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    in vitro fertilisation (ivf)

    What Is IVF Treatment and How Does It Work?

    • 11007 views
    • 4.5   (1 Votes)
    Medically Reviewed by Dr. Deepika Tiwari - MS, MBBS on 06 Jul 2019 - Written by Dr. Astha Dayal - MRCOG, Diploma, MBBS - Grammatically Approved by Dr. Kavita Jaggi Agrawal - MS, MBBS

    In Vitro Fertilization (IVF) is infertility treatment. In IVF, eggs and sperm are fertilized in IVF laboratory. IVF treatment works with the use of medications, eggs, and sperm retrieval process, fertilization, and embryo transfer procedure. IVF is successful with positive implantation leading to pregnancy.

    Couples or individuals struggling with infertility issues experience certain life-changing instances such as hope-disappointment cycle, social isolation, physical and emotional changes. Infertility, sometimes even leaves a dramatic impact on the relationship of couples. Patients who are unable to conceive are dissatisfied with themselves and their marriages. Based on several research studies, women tend to experience more discontentment and greater emotional challenges than men. In Vitro Fertilization (IVF) is a complex series of a process used to treat fertility or genetic problems and help couples or individuals with the conception of a child. During the IVF procedure, mature eggs are retrieved from the woman and fertilized by sperm in a medical laboratory in the IVF center. In Vitro Fertilization (IVF) refers to a technique where embryo(s) are created by combining the eggs of a woman and sperm of the male partner in a special laboratory. Depending on the evaluation and age of the woman, the embryos are transferred to the woman’s uterus via her cervix to increase the chances of implantation, thereby pregnancy. In the present scenario, IVF success rates have increased dramatically among modern couples.

    This article contains detailed information about:

    After having a fair idea of infertility and how IVF treatment helps patients in achieving pregnancy with high success rates, let us discuss some in-depth information about IVF treatment. 

    1. What is IVF treatment?

    In Vitro Fertilization treatment, which is popularly referred to as IVF, has captured the attention of the public since its useful introduction in 1978. In Vitro Fertilization (IVF) procedure involves extracting eggs from a woman's ovaries and combining them with sperm outside the body. Since then, IVF treatments have helped a tremendous number of people become parents. The procedure is usually performed in a Petri dish; "in vitro" is Latin for "in glass" to allow a healthy conception to occur. The eggs fertilized by this procedure turn into an embryo which is then placed in a woman's uterus, where they are allowed to develop into a fetus and eventually a baby. An ultimate benefit of IVF treatment is that it has the potential to provide individuals or couples diagnosed with infertility issues a chance to conceive children which are genetically related to them. With the advent of Pre-implantation genetic screening and diagnosis, it is possible to choose the healthier embryos and PGD test also prevents passing on any genetic disorder to the child. (1)

    What is IVF Treatment

    Today, Assisted Reproductive Technology is available throughout the world, and the practice is largely different from that used during the initial days of infertility treatments. Advancements in laboratory technology and clinical expertise have allowed IVF to evolve into a medical procedure that is readily accessible, efficient, safe, and relatively affordable. More than 8 million IVF children have been born across the world till date, and it is being projected that continued enhancements will widen the appeal and applicability of IVF treatments throughout. (2) Since the birth of the first IVF baby named Louise Brown in 1978, an abundance of breakthroughs in both clinical expertise and basic science have rendered increasing numbers of infertile couples the chance to have a baby. The statistics presented by the Centers for Disease Control (CDC) showed that 48, 000 babies were born in the US and over 1, 00,000 successful ART cycles were performed in the year 2003 alone. (3) The field of assisted reproductive technology is speedily progressing with several new advances over the last decade. (4) IVF and embryo transfer procedure for the treatment of human infertility has now resulted in the incredible birth of over 8 million babies. The technique did not arise as a quantum episode but was built on the efforts and hard work of many earlier scientists in the fields of reproductive endocrinology and development. (5) The Center for Disease Control and Prevention presented its Fertility Clinic Success Rates Report for the year 2017. The report showed that the year witnessed over 2,84,385 ART cycles took place at 448 reporting IVF clinics in the United States. This positively resulted in live births of 68,908 babies and 78,052 liveborn infants which benefited the country. (6)

    2. What is Infertility and how does IVF help to deal with it?

    According to the definition given by the Centers for Disease Control and Prevention, infertility is the inability to get pregnant after trying for one year or longer despite having regular and unprotected intercourse. As fertility levels in women declines steadily with age, some IVF specialists evaluate and treat women aged 35 years or more after 6 months of unprotected intercourse. Women with infertility should consider booking an appointment with an acknowledged healthcare provider like Elawoman to get their treatment started as early as possible. (7)

    3. What are male and female fertility issues?

    Female Infertility Issues:

    For women, it’s all about producing the egg and its movement into the fallopian tubes to allow the sperm to fertilize it. If all goes well, the fertilized egg consequently becomes an embryo and is implanted on the wall of the uterus and develops accordingly. Anything that intrudes with this process is a potential cause of infertility. In females, fertility issues are caused when there are problems associated with the uterus or fallopian tubes. Endometriosis can cause scar tissue that may block the fallopian tubes or adheres to the ovaries. It is one of the most common causes of infertility, and around 30 to 50 percent of women with fertility problems are diagnosed with endometriosis, as per the values presented by the American Society for Reproductive Medicine (ASRM.) In other cases, the fallopian tubes may not be blocked but are not capable enough to move the egg along to the uterus to allow fertilization.

    Male Infertility Issues:

    In most of the cases, male factor infertility is observed when the male partner is unable to impregnate his partner despite being involved in sexual intercourse for a year or more. Usually, male factor infertility does not show any significant or observant symptom or sign. However, in rare cases, men may experience some symptoms of hormonal imbalance like changes in sexual function or hair growth. Men should visit the best IVF centre if he experiences:

    • A low sperm count or other issues related to sperm
    • Men having a history of prostate, testicular, or sexual problems
    • Men who have undergone treatment for cancer
    • Men whose testicles that are small in size 

    4. How Does IVF Work?

    IVF works by using a combination of medications and surgical procedures to help sperm fertilize an egg, and help the fertilized egg implant successfully into the uterus. One or more embryos (fertilized egg) are then implanted directly into the uterus. The process includes ovulation induction, egg retrieval process, fertilization in a specialized laboratory and embryo transfer procedure. Pregnancy occurs if any of the embryos implants in the lining of the uterus, typically called as an endometrial lining. It is a process wherein eggs are extracted; sperm is retrieved and is combined in a laboratory dish in a specialized IVF lab. The prepared embryo(s) are then transferred into the uterus in order to allow a healthy pregnancy to occur. Other forms of ART procedures include Zygote Intrafallopian Transfer (ZIFT) and Gamete Intrafallopian Transfer (GIFT) which are known as modified versions of the most popular In Vitro Fertilization (IVF) procedure.

    How Does IVF Work

    IVF is one of the most successful treatments used in cases where the fallopian tubes are absent or severely damaged or when there is unexplained or male-factor infertility. In this process of ART, both male and female infertility problems are treated efficiently by the fertility specialists and are usually recommended when basic fertility techniques have not been successful. During IVF treatment, a woman’s ovulatory process is examined and stimulated before eggs are extracted from the ovaries and sperm are allowed for fertilization in a fertility laboratory. The fertilized eggs undergo embryo culture for a time period of two to six days and one or more embryo is transferred into the uterus, hopefully heading towards a successful pregnancy. Due to its high success rates, the technique has been used more frequently in recent years as the first line of infertility treatment. The infertility experts offer compassionate care for individuals and couples planning to start a family, including patient-centered plans tailored to individual needs. It is a good idea for any individual or couple to talk to a health care facilitator before trying to get pregnant. They can help get patients’ body ready for a healthy baby, and can also answer their queries on fertility and give tips on conception. Learn more at elawoman.com. (8) IVF treatment works for certain medical conditions related to male and female reproductive health who are planning for a baby. Below is a list of indications for which IVF works in the best possible manner.

    5. Indications of IVF procedure: 

    Considering IVF treatment can prove to be a big decision. It can be challenging and undoubtedly expensive and success of the treatment is not guaranteed as the success depends on several factors. (9)

    IVF treatments can be used to treat infertility in the following cases:

    • Blocked or damaged fallopian tubes

    Fallopian tube blockage or damage with the same are considered as one of the significant causes of female factor infertility. The condition usually does not show any symptoms. Yet, there are certain risk factors associated which can impact women’s health. (10)

    • Male factor infertility including decreased sperm motility or sperm count 

    Males whose sperm-related parameters are below the WHO normal values are considered to be diagnosed with male factor infertility. The most common of these factors are poor sperm motility (asthenospermia), low sperm concentration (oligospermia), and abnormal sperm morphology (teratospermia). (11)

    • Women with ovulation disorders

    For a successful conception or pregnancy, ovulation process plays a vital role. To achieve a successful pregnancy, the egg must be released from the ovary and the sperm should also reach the egg to allow fertilization. These can be confirmed with a blood test. (12)

    • Female partners who have had their fallopian tubes removed

    IVF can prove to be successful for women who have had their fallopian tubes removed due to certain health conditions or due to the risk of ectopic pregnancies. (13)

    • Individuals with a genetic disorder

    Parents or individuals who are at risk of passing on the genetic disorder in their child usually opt for IVF treatments with the assistance of modern medical tests such as Preimplantation Genetic Diagnosis (PGD) test. In IVF, a predetermined number of embryos are picked for implantation which has the desired number of chromosomes and the ones which are disease-free. (14)

    • Unexplained infertility

    The principal treatments for unexplained infertility include IVF, clomiphene citrate, Intrauterine Insemination (IUI) and controlled ovarian hyperstimulation (COH). (15)

    IVF treatment works in a series of steps which include infertility issue diagnosis, ovulation induction (with the help of fertility medications), egg and sperm retrieval process, fertilization process, embryo culture, and embryo transfer. Below is explained in detail how IVF works and the process involved in IVF treatment.

    6. IVF Treatment Process:

    Getting started with the IVF treatment process can be exciting yet full of anxiety for couples or individuals opting for the same. Typically, IVF is pursued only after other infertility treatments do not give expected results. Couples or individuals may have been trying for months or years to conceive before choosing IVF treatment process for successful conception. Below are explained in detail all the essential steps taken in IVF treatment process. 

    IVF Treatment Process

    Step 1: Fertility Medications

    As the first step in IVF treatment process, fertility medications are given to women for the purpose of stimulating egg production. (16) Fertility drugs are commonly used in other infertility treatments and In Vitro Fertilization to achieve a healthy pregnancy. Fertility drugs in IVF are prescribed to prepare the body for the treatment and encourage ovaries to release more eggs. (17) The stimulation phase starts from day 1 of a woman’s period. In a natural monthly cycle, the ovaries usually produce 1 egg, as per the fertility experts. Medications are prescribed for 8 to 14 days to encourage the follicles in the ovaries to produce more eggs. Medicines are prescribed based on the unique medical condition of the patient. These fertility drugs are given usually in the form of injections, which may vary from 1-2 for the cycle or 1-2 shots per day. The medications which are used for Ovarian Stimulation in women include:

    • Gonadotropins (Glycoprotein Polypeptide hormones)
    • Antioxidants and vitamins
    • Bromocriptine and Cabergoline
    • Clomiphene citrate (Clomid)
    • Metformin (18)

    Step 2: Egg Retrieval

    Once the ovarian follicles have achieved an adequate stage and size of the development, a trigger shot is given to induce final maturation of the eggs. The timing of this injection plays an important role in the outcomes of the IVF cycle and needs to be precise in each of the infertility treatment cases. An egg retrieval process is then scheduled by the best IVF specialist for 36 hours following this trigger shot. (19) In this IVF treatment process, eggs are retrieved via a minor surgical procedure. An ultrasound imaging is used gently to guide a needle attached to a catheter via the vaginal wall. Eggs are then carefully extracted using light suction under the guidance of an infertility specialist. These eggs are collected in test tubes which are then handed off to an experienced embryologist. All these procedures are performed under the supervision of experienced IVF doctors. Pain reliever medications are given to reduce and remove potential pain or discomfort associated with the procedure.

    Step 3: Sperm Retrieval

    The male partner in this process is asked by the best fertility experts to produce a sample of semen from which sperm is retrieved for the fertilization procedure. This sample is prepared in the lab to combine with the eggs. Different protocols are used by different IVF clinics for IVF treatments. (20)

    Step 4: Fertilization

    In this IVF treatment process, the male partner’s sperm is combined with the best quality eggs. The process of combining sperm with eggs is called fertilization. In order to obtain positive results, these eggs and sperm are stored in an environmental control chamber to encourage fertilization. In certain cases there may arise some chances of low fertilization, Intracytoplasmic Sperm Injection (ICSI) may be used by the doctor. In ICSI procedure, the sperm is directly injected into the eggs by an embryologist in the medical laboratory. (21)

    Step 5: Embryo Culture

    Embryo Culture is also a part of the ART procedure. In this process, good quality embryos are developed in specialized IVF laboratory to allow a successful pregnancy to occur. The goal of embryo culture is also to improve the chances of a successful delivery of a healthy baby. (22)

    Step 6: Embryo Transfer

    Embryo transfer is the last and most important step of the In Vitro Fertilization (IVF) treatment. The process takes place usually three to five days following egg retrieval and fertilization process. It is considered to be a crucial part of the process on which success of pregnancy is dependent. This process is considered similar to the procedure of a pap smear. A specialized speculum (medical tool) is carefully inserted by an IVF expert into the woman’s vagina to transfer the embryos in the uterus. The process usually doesn’t require any sedation as the process is painless in most of the cases. (23)

    7. IVF treatment Success Rates:

    There are many factors which determine IVF success rates. The success rates of IVF procedure decline notably as the age of the woman increases. Age, therefore, plays a significant role in the success rates of IVF treatment. In order to increase the IVF treatment success rates, it is advised by the best IVF doctors that the treatment should be conducted on time to achieve a healthy pregnancy. IVF is advantageous for couples or individuals combating infertility and seeking fertility treatments to have babies. The percentage of IVF treatments which resulted in a live birth from 2014 and 2016 was:

    • 29 percent success for women under 35
    • 23 percent success for women aged 35 to 37
    • 15 percent success for women aged 38 to 39
    • 9 percent success for women aged 40 to 42
    • 3 percent success for women aged 43 to 44
    • 2 percent success for women aged over 44

    8. Global IVF Market statistics:

    The global IVF market accounted for $9,015 million in the year 2015 and is estimated to accumulate revenues worth $17,714 million by 2022, registering a CAGR of 10.2 percent over the forecast period. The growth of the market is attributed to the changing lifestyle conditions; declined conceiving rates, fertility disorders and delayed pregnancy are the major factors that drive the IVF market growth. Other factors like delayed parenthood opted by couples and favorable reimbursement and certain financial constraints will also contribute to the growth of the market. 

    Global IVF Market Statistics

    9. Risks and Complications of IVF procedure: 

    Specific steps of an In Vitro Fertilization (IVF) cycles carry certain risks, which include:

    • Multiple births: IVF increases the chances of multiple births as usually more than one embryo is implanted in the uterus. A pregnancy with multiple fetuses carries a higher risk of premature labor and low birth weight than a normal pregnancy does.
    • Premature delivery and low birth weight: Research study suggests that the use of IVF slightly elevates the risk that a baby will be born early or will be having a low birth weight.
    • Ovarian hyperstimulation syndrome: Use of injectable fertility medications, like Human Chorionic Gonadotropin (HCG), to stimulate ovulation can lead to ovarian hyperstimulation syndrome, in which the ovaries become painful and swollen.
    • Signs and symptoms typically which usually last a week and include mild abdominal pain, vomiting, diarrhea, bloating, and nausea. If the patient conceives, however, these symptoms might last several weeks. 
    • Miscarriage: The chance of miscarriage for women who try getting pregnant using IVF treatments with fresh embryos is similar to that of women who conceive naturally — about 15 to 25 percent. The chances of a possible miscarriage increase with the increase in maternal age. Using frozen embryos during IVF, however, may slightly elevate the chance of miscarriage.
    • Egg-retrieval procedure complications: Use of an aspirating needle for the collection of eggs could possibly lead to bleeding, infection or damage to the bowel system, a blood vessel or bladder. Risks are also associated with general anesthesia when used.
    • Birth defects: Maternal age is the primary risk factor in the development of birth defects, no matter using which method, the child is conceived. More research is needed to ascertain whether baby conceived using IVF is at an increased risk of certain birth defects. Some fertility experts believe that the use of IVF treatment does not increase the chances of having a baby with birth defects.
    • Ovarian cancer: Although some previous studies established a link between certain medications used for ovarian stimulation and the development of a specific type of ovarian cancer, more recent studies do not support these findings.
    • Stress: Use of IVF can be mentally, physically and emotionally challenging. Support from IVF counselors, friends, and family can help couples through the roller coaster of IVF treatments.

    10. How Much Is IVF Treatment?

    The average cost of IVF treatment ranges between Rs. 2 lacs to Rs. 3.5 lacs. The cost of IVF treatment is inclusive of diagnostic procedures (inclusive of ultrasound imaging), personnel, and materials. Other things which are included in the cost of IVF treatment are the cost of medication, IVF doctor’s fees, location of IVF centre, cost of an IVF laboratory, cost of complications, cost per treatment cycle and cost per ongoing pregnancy. (24) The average cost of IVF treatment in the US is dependent upon patient characteristics, insurance coverage, and the IVF centre. There are several factors, which affect the cost of IVF treatment. Some of the factors responsible for IVF treatment include:

    • Ultrasounds
    • Lab Tests
    • Sperm Preparation
    • Egg Retrieval
    • Embryo Culturing
    • Embryo Transfer
    • Embryo Storage
    • Egg/Sperm Donation
    • Embryo Donation
    • ICSI
    • Pre-implantation Genetic Screening and Diagnosis (PGD/PGS) test

    Elawoman provides a facility of medical loan facilities and helps patients in obtaining the appropriate discounts and offers for the treatment. It offers special payment and pricing options for its patients in need. Elawoman’s service is completely FREE to all the patients seeking help in starting their parenthood journey. Elawoman also guarantees the lowest treatment cost for all infertility services. To get all your queries related IVF treatments, IVF treatment process and other information related to infertility, feel free to visit elawoman.com or talk to the best fertility expert by dialing +918929020600.

    Dr. Astha Dayal

    Written by

    MRCOG, Diploma, MBBS, MD
    Obstetrician, Infertility Specialist
    Gurgaon

    Dr. Astha Dayal is an infertility specialist who has been practising for many years to help women conceive naturally as well as with the help of assisted techniques. Her extensive knowledge in Dysmenorrhea Treatment, High-Risk Pregnancy, Intrauterine Insemination (IUI) and Abortion and Infertility Treatments makes her one of the most preferred Gynecologists in Gurgaon.

    She completed MBBS and MD in Obstetrics and Gynaecology from G B Pant Hospital and Maulana Azad Medical College, New Delhi in 2003 and 2008 respectively. Following this, she pursued MRCOG from Royal College of Obstetricians and Gynaecologists in London in 2011. She is also a member of World Association of Laparoscopic Surgeons (WALS), Royal College of Obstetricians and Gynaecologists (RCOG), London and Federation of Obstetric and Gynecological Societies of India (FOGSI). You can get the contact details of Dr. Astha Dayal at elawoman.com

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    Rajan Nandin

    May 30, 2019, 4:45 p.m. 4.5

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    The information displayed on this webpage covers general information on several medical conditions, fertility treatments, IVF ICSI, surrogacy procedure, home remedies, and their respective treatments. The exclusive purpose of the displayed information is for the sake of general understanding and it has been collected from open sources which heavily rely on research and laboratory tests. However, the information shared here should not be considered as a medical advice or an alternative to consultation with a registered medical practitioner or licensed healthcare professional.

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