Is IVF a good option for you?
Would it be suitable? What are the tests to be taken? Find out.
The birth of Louise Brown through in vitro fertilization (IVF) in 1978 was a major milestone in infertility treatment. It dramatically changed the treatment options for infertile
couples, and techniques for assisted reproduction have evolved rapidly
since then. In a short span of 20 years, IVF has become the cornerstone of
reproductive medicine, and IVF clinics today routinely perform techniques
which were thought to belong to the realm of science fiction a generation
IVF is the basic assisted reproduction
technique, in which fertilization occurs in vitro (literally, in glass).
The man's sperm and the woman's egg are combined in a laboratory dish,
and after fertilization, the resulting embryo is then transferred to the
woman's uterus. The five basic steps in an IVF treatment cycle are superovulation
(stimulating the development of more than one egg in a cycle), egg retrieval,
fertilization, embryo culture,
and embryo transfer.
IVF is a treatment option for couples
with various types of infertility, since it allows the doctor to perform
in the laboratory what is not happening in the bedroom - we no longer have
to leave everything upto chance!
Initially, IVF was only used when
the woman had blocked, damaged, or absent fallopian tubes (tubal factor
infertility). Today, IVF is used to circumvent infertility caused by practically
any problem, including endometriosis; immunological problems; unexplained infertility; and male factor infertility. It is a final common pathway,
since it allows the doctor to bypass nature's hurdles and overcome its
inefficiency, so that we can give Nature a helping hand!
Tests Prior to
In order to perform IVF, only 3 things
are required - eggs, sperm and a uterus, and before starting the IVF cycle,
the doctor will check these.
First, a sperm survival test is carried
out This is a "trial" sperm wash, using exactly the same method as
will be actually used in IVF, to assess whether an adequate number of sperm
can be recovered in order to do IVF. This test will also help the laboratory
to decide which method of sperm processing should be used during IVF.
A blood FSH level will provide an
idea of the "ovarian reserve", and provide information on whether or not
the woman will produce enough eggs after
superovulation. For older women,
some clinics do a clomiphene citrate challenge test. If the FSH level is
very high, this suggests early ovarian failure, and it may be a better
idea to consider donor eggs.
Many clinics may do a hysteroscopy,
in order to assess that the uterine cavity is totally normal. They may
also do a "dummy" embryo transfer to make sure there are no technical problems
with this procedure. Some clinics also do a cervical swab test, to rule
out the presence of infection in the cervix.
If a woman has blocked fallopian tubes with large hydrosalpinges, some clinics will remove these prior to
the IVF cycle, because they feel that the presence of a hydrosalpinx decreases
pregnancy rates after IVF.
For men who have difficulty in producing
a semen sample "on demand", the clinic may also freeze and store the sample
prior to treatment, as a backup. This can help to prevent the tragedy of
having to abort an entire treatment cycle because the man could not produce
a semen sample when needed.
Blood tests which may be done include
tests for immunity to rubella; and tests for Hepatitis B, and AIDS. Most
doctors will also advise patients to start taking folic acid, as part of
pre-pregnancy care, as this helps to reduce the risk of certain birth defects.
Patients who stand a very poor chance
of success with IVF include the following:
Older women, whose ovaries are failing.
However, there is no upper age limit at which IVF should not be done. And,
in fact, for older women, it might represent their only chance of success.
It's not really the age of the woman which is the limiting factor; it's
the quality of her eggs.
Men whose sperm count is very low. Most
clinics will consider doing IVF only for men with at least 3 million motile
sperm in the ejaculate. If the sperm counts are lower than this, then ICSI
(or microinjection) is a better option.
Women with a damaged uterus (for example,
because of healed tuberculosis) because the chance of successful implantation
of the embryo in the uterus becomes very poor.
It is also not advisable to go
in for IVF treatment without trying simpler treatment options first. IVF
is a complex procedure involving considerable personal and financial commitment,
so other treatments are usually recommended first.
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- The Indiaparenting Team