IVF, In vitro fertilization, is an infertility treatment of fertilizing an egg, in which the egg is combined with sperm in a laboratory, outside the body. In vitro is referred to “in glass”. This process includes monitoring and stimulating the ovulation process of a woman followed by removing the ovum or ova which are eggs from a woman’s ovaries and letting the sperm to fertilize them in a liquid. This process is conducted in a laboratory. After that, the zygote (fertilized egg) undergoes the process of embryo culture for two to six days and it is then implanted in the same or some other woman’s uterus, with the intention of conceiving successful pregnancy.
Dr Suman Explained that “In Vitro Fertilization is a form of assisted reproduction technology which is used for infertility treatments and surrogacy. The fertilized egg is sometimes implanted in the surrogate’s uterus and if she conceives then the child is genetically not related to the surrogate.” In some countries, IVF has been banned or it is being regulated otherwise according to the availability of IVF treatment which is giving rise to fertility tourism. This process of IVF is usually not used until all the available options have failed or been resulted unlikely to work. The restrictions on the availability of IVF treatment include age and cost in order to carry a healthy pregnancy in a definite term for a woman. IVF process from start to finish is a safe process with high success rates.
With this process of IVF and egg donation, all the women who have past their years of reproductive, having male partners who are not fertile, women having infertility issues like endometriosis or they have reached their menopausal period can still become pregnant. According to a study, after the IVF treatment, some people started conceiving without any treatment. And according to some statistics in the year of 2018 more than 8 million children were born globally due to this process of IVF and other infertility treatments. Nowadays the IVF process in India is also getting very popular amongst people.
The very first step in the process of IVF is to stimulate the ovaries so that it produces more than just one egg. Most of the IVF treatment cycles include the intake of injections and medications (fertility medications) recommended by the doctors to increase the level of hormones to stimulate eggs. The medications help to encourage the eggs, ovum to grow to its definite size so as to consider them as “mature” eggs. During the IVF cycles, there are frequent blood testing to check the hormone levels and vaginal ultrasounds to monitor the follicles which are the sacs enclosed to the eggs. This is done in every two to three days at the beginning of the stimulation of ovaries and as early as every day during the period of the medications.
Sometimes women are recommended medications based on their conditions, such as:
MEDICATION FOR THE STIMULATION OF OVARY
For the stimulation of ovaries, the doctor might recommend some injectable medications which contain a luteinizing hormone LH or a follicle-stimulating hormone FSH or both of these. These medicines tend to produce egg (more than one) to produce at the same time.
MEDICATION FOR THE MATURATION OF EGGS
Usually, in a timed lap of eight to fourteen days, the doctor will recommend you a human chronic gonadotropin which helps the eggs to mature.
MEDICATION FOR THE PREVENTION OF PREMATURE OVULATION
The medicines help prevent the body from releasing eggs before the time.
MEDICATION FOR THE PREPARATION OF THE UTERUS LINING.
The doctor might recommend beginning with taking progesterone supplements during the embryo movement or on the egg retrieval day to make the uterus lining a little more receptive for the implantation.
Retrieving of eggs
Egg retrieval can be conducted in the doctor’s clinic and 34 to 36 hours are needed for the surgery to be done before ovulation and after the final injection. Retrieving of the eggs can be considered as a small surgical process and is conducted in an appropriate surgical technique. The general anesthesia is used during this process and a very thin surgical equipment is used which is known as a catheter, it is placed into the uterus and through the cervix to reach the ovaries.
A process in which an ultrasound probe is inserted inside the vagina for the identification of follicles is the usual retrieval method, known as transvaginal ultrasound aspiration. Followed to that a thin and tiny needle is used to insert into the ultrasound guide which goes via vagina and towards the follicles.
In some cases, the ovaries are not accessible through the process of transvaginal ultrasound then an abdominal surgery or laparoscopy is taken into the count. It is a process wherein a small cut is made around the navel and a laparoscope which is a viewing instrument is inserted into it for the retrieval of the eggs.
After that, the doctor removes the eggs by the help of a needle which is connected to the suction device. In about twenty to thirty minutes multiple eggs can be eliminated. The mature eggs are kept inside a liquid solution. The eggs which when appears healthy will be combined with sperm. However, all the eggs do not get successful in the fertilization.
After the process of egg retrieval, women reports cramping and feelings of fullness and pressure.
It is done using either of the two very popular methods:
Matured eggs and sperm are fused during this process and left overnight for incubation.
INTRACYTOPLASMIC SPERM INJECTION (ICSI)
icsi is used if there is any problem in quality of semen or there is any failure in IVF cycles. In this process, sperm (only healthy) is put directly into each mature egg.
In a number of situations, the doctor might suggest other processes before the transfer of an embryo.
If women are older or if they have already had failed IVF attempts multiple times then the doctor may recommend this process of assisted hatching. In about four to five days after fertilization, an embryo starts “hatching” from the surrounding membrane, this process allows it to implant inside the uterus lining. It is a technique wherein a hole is conducted in the surrounding membrane of an embryo right before the transfer which helps in the hatching and implantation of the embryo.
The transfer of embryo is also done at the doctor’s clinic and generally takes place about six days after the retrieval of the eggs.
-Mild sedative is given to women. This process is usually painless, however some women may experience bit discomfort.
-A thin, long and flexible surgical equipment known as catheter is inserted inside the vagina via cervix and into the uterus.
-A syringe with one or more than one embryos presented in a little fluid will be attached to one of the ends of the catheter.
-The doctor will place the embryo or the embryos inside the uterus with the help of the syringe.
-If the process will be successful then an embryo will start to implant at the uterus lining in about six to ten days after the retrieval of an egg.
After the transfer of embryo women easily get back to their normal routine. However, the ovaries might remain enlarged. Women are advised to avoid vigorous activities which can lead to discomfort.
Usual side effects are:
-Discharge of a bloody fluid within a short period after the treatment which may happen cuz of the swabbing the cervix.
-Tenderness of the breasts by the high levels of estrogen.
– Mild bloating and cramping.
Some steps of an in vitro fertilization process which carry risks are:
The Process of IVF increases the complications of multiple pregnancies when more than one embryos are implanted in the uterus. The pregnancies with more than one fetuses carry a very high risk of premature labor than pregnancies with a single fetus. According to research, the use of IVF treatment increases the risk of premature delivery with very low birth weight.
OVARIAN HYPERSTIMULATION SYNDROME
The use of injectable infertility medications like human chorionic gonadotropin to enhance ovulation may cause ovarian hyperstimulation syndrome under which the ovaries become painful and swollen. Signs and symptoms of ovarian hyperstimulation syndrome usually last a week and also involves mild abdominal pain, nausea, bloating, diarrhea and vomiting. Even if the women become pregnant the symptoms may last for several weeks. It is rare to develop a very severe type of ovarian hyperstimulation syndrome which can also cause steady weight gain or shortness of breath.
The chances of miscarriages for women who conceive by the process of in vitro fertilization with fresh embryos is the same as that of women who conceive by natural process. About fifteen to twenty percent of women experiences miscarriages but the number keep on increasing with the maternal age. Usage of frozen embryos during the IVF process also increases the risk of miscarriage.