Insight into In-Vitro Fertilisation (IVF): Procedure, Preparation & Risks

There are a very few joys in the world that can compare to the joy of being blessed with a child. Unfortunately, due to various factors, an increasing number of couples these days are finding it difficult to conceive. That’s where In-Vitro Fertilisation, or IVF for short, comes in as a ray of hope for such couples to make their dream of parenthood come true. That said, it is extremely important for couples to understand the finer lines of this procedure, in order to have a successful outcome and minimise its risks. To help, in this blog post, we cover all that you need to know about IVF, including its preparation and risks. But first, let’s cover the basics. 

What is IVF?

IVF, or In Vitro Fertilisation, is a medical procedure designed to help individuals or couples conceive a child. It involves combining an egg and sperm outside the body in a laboratory setting to create an embryo, which is then implanted into the uterus. IVF is commonly used to treat infertility and other reproductive issues.

What are the Steps of IVF Treatment?

The steps of IVF treatment typically include:

1. Birth Control Pills or Oestrogen: Prior to the start of the IVF cycle, birth control pills or oestrogen may be prescribed to regulate the menstrual cycle and prepare the ovaries for stimulation.
2. Ovarian Stimulation: Hormone injections are administered to stimulate the ovaries to produce multiple eggs rather than the single egg that typically develops each month. This increases the chances of retrieving multiple eggs for fertilisation.
3. Monitoring: Regular blood tests and ultrasounds are conducted to monitor the development of the ovarian follicles (where the eggs develop). This helps to track the response to the stimulation medications and adjust dosages if necessary.
4. Trigger Shot: Once the follicles have reached the appropriate size, a trigger shot of human chorionic gonadotropin (hCG) or another medication is given to induce the final maturation of the eggs and prepare them for retrieval.
5. Egg Retrieval: Approximately 36 hours after the trigger shot, a minor surgical procedure is performed to retrieve the mature eggs from the ovaries. This is typically done under sedation using a thin needle guided by ultrasound.
6. Fertilisation: The retrieved eggs are combined with sperm in a laboratory setting to achieve fertilisation. This can be done using conventional fertilisation or through Intracytoplasmic Sperm Injection (ICSI), where a single sperm is injected directly into an egg.
7. Embryo Development: The fertilised eggs (embryos) are cultured in the lab for a few days to allow them to develop. Embryologists monitor the embryos to assess their growth and quality.
8. Embryo Transfer: One or more healthy embryos are selected and transferred into the uterus using a thin catheter. This is a simple procedure that does not require anaesthesia.
9. Pregnancy: About two weeks after the embryo transfer, a pregnancy test is conducted to determine if implantation and pregnancy have occurred. If successful, the pregnancy will be monitored through regular follow-ups.

Who should Go for IVF?

IVF may be considered for individuals or couples experiencing various fertility issues, including:

• Blocked or Damaged Fallopian Tubes: Women with tubal factor infertility, where the fallopian tubes are blocked or damaged, preventing the egg and sperm from meeting naturally.
• Male Factor Infertility: Men with low sperm count, poor sperm motility, or other sperm-related issues that affect the ability to fertilise an egg.
• Ovulation Disorders: Women who have irregular or absent ovulation, such as those with polycystic ovary syndrome (PCOS).
• Unexplained Infertility: Couples who have not been able to conceive despite having no identifiable cause of infertility after thorough evaluation.
• Age-Related Infertility: Women over the age of 35 who you have not been able to conceive naturally, as fertility tends to decline with age.
• Endometriosis: Women with endometriosis, a condition where tissue similar to the lining of the uterus grows outside the uterus, potentially affecting fertility.
• Genetic Disorders: Couples at risk of passing on genetic disorders to their children may use IVF in conjunction with preimplantation genetic testing (PGT) to ensure healthy embryos.
• Previous Failed Fertility Treatments: Individuals or couples who have not succeeded with other fertility treatments, such as intrauterine insemination (IUI), may consider IVF.
• Single Women: Same-sex couples or single individuals who wish to have a biological child may use IVF with donor sperm or eggs and a gestational carrier if needed.

What are the Risks and Complications of IVF?

IVF, while generally safe, does carry certain risks and potential complications, including:

• Ovarian Hyperstimulation Syndrome (OHSS): This occurs when the ovaries over-respond to the fertility medications, leading to swollen and painful ovaries. Symptoms can range from mild (bloating, mild pain) to severe (rapid weight gain, severe abdominal pain, shortness of breath).
• Multiple Pregnancies: IVF increases the likelihood of multiple pregnancies (twins, triplets, etc.), which can pose higher risks for both the mother and the babies, including preterm birth and low birth weight.
• Ectopic Pregnancy: This occurs when a fertilised egg implants outside the uterus, usually in a fallopian tube. Ectopic pregnancies can be dangerous and require prompt medical attention.
• Emotional and Psychological Stress: The IVF process can be emotionally and psychologically taxing, involving significant stress, anxiety, and sometimes disappointment, especially if multiple cycles are required.
• Bleeding and Infection: The egg retrieval procedure carries a small risk of bleeding, infection, or damage to the bowel, bladder, or blood vessels.
• Ovarian Torsion: Rarely, the ovaries can become twisted due to enlargement from stimulation, which can cut off their blood supply and cause severe pain and require surgical intervention.
• Medication Side Effects: Fertility medications can cause side effects such as headaches, mood swings, abdominal pain, hot flashes, and bloating.
• Failed Cycle: Despite best efforts, IVF does not guarantee a successful pregnancy. A cycle can fail at any stage, leading to emotional and financial strain.

It’s important for individuals or couples considering IVF to discuss these risks and complications with their healthcare provider to make an informed decision.

How to Prepare for IVF Treatment?

Preparing for IVF treatment involves several steps to ensure you are physically and emotionally ready for the process. Here are some key preparations:

Medical Evaluation

• Consultation with a Fertility Specialist: Meet with a fertility specialist to discuss your medical history, perform necessary tests, and develop a tailored treatment plan.
• Health Check-ups: Ensure you are up to date with general health check-ups and address any underlying medical conditions.

Lifestyle Modifications

• Healthy Diet: Adopt a balanced diet rich in vitamins, minerals, and antioxidants to support reproductive health.
• Regular Exercise: Engage in moderate exercise to maintain a healthy weight and reduce stress.
• Avoid Harmful Substances: Quit smoking, limit alcohol intake, and avoid recreational drugs.

Emotional and Psychological Preparation

• Counselling: Consider seeing a counsellor or joining a support group to manage the emotional aspects of IVF.
• Stress Reduction: Practise stress-reducing techniques such as yoga, meditation, or mindfulness.

Financial Planning

• Cost Assessment: Understand the costs involved in IVF treatment, including medications, procedures, and potential additional expenses.
• Insurance and Financing: Check if your insurance covers any part of the treatment and explore financing options if needed.

Medication and Supplements

• Prescribed Medications: Follow your doctor's instructions regarding any medications or hormone treatments needed before starting IVF.
• Supplements: Take any recommended supplements, such as folic acid, to improve your chances of a successful outcome.

Organisational Preparation

• Schedule Coordination: Plan your schedule to accommodate clinic visits, monitoring appointments, and procedures.
• Support System: Arrange for support from family and friends, especially during the more intensive phases of the treatment.

Education

• Research: Educate yourself about the IVF process, potential risks, and what to expect during each step of the treatment.
• Questions for Your Doctor: Prepare a list of questions to discuss with your fertility specialist to address any concerns or uncertainties.

Being well-prepared can help you feel more in control and increase your chances of a successful IVF treatment.

What to expect after IVF treatment?

After IVF treatment, you can expect several steps and potential outcomes, each of which involves careful monitoring and follow-up:

Immediate Post-Procedure Recovery

• Rest and Recovery: After the embryo transfer, you may be advised to rest for a short period. Some women may experience mild cramping or spotting, which is normal.
• Resuming Activities: You can usually resume normal activities within a day or two, but strenuous exercise and heavy lifting should be avoided.

Two-Week Wait

• Emotional Considerations: This period can be emotionally challenging as you wait to find out if the procedure was successful. Support from family, friends, or a counsellor can be helpful.
• Medication: You may need to continue taking prescribed medications, such as progesterone, to support the uterine lining and implantation.

Pregnancy Test

• Timing: Approximately two weeks after the embryo transfer, a blood test (beta hCG) is performed to determine if you are pregnant.
• Results: If the test is positive, it indicates a potential pregnancy, and further monitoring will be required. If negative, your doctor will discuss next steps and options for future cycles.

Early Pregnancy Monitoring

• Follow-Up Appointments: If pregnant, you will have regular blood tests to monitor hormone levels and ultrasounds to confirm the pregnancy and check for a heartbeat.
• Pregnancy Support: You may continue to take certain medications to support the pregnancy during the first few weeks.

Handling Multiple Pregnancies

• Risks: IVF increases the likelihood of multiple pregnancies, which come with higher risks and require careful monitoring.
• Decisions: In the case of multiple embryos, decisions about selective reduction may be discussed to reduce risks.

Emotional and Psychological Support

• Coping with Outcomes: Whether the outcome is positive or negative, emotional support is crucial. Counselling or support groups can provide valuable assistance.
• Future Planning: If the cycle is unsuccessful, your doctor will help you understand the reasons and discuss options for future treatment, including the possibility of additional IVF cycles or alternative treatments.

Financial Considerations

• Cost Implications: Be prepared for the financial aspects, especially if multiple cycles are needed. Review insurance coverage and financing options as necessary.

Every individual's experience with IVF is unique, and outcomes can vary. It is important to maintain open communication with your healthcare provider throughout the process to address any concerns and receive the appropriate care and support.

Final Words

If you are considering IVF treatment or have questions about your fertility options, it is crucial to consult with a specialist who can provide personalised guidance and support. Max Hospitals, with experienced fertility experts and state-of-the-art facilities, is dedicated to helping you achieve your dream of parenthood. Our compassionate and comprehensive approach ensures that you receive the best possible care at every step of your journey. Reach out to a specialist at Max Hospitals today, to explore the options available to you. Your path to parenthood begins here.