IVF is never the first step in the treatment of infertility. Instead,
it's reserved for cases in which other methods such as fertility drugs,
surgery, and artificial insemination haven't worked.
If you think that IVF might make sense for you, carefully assess any
treatment center before undergoing the procedure. Here are some questions to
ask the staff at the fertility clinic:
·
What is your pregnancy ratio per embryo
transfer?
·
What is your pregnancy rate for couples in our
age group and with our fertility problem?
·
What is the live birth rate for all couples who
undergo this procedure each year at your facility?
·
How many of those deliveries are twins or other
multiple births?
·
How much will the procedure cost, including the
cost of the hormone treatments?
·
How much does it cost to store embryos and how
long can we store them?
·
Do you participate in an egg donation program?
What Can I Expect From IVF?
The first step in IVF involves injecting hormones so you produce
multiple eggs each month instead of only one. You will then be tested to
determine whether you're ready for egg retrieval.
Prior to the retrieval procedure, you will be given injections of a
medication that ripens the developing eggs and starts the process of ovulation.
Timing is important; the eggs must be retrieved just before they emerge from
the follicles in the ovaries. If the eggs are taken out too early or too late,
they won't develop normally. Your doctor may do blood tests or an ultrasound to
be sure the eggs are at the right stage of development before retrieving them.
The IVF facility will provide you with special instructions to follow the night
before and the day of the procedure. Most women are given pain medication and
the choice of being mildly sedated or going under full anesthesia.
During the procedure, your doctor will locate follicles in the ovary
with ultrasound and remove the eggs with a hollow needle. The procedure usually
takes less than 30 minutes, but may take up to an hour.
Immediately following the retrieval, your eggs will be mixed in the
laboratory with your partner's sperm, which he will have donated on the same
day.
While you and your partner go home, the fertilized eggs are kept in
the clinic under observation to ensure optimal growth. Depending on the clinic,
you may even wait up to five days until the embryo reaches a more advanced
blastocyst stage.
Once the embryos are ready, you will return to the IVF facility so
doctors can transfer one or more into your uterus. This procedure is quicker
and easier than the retrieval of the egg. The doctor will insert a flexible
tube called a catheter through your vagina and cervix and into your uterus,
where the embryos will be deposited. To increase the chances of pregnancy, most
IVF experts recommend transferring three or four embryos at a time. However,
this means you could have a multiple pregnancy, which can increase the health
risks for both you and the babies.
Following the procedure, you would typically stay in bed for several
hours and be discharged four to six hours later. Your doctor will probably
perform a pregnancy test on you about two weeks after the embryo transfer.
In cases where the man's sperm count is extremely low, doctors may
combine IVF with a procedure called intracytoplasmic sperm injection. In this
procedure, a sperm is taken from semen -- or in some cases right from the
testicles -- and inserted directly into the egg. Once a viable embryo is
produced, it is transferred to the uterus using the usual IVF procedure.
What Are the Success Rates for
IVF?
Success rates for IVF depend on a number of factors, including the
reason for infertility, where you're having the procedure done, and your age. Statistics
for all assisted reproductive technology (ART) procedures performed including
IVF, GIFT, and ZIFT, although IVF is by far the most common; it accounts for
99% of the procedures.
·
Pregnancy was achieved in an average of 29.4% of
all cycles (higher or lower depending on the age of the woman).
·
The percentage of cycles that resulted in live
births was 22.4% on average (higher or lower depending on the age of the
woman).
Are There Other Issues With IVF
to Consider?
Any embryos that you do not use in your first IVF attempt can be
frozen for later use. This will save you money if you undergo IVF a second or
third time. If you do not want your leftover embryos, you may donate them to
another infertile couple, or you and your partner can ask the clinic to destroy
the embryos. Both you and your partner must agree before the clinic will
destroy or donate your embryos.
A woman's age is a major factor in the success of IVF for any couple.
For instance, a woman who is under age 35 and undergoes IVF has a 39.6% chance
of having a baby, while a woman over age 40 has an 11.5% chance. However, the
success rate is increasing in every age group as the techniques are refined and
doctors become more experienced.
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