walls or endometrial lining.

The uterine walls play a vital role in pregnancy. This is where the developing embryo will embed itself and continue to grow. The process is known as implantation marking the beginning of the pregnancy term.

How Does IVF Work?

In a nutshell, the IVF procedure revolves around taking the egg cells and sperms outside the body and uniting them in the culture dish. Then, after preparing the uterine walls, the embryos are implanted. To confirm the success of the procedure, a pregnancy test has to be performed.

What Are the Five Stages of In Vitro Fertilization?

1. Ovarian Stimulation

In this stage, the woman is given hormones to stimulate the production of healthy egg cells. Compared to the natural ovulation process, the introduction of hormones and medications will produce more egg cells, about 10 to 15, to increase the chances of embryo development.

2. Egg retrieval and Semen Collection

Once the egg cells are matured enough for harvest, they will be retrieved through a minor surgery performed with the aid of transvaginal ultrasound.

The procedure is known as follicular aspiration. The woman is under anesthesia as a needle is inserted into the ovary. The process is performed with the guide of an ultrasound wand. Then, the needle will collect the eggs with their surrounding fluid from the ovary.

The male partner will now provide the semen sample the same day as the egg cells are harvested.

3. Insemination

With the egg cells and sperm cells ready in the dish, the technician will unite them for fertilization. Usually, they are left on the dish to unite naturally. 

However, if the sperm cells fail to penetrate the egg cells on their own, a process called intracytoplasmic sperm injection (ICSI) is performed. 

In this procedure, the most viable sperm is selected based on shape, size, and other factors. Then, with the aid of tools, the sperm is injected directly into the egg cell.   

4. Embryo culture

For about a week or less, the embryo is observed on the dish. During those times, it should have already undergone multiple divisions and continuous development. 

Around this time as well, your doctor may perform genetic testing to check the normalcy and healthy embryonic growth. 

Moreover, the female partner or the surrogate is given medication to prepare the uterine lining for implantation.

5. Embryo Transfer

When the embryo reaches the blastocyst stage, it’s now ready to be embedded on the uterine wall. 

In the case of IVF, four embryos at most are implanted. The number of embryos depends on the age of the female and how many eggs were retrieved. This is done to ensure that at least one embryo survives to full term.

To validate successful implantation, a pregnancy test is performed. 

Once the test comes positive, the doctor will perform a transvaginal ultrasound in a few weeks to check how many embryos successfully developed on the endometrial lining.

How Long Does It Take to Get Pregnant With IVF?

The typical process lasts around two months, including the laboratory testing and the IVF procedures. However, this could take short or longer depending on factors such as the severity of infertility issues.

Nonetheless, if the process runs smoothly, IVF can last for four weeks, similar to your normal menstrual cycle or that of your female partner.

Does IVF Lead To A High-Risk Pregnancy?

No. IVF by itself does not induce high-risk pregnancy. In fact, a majority of women who have undergone IVF experienced normal healthy pregnancies. 

On the other hand, if you’re over 40 and have decided to go through IVF, you may be looking at carrying a complete term on high risk.

However, there is a stigma that IVF pregnancies pose more health threats than natural pregnancies.

According to research, IVF and ICSI have a higher correlation of pregnancy complications primarily because of circumstantial relations. 

Women undergoing IVF are mostly diagnosed with fertility issues and are older, which influences the pregnancy outcome. This is why complying with the requirements and preparing your body for IVF are crucial steps.

Nevertheless, experts continue to deem IVF and ICSI as safe and effective alternative methods for pregnancy.

How Much Does It Cost to Do In Vitro Fertilization?

On average, a single IVF cycle can cost anywhere between $12,000 to $20,000.

Some insurance plans cover the cost of the procedure, but this depends mainly on the policy you avail of and whether the company offers the said coverage.

Moreover, the actual cost depends on the fertility treatments you need to undergo.

What Are the Side Effects of In Vitro Fertilization?

IVF may have several side effects, but none of them are life-threatening. Perhaps just mildly uncomfortable. 

Check out some of the potential side effects you may experience during the IVF procedure.

Ovarian hyperstimulation syndrome (OHSS) is an amplified response to superovulation or ovarian hyperstimulation. Symptoms of OHSS include the following:

  • Bloating
  • Nausea or vomiting
  • Weight gain
  • Abdominal pain  
  • Diarrhea

Other sides effects are:

  • Breast tenderness
  • Headache
  • Hot flushes
  • Mood swings
  • Fatigue
  • Allergic reactions
  • Bruising at the injection site
  • Emotional stress

The Bottom Line

It’s no secret that in vitro fertilization involves delicate procedures. Not to mention its staggering cost for a single cycle.

That’s why you will need to take in all the information you can get before deciding to go in vitro. A crucial part of this is the requirements and laboratory tests needed for IVF eligibility.

Furthermore, it is still best to coordinate and consult your OB GYN and fertility doctor. IVF’s success rate depends on how issues are resolved before and during the procedure. 

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