You’ve probably heard about IVF as a treatment for infertility and it can be the best treatment for some fertility problems. However, it doesn’t work for every couple and it can put a severe strain on your body and your relationship. So it’s worth knowing as much as you can about it before you begin, so you know the chances of getting pregnant, the risks and problems you may face and what questions to ask your clinic.
What is IVF?
In a normal conception, the sperm from the man and the egg from the woman meet in the woman’s fallopian tubes (the tubes that connect the ovaries and the womb). The egg is fertilised and passes down into the womb, where it embeds in the lining and becomes an embryo, then the process of fertilising the egg takes place outside of the woman’s body in a laboratory – hence the term Test Tube Baby.
During the IVF process, the woman’s eggs are removed during a small surgical procedure and fertilised in a laboratory using a specimen of sperm from the woman’s partner, or donor sperm if necessary. The fertilised egg, called an embryo, is next surgically implanted into the uterus (womb) of the woman.
The IVF process:
• The woman is given fertility drugs (usually by injection) to stimulate egg production.
• Egg production is monitored with a vaginal ultrasound scan.
• The eggs are then collected when a surgeon passes a fine needle through the vagina and into the ovaries. This is usually carried out under a mild sedation or general anaesthetic. Nine or 10 eggs on average are collected.
• A sperm sample is taken from the man or sperm from a donor is used.
• The sperm and eggs are mixed together in a laboratory; any eggs that become fertilised are called embryos.
• The woman is given progesterone, which helps thicken the lining of the uterus and prepares it for pregnancy.
• Next, one or two of the most viable embryos are collected and placed, through the vagina, into the uterus with a tiny catheter (this may rise to three embryos if the woman is over 40). This happens around two to three days after the eggs have been collected and fertilised.
• Two to three weeks later, an ultrasound scan is used to find out if the procedure has resulted in a successful pregnancy.
What are the risks?
Of course, if IVF is successful and works first time, it is a fantastic treatment for couples who would not be able to get pregnant naturally. However, there are some risks and drawbacks you should be aware of.
Be realistic about your chances. IVF treatment does not always end in a pregnancy – in fact, only 20-25% of IVF treatment cycles result in a birth. Younger women have a better success rate but your chances decrease dramatically over the age of 40.
Though the chances of having more than one baby is decreasing due to fewer embryos being implanted and better treatment outcomes, there is still a chance of having a multiple pregnancy with IVF. In 2008, around 24% of IVF cycles result in multiple births; this can cause health problems for the mother and the children, as the pregnancy puts a huge strain on the mother’s body and twins or triplets are more likely to be born prematurely and have low birth weights.
Ovarian Hyper Stimulation Syndrome (OHSS)
The drugs doctors use to stimulate the ovaries into producing many eggs can lead to a potentially serious condition called Ovarian Hyper Stimulation Syndrome (OHSS). If you have this reaction, the ovaries get larger and are painful, which can lead to abdominal pain. More severe symptoms include shortness of breath, fluid retention in the abdomen and blood clot formation. In severe cases, you may have to stay in hospital.
As with any surgical procedure and even though those employed during IVF are fairly minor, there is a risk of infection from the needles used to extract the eggs from the ovaries. Antibiotics usually clear this up quickly and surgical hygiene means this occurs rarely.
Emotional and psychological problems
All couples find IVF stressful and emotionally demanding. You or your partner may suffer from anxiety or depression and you should be offered counseling to help you deal with the emotional stresses of IVF and the constant procedures, tests and scans.