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Houston Fertility Journal

    What is In Vitro Fertilization (IVF)?

    June 22, 2018 / by Center of Reproductive Medicine   

    Center of Reproductive Medicine


    For many couples that are struggling in their journey to expand or start their families, the idea of In Vitro Fertilization better known as IVF will come up. There are a lot of misconceptions about it floating around on blogs and in the media, however. Today, we’ll break down some of those misconceptions, and hopefully answer many of the questions you may have about IVF.

    Things like:

    • What is IVF?
    • Will IVF guarantee me a baby?
    • Do all couples need IVF?
    • Are there side effects to IVF treatments?
    • Can you do anything to help your chances of success with IVF?
    • Is it true IVF is only for the wealthy?
    • And many others

    What Exactly is In Vitro Fertilization?

    The basics: In Vitro Fertilization or IVF, is a fertility treatment that involves the extraction of eggs and sperm samples, then combining them manually in a lab. If and when fertilization occurs, the embryo or embryos are placed back into a female’s uterus in hopes of implantation.   

    The conditions must be just right for fertilization to take place

    As fertility expert Robert Winston says, precisely the right conditions must be in place for fertilization to occur with an IVF procedure.

    “You need the right temperature, the right medium, the right amount of gas (enough carbon dioxide and so on) in the atmosphere, and then you put this in an incubator for between two and five days. Then, the resulting embryos, if there is a resulting embryo, sometimes embryos, are put back into the uterus. And with luck, one or more will implant.”

    How does IVF work?

    Now that you’ve got the basics, let’s break down how an IVF procedure works step-by-step:

    1. The first step is the stimulation of egg production through the use of prescribed fertility medications. As Winston explained, the trouble is that a woman only produces one egg each cycle that is fertilizable. Therefore, what must be done is the administration of drugs to make a larger quantity of eggs that can be fertilized, in hopes of achieving a viable embryo, or several embryos.

    After fertility medications are administered, a transvaginal ultrasound will be performed to examine the ovaries. Blood samples for the purposes of checking hormone levels will also be taken.

    1. The second step involves the retrieval of the fertilizable eggs through a minor surgical procedure. This procedure involves using ultrasound imaging to guide a hollow needle through the woman's pelvic for the extraction of the eggs.

    If this sounds like it will be painful, fear not. Your fertility doctor will administer medication that should help reduce or even prevent any discomfort you may have during this procedure.

    1. Next, the male will be asked to give a sperm sample. This sample will be used to combine with the eggs in hopes of fertilization. Which brings us to the fourth step.
    1. This step is where the sperm and eggs are manually combined, and stored in a laboratory dish to aid in fertilization. This process is commonly referred to as insemination.

    Depending on whether or not there is a low probability of fertilization occurring, intracytoplasmic sperm injection (ICSI) might be used. The way ICSI works it that the sperm will be directly injected into an egg to better encourage fertilization of the egg.

    The fertilized egg, if one should be produced, is called an embryo.

    1. Finally, is the implantation process. Roughly three to five days after the retrieval and fertilization, the embryo or embryos, will be physically transferred into the woman’s uterus by way of a catheter (a thin, flexible tube). Most women don’t feel any discomfort during this process, but some do experience mild cramping.

    Once the embryo or embryos have been transferred your doctor will advise you as to what will happen next, and will most likely continue prescribing fertility medications. Should the IVF procedure be successful, implantation will happen between six and ten days after the eggs have been retrieved. Roughly two weeks after the embryo transfer you may be advised to take a pregnancy test.

    Will IVF guarantee me a baby?


    As with all things, there are no guarantees in medicine. Anyone who says otherwise may prove to be untrustworthy. While there may be things you can do to increase your chances of success, two people in the same physical health, with similar attributes, doing “all the right things” may have very different results.

    There are too many factors in play within our bodies to make blanket claims, and bold promises. Unfortunately, this means that there is no guarantee that once the sperm and eggs are extracted and combined, that fertilization will take place. There are also no assurances that if an embryo or embryos do result from the procedure that implantation will occur, or that you will become pregnant.

    As Mr. Winston says, “That treatment (IVF) is really very simple in essence, but it’s very complicated to do because there’s no question, it requires quite a lot of expertise to produce it.”

    He went onto say, “A human embryo, even when it looks ideal under a microscope,” may not have good odds for implantation. On the other hand, one thing that does raise the success rates for IVF procedures is having more than one embryo to put back in the uterus. This is why fertility specialists try to extract so many eggs in one IVF procedure.

    IVF Success Rates by the Numbers

    According to the American Pregnancy Association, “In the United States, the live birth rate for each IVF cycle started is approximately:

    • 41-43% for women under age 35
    • 33-36% for women ages 35 to 37
    • 23-27% for women ages 38 to 40
    • 13-18% for women ages over 40”

    It’s important to remember these numbers do not account for all factors, however. Female A who for all intents and purposes appears to have the exact same medical conditions, may achieve pregnancy, whereas Female B does not.

    Do all couples need IVF?


    The short answer to this question is no, not all couples will need IVF to get pregnant. On the other hand, IVF is sometimes considered a viable option when:

    1. Women have fallopian tubes that are damaged or that are no longer intact
    2. There are genetic abnormalities preventing a traditional pregnancy from occuring
    3. Ovulation disorders or ovarian failures exist
    4. The male has low sperm count or low sperm motility
    5. There are genetic disorders or physical issues that prevent the male’s sperm from entering the female and her reproductive organs
    6. A woman has endometriosis, uterine fibroids, a severe case of polycystic ovary syndrome (PCOS), or some other medical condition that makes reproduction difficult or impossible

    In truth, some cases of infertility simply can’t be explained. There could be a whole host of issues at play leading to a couple’s inability to conceive. That’s typically what sends them on the path of working with a fertility doctor in the first place. In many cases it’s only when all other options have been attempted, and/or explored, that couples turn to IVF.

    Are there side effects to IVF treatments?

    There could be, yes. Side effects of IVF could include one or a combination of the following:

    • Mild cramping
    • Bloating
    • Breast tenderness
    • Constipation
    • Passing of fluid after the procedure. This fluid is usually small and can be clear sometimes and other times stained with blood.

    These symptoms are normal, and are often the same ones women who are pregnant endure.

    Symptoms that may be cause for concern are:

    • Severe pelvic pain
    • Blood in the urine/passing blood
    • Vaginal bleeding that is heavy
    • A fever that is more than 100.5 °F

    If you’re experiencing these symptoms after your IVF treatment, it’s best to call your doctor immediately. They could be a sign something significant is wrong.

    Many women experience side effects from their fertility medications as well. These side effects can include things like headaches, mood swings, hot flashes, and bloating.

    In rare cases women taking fertility medications experience Ovarian hyperstimulation syndrome or OHSS. OHSS is a condition where your ovaries become swollen and/or painful. Women experiencing OHSS often suffer from nausea, vomiting, a decrease in urination, shortness of breath, a sudden increase in weight gain over three to five days, faintness, or a combination of all of the above. In the event you are feeling excessive pain, go ahead and call your doctor. It’s better to be safe than sorry.

    Can you do anything to help your chances of success with IVF?


    We mentioned earlier in this article that there are no guarantees of success with In Vitro Fertilization. Still, many people would argue that there are in fact things you can do to increase your odds of success.

    These things may include:

    • Ensuring your uterus is ready for pregnancy: Though they probably already will, have your fertility doctor examine your uterine cavity to look for things like scar tissue, fibroids and polyps. These things can prevent implantation.
    • Make sure your fallopian tubes are clear of fluids: If there is fluid present, blocking them or removing them completely could help your success rate.
    • Check your partner’s sperm before trying IVF: Do a complete analysis of your partner’s sperm to ensure the quality and quantity, as well as the motility of the sperm are acceptable for an IVF attempt.
    • Consider the medications your on, and your lifestyle: Discontinuing use of things like cigarettes, illicit substances, an abundance of alcohol, and even excessive caffeine, could help your body to be better prepared for IVF. it may be a good idea to discuss medications, supplements and herbs you’re ingesting with your doctor as well.

    Some people believe that you must also reduce your stress, stay on bed rest, and go on a special diet for IVF to be successful. There is not enough scientific data on these beliefs to give a definite answer one way or the other. Then again, we can say without a doubt, that the healthier you are, the better your chances are overall for success.

    You can discuss your health, habits, and concerns with your fertility doctor.  A good practitioner will help you through every aspect of your journey. And, despite what you may be feeling, know this - there are no silly questions. It’s much better to ask every question, and know the best course of action before moving forward, than to guess haphazardly and risk anything that could decrease your chances of success.

    Is it true it’s only for the wealthy?

    There is no definitive answer to this question. Yes, In Vitro Fertilization is a procedure that is certainly on the higher end in terms of costs, but that doesn’t mean it’s only for the wealthy. Though most insurance policies will not cover fertility treatments, there are financial options available that help many couples to continue with their journey of trying to achieve pregnancy with IVF.

    The financial concerns is just one of the many reasons it’s so important to work with fertility specialists who understand your unique needs. A good doctor will not be one that only focuses on trying to take every dollar they can from you. We’ve heard the horror stories, and those types of doctors give good fertility specialists a bad name.

    Here at the Center of Reproductive Medicine we understand how devastating it can be to choose between trying another fertility treatment and paying your bills. That’s why our compassionate staff works with your directly to help you make the best decisions possible for your family. We will never pressure you in any way.

    Would you like to learn more about the Center of Reproductive Medicine?

    Infertility can be a difficult journey, but you don’t have to go it alone. You deserve to work with professionals who understand exactly what you’re going through. We’d be honored to walk this path with you. To learn more about our our fertility specialists, treatments available, and more, click here.

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