Introduction to In Vitro Fertilization (IVF)

Jack Prot

In Vitro Fertilization or IVF as it is more commonly known, is the process by which eggs and sperm are put together in a glass under laboratory conditions. This is so the sperm is able to fertilize the egg. Literally speaking, the term IVF just means ‘fertilisation in a glass’ or you may also have heard another term associated to this procedure as ‘test tube babies’.

During the process of IVF, the eggs are taken from the woman’s ovaries and fertilised with the sperm in a laboratory or specialist clinic. Once the egg is fertilised, the embryo is then put back into the woman’s womb so pregnancy can begin.

Before a woman can start with IVF treatment using her own eggs, she needs to undergo a series of hormone treatments in order to help control ovulation. This is when the body produces eggs on a regular basis, so the hormone treatment is given to reduce the unpredictable possibility of ovulation. If the eggs are produced when they are not required this could lead to ruining that particular IVF procedure. The hormone treatment itself is usually administered in one of two ways, GNRH Agonist or GNRH Antagonist.

GNRH Agonist controls ovulation by shutting down a woman’s pituitary. For 2 weeks the woman is monitored closely before any eggs are retrieved. While at home, the woman’s partner will then inject her with more stimulating hormones that will encourage the ovaries to make more eggs than it would do normally. This is called superovulation.

GNRH Antagonist is used in similar ways but lasts over 5 days in which follicle stimulating hormone are injected so that the eggs can begin to superovulate.

The eggs are then collected about 36 hours after this procedure. Guided by ultrasound a doctor will remove them by using needle aspiration. After this, the man’s sperm is then collected by way of masturbating. If there is a problem and the man is unable to ejaculate, then sperm is collected directly from testicle using a surgical procedure. The eggs and sperm are then placed into a dish under special laboratory conditions. They are then incubated and carefully monitored for up to 120 hours. The best and most suitable fertilised eggs are then taken and transferred to the uterus using a catheter that is inserted directly into the cervix. Any embryos that successful embedded into the uterus could then result in pregnancy and birth the birth of a baby or babies.

Why Have This Type of Treatment?

An IVF procedure may be used if a woman or a man has a problem with their body’s reproductive systems. Such as, a woman’s fallopian tube might have a blockage or be missing altogether meaning that eggs are unable to travel down to the uterus naturally. She could have other unexplained infertility issues that have gone on for a prolonged period of time and due to her age and personal situation may try to use IVF to become pregnant. But is it not just a woman’s health problem that can lead to the use of IVF. It is also commonly used if a man has a low sperm count and is also used if other artificial insemination procedures have not been a success.

The benefit to this type of treatment is that it can still be successful even if the woman has no fallopian tubes, or they are blocked and unable to be repaired. Even if a woman is unable to produce her own eggs IVF treatment can still be performed. Another benefit to having this treatment is that a couple are able to test for a potential disorder that could be inherited while transferring embryos.

In America the cost of having treatment of this kind can range anywhere from $10,000 to $20,000, yet the successfulness of the procedure can depend on many factors, including, age, health and the history of pregnancy. Statistics claim about 40% of women under the age of 35 successfully fall pregnant using IVF treatment, yet when a woman is over 35 the procedure can be much less successful. Also, a woman who has already had children naturally is much more likely to be successful with IVF treatment than a woman who hasn’t. However, the advantage of having a natural birth begins to decrease as women age from 30 to 40.

What Are The Risks?

One of the main risks associated with in vitro fertilisation is that it can increase the chances of hyperstimulation of the ovaries which can lead to multiple pregnancies. The hyperstimulation occurs in approximately 2% of all women using IVF treatment and almost 40% of births from IVF treatment resulted in producing twins or higher number of babies. However, doctors should be able to advise the woman on multi pregnancies and in turn decide how many embryos will need to be transferred. Depending on a woman’s age and condition the decision might be made to limit the number of transferable embryos in order to increase the changes of healthy pregnancy and survival with one baby. Many IVF procedures are not only physically demanding for the woman but they can also be emotionally difficult too.

As mentioned, a woman’s chances of successfully conceiving are dramatically reduced the older she is. Women aged 40 and over may have anywhere between a 4% to 10% chance of being successful, so it is important great consideration is placed on the financial implications as one cycle of in vitro fertilisation treatment can cost as much as $20,000 which, if unsuccessful, can be a lot of money to spend on a procedure of this kind. However, a successful pregnancy can often be worth more than anything to a couple who have tried, unsuccessfully to conceive in the past. Prices can also often vary depending on the private health clinic and it is important that people who are thinking about IVF discuss in great detail with the clinic before undergoing such treatment. Sometimes there can be an additional charge incurred for further treatment, injections and medications so it is important to understand fully the financial implications of treatment of this kind.

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