Fertility treatment: In vitro fertilization (IVF)

In vitro fertilization (IVF) is a fertility procedure that combines sperm and eggs in a laboratory. The resulting embryos are evaluated for their quality, and one or more are introduced through the cervix into the uterus.

IVF is by far the most extensively used high-tech fertility treatment, accounting for more than 99 percent of Assisted Reproduction Technique (ART) procedures. Approximately 1.5 percent of US-born babies are treated with ART.

Is In vitro fertilization (IVF) for me?

In vitro fertilization (IVF) can help you get pregnant if you have difficulties with ovulation or egg quality, blocked fallopian tubes or endometriosis; if your spouse has difficulties with the sperm count or the mobility; or if you use donor eggs to get pregnant.

IVF can also be an option if your doctor can not pinpoint the problem (this is called "unexplained infertility") or if other treatments were unsuccessful.

How does IVF work?

The IVF treatment schedule usually looks like this:

·Ovo stimulation. Eight to 14 days before the onset of the menstrual cycle, you are taking a gonadotropin, a kind of fertility drug that stimulates your ovaries to develop several mature eggs for fertilization (rather than just 1). You also need to take a artificial hormone such as leuprolide or cetrorelix, so your body does not release the eggs too soon.

·Follikelentwicklung. While taking these medications, visit your doctor's office or clinic every two to three days to control your blood hormone levels and use ultrasound measurements of your ovaries. That will allow your doctor to monitor the development of the follicles - the fluid-filled sacs in which the eggs are ripening.

·The trigger shot. When the follicles are ready, you will receive a "trigger shot," an injection that causes the eggs to fully mature and fertilize. About 36 hours after the launch, your eggs are ready to be picked up.

·Recover the eggs. Your doctor will give you an anesthetic and insert an ultrasound probe into your vagina to look at your ovaries and recognize the follicles. A thin needle is then inserted through the vaginal wall to remove the eggs from the follicles. Eight to 15 eggs are usually retrieved. You may get a few cramps after a few days, but most women will feel better in a day or two.

·Fertifizierung. An embryologist (a scientist specializing in eggs, sperm and embryos) examines your eggs before combining them with your partner's semen and incubating them overnight. Fertilization usually occurs during this time, but eggs that are not normal should not be treated. (If sperm condition is bad or if fertilization was not successful during previous IVF cycles, your doctor might recommend a technique called Intracytoplasmic Sperm Injection (ICSI).) In ICSI, a single sperm is injected directly into each mature egg.)

·Growth of embryos. Three days after egg retrieval, some of the successfully fertilized oocytes become six- to ten-cell embryos. On the fifth day, some of these embryos become blastocysts with a fluid-filled cavity and tissues that begin to separate into placenta and baby.

·Embryonenauswahl. The embryologist selects the most viable embryo or embryos to be stored in your uterus three to five days after taking the egg. Additional embryos, if any, can be frozen and used for future IVF cycles.

·Seeding of embryos. Depending on your age and analysis, your doctor places between 1 and five embryos in your uterus by entering a thin tube (a catheter) through your cervix. You may feel a slight cramp, but you do not need anesthesia.

·Successful implantation. When the treatment works, an embryo is implanted in your uterine wall and remains to grow into a baby. Keep in understanding that if more than one embryo is transferred, your chances of becoming pregnant are higher, as well as the likelihood of multiple pregnancies - about 20 percent of IVF born babies are twins, triplets, or more.

You can do a pregnancy test about two weeks after the embryos have been implanted into your uterus.

How long does IVF take?

It takes about four to six weeks to develop an IVF cycle.

You have to wait a few weeks for your eggs to be ripe. Then you and your spouse spend about half a day in your doctor's office or clinic, where your eggs are recovered and fertilized. You have to return three to five days later to introduce the embryos into your uterus, but you can go home the same day.

What is the success rate for IVF?

The results of IVF vary dramatically, depending on the reasons for each couple's infertility and their age. Immature women usually have healthier eggs and higher success rates. Based on recent national data, the percentage of IVF cycles leading to living birth (where one or more babies are born) is approximate:

·40 percent of women under the age of 34

·31 percent of women aged 35 to 37 years

·21 percent of women aged 38 to 40 years

·11 percent of women aged 41 to 42 years

·5 percent for women aged 43 and over

What are the benefits of IVF?

·Successful track record. IVF is the oldest assisted reproductive system (ART) on the block - it's been nearby since 1978. IVF has been practiced long enough for researchers to carry out extensive health studies on children conceived using this method. So far, no medical problems are directly linked to the procedure.

·no connection to cancer. Recent studies have shown no association between ovulation-inducing fertility medicines and cancer. Early studies advised that exposure to fertility drugs could increase the risk of ovarian cancer or other cancers of the female reproductive system.

·Improved techniques. The researchers refine and develop the IVF procedure further. For example, advances in cryopreservation of embryos (freezes) have resulted in IVF pregnancy rates that are approximately the same for frozen and fresh embryos.

What are the disadvantages of IVF?

Cost-intensive and time-consuming Fertilizing your eggs outside of your body require expensive lab work and medication. Monitoring your fertility drug response also requires a lot of time, frequent visits to the doctor's office for blood tests and ultrasound scans.

·Odds of multiples. Since more than one embryo can be stored in your uterus, your chance of getting twins or more is about 20 percent. Although many couples consider this a blessing, multiple fetuses increase your risk of miscarriage and other complications, such as premature labor. Some doctors advise you to consider selective reduction when three or more embryos are happily implanted. That is a serious decision with big emotional and psychological consequences. IVF researchers are working on techniques to prevent multiple fetuses.

·Risk of ectopic pregnancy. Women who have difficulty getting pregnant are at increased risk for ectopic pregnancy, regardless of how pregnant they are. And all artificial insemination treatments, including IVF, also make ectopic pregnancy more likely. An ectopic pregnancy occurs when the embryo is implanted in an oviduct or the abdominal cavity rather than in the uterus. It is treated with the drug methotrexate or by surgically removing the embryo to prevent it from seriously injuring the mother as he continues to grow.

·Risk of ovarian hyperstimulation syndrome (OHSS). OHSS can occur when women respond too well to fertility drugs and produce too many eggs. About 10 to 20 percent of women taking gonadotropins develop a mild form of OHSS, a condition characterized by weight gain and a full, bloated feeling. Some also have shortness of breath, dizziness, abdominal pain, nausea, and vomiting. When you have OHSS, your ovaries swell many times their normal size and produce fluid that builds up in your abdominal cavity. Normally, this will be resolved with careful monitoring by a doctor and bed rest. But in rare cases it is life-threatening, and you may need to be hospitalized for more intensive monitoring or treatment.

·Possible developments for the baby. Babies who are managed with high-tech treatments for infertility such as IVF are more likely to be born prematurely or have a low birth weight. You may also have a slightly higher risk of birth defects. But experts are not sure if that comes from the factors that cause infertility (like age) or the treatments.

·It may not work. Up to 20 percent of IVF cycles can be stopped before the eggs are removed, usually because not enough follicles have been developed. Reducing the risk of OHSS is another reason for the cancellation.

What does IVF cost?

In India, Pund Check YashIVF hospital IVF treatment cost in Pune also, In the United States, expect to spend an average of $ 12,400 on a cycle of IVF when using your partner's eggs and sperm. The amount you pay depends on how much medicine you need, where you live, and whether your state requires insurance coverage for fertility treatments. If your insurance does not cover these, you probably have to pay the full cost in advance.