IVF- stands for in vitro fertilization, in vitro means outside the body. It is one of the most commonly known and effective ways of Assisted Reproductive Technology (ART). It works by using a combination of medicines and surgical procedures to help sperm fertilize an egg in a laboratory dish, and help the fertilized egg implant in your uterus.
The history of in vitro fertilization (IVF) goes back more than half a century. In 1959 the first birth in a nonhuman mammal resulting from IVF occurred, and in 1978 the world’s first baby conceived by IVF was born. As medicine advanced, IVF was transformed from natural research to a simulated clinical treatment. There have been many innovations and experiments in the refinement process of IVF, and today millions of births have occurred with the help of IVF all over the world.
In the last few decades, there has been an enormous upsurge in the number of couples facing infertility. This has been attributed to changes in lifestyle, environment, and very pertinently the economic and academic aspiration of women, leading to a delay in childbearing. IVF gives the maximum chance of success (30-50%). Be that as it may, simpler treatments like intrauterine insemination (IUI) and ovulation induction are worth trying if the woman is below 35 years and/or the number of years for which the couple has been trying to conceive is less than three. Whilst these are less intensive the chances of success are around 10-15% per cycle.
IVF is the only treatment if the fallopian tube is damaged or blocked, it becomes difficult for an egg to be fertilized or an embryo to travel to the uterus.
If there’s any disorder in ovulation (absence or infrequent ovulation), very few eggs are available for fertilization.
Endometriosis occurs when tissue similar to the lining of the uterus implants and grows outside of the uterus — often affecting the function of the ovaries, uterus, and fallopian tubes
Fibroids are benign tumors in the uterus. They are common in women in their 30s and 40s. Fibroids can interfere with the implantation of the fertilized egg.
Unexplained infertility means no cause of infertility has been found despite evaluation for common causes.
IVF was used to help both men and women in dealing with pregnancy and infertility problems.
Process of IVF
IVF in simple words means uniting egg and sperm outside the body in culture. But there’s so much more to IVF that happens before and after that.
Medication: Several different medications are used -The more eggs you produce, the more chances you’ll have of successful fertilization later on in the treatment.
a) To stimulate ovaries injectable medication containing a follicle-stimulating hormone (FSH), a luteinizing hormone (LH), or a combination of both.
b) When the follicles are ready for egg retrieval generally after eight to 14 days you will take human chorionic gonadotropin (HCG) or other medications to help the eggs mature.
c) Medications are used for the prevention of premature ovulation or from releasing the developing eggs too soon.
d) On the day of egg retrieval or at the time of embryo transfer, a doctor might recommend taking progesterone supplements to make the lining of the uterus more receptive to implantation.
Harvest the egg: Egg retrieval can be done in a doctor’s office or a clinic 34 to 36 hours after the final injection and before ovulation. During egg retrieval, pain medication is given. Transvaginal ultrasound aspiration is the usual retrieval method. An ultrasound probe is inserted into the vagina to identify follicles. Then a thin needle is inserted into an ultrasound guide to go through the vagina and into the follicles to revive the eggs. If ovaries aren’t accessible through trans vaginal ultrasound, an abdominal ultrasound may be used to guide the needle. The eggs are removed from the follicles through a needle connected to a suction device, multiple eggs can be removed within a span of 20 minutes. After egg retrieval, the feeling of cramping and fullness or pressure is experienced. Mature eggs are placed in a nutritive liquid and incubated. Eggs that appear healthy and mature are mixed with sperm in an attempt to create embryos. However, not all eggs may be successfully fertilized. The process of combining the best sperm with the best eggs is called insemination. It usually takes a few hours for a sperm to fertilize an egg. The sperm can directly be injected into the egg instead, a process known as intracytoplasmic sperm injection (ICSI).
Sperm retrieval: If the partner’s sperm is being used, a semen sample needs to be provided at the doctor’s office or clinic on the morning of egg retrieval. The semen sample is often collected through masturbation. Other methods, such as testicular aspiration, the use of a needle, or surgical procedure to extract sperm directly from the testicle are sometimes required. Donor sperm also can be used. Sperms are separated from the semen fluid in the lab.
Transfer of embryo into uterus: It usually takes place after two to five days of egg retrieval. This procedure is usually painless, although mild cramping can be experienced. About three to five days after fertilization, the doctor will place the embryos in the uterus using a catheter. This part of IVF is performed in the doctor’s office while the patient is awake. Multiple embryos are transferred back with hopes that at least one will implant itself in the lining of the uterus and begin to develop. Sometimes more than one embryo ends up implanting, which is why multiples are common in women who use IVF. The IVF process basically replicates natural reproduction. The next step after the IVF process is the pregnancy test which determines whether the procedure worked or not.
The success rate of IVF
The success rate for a single cycle of IVF treatment is about 50-72%, depending on specific patient characteristics. Therefore, several cycles of IVF treatment can be required for the successful implantation of the fertilized embryo in the uterus.
Factors on which success rate can be dependent-
- The cause of infertility
- Ovarian test result
- Whether or not a pregnancy or live birth has occurred before
- The strategy that has to be used
The following are some of the risks involved while undergoing IVF treatment:
- Ovarian hyper-stimulation syndrome (can be mild or severe) (OHSS-Ovarian Hyperstimulation Syndrome)
- Faintness, shortness of breath, severe stomach pain (accompanying OHSS)
- Weight gain, decreased urinary output (accompanying OHSS)
Some people may also experience fatigue, abdominal pain, sore breasts, irritability, nausea, and headaches. A very small ratio of people also experiences extreme abdominal pain that might require admission to hospital, dehydration, or vomiting.
The treatment and cost vary from hospital to hospital. It is not the cheapest procedure but is one of the most effective methods of assisted reproduction. According to the American Society for Reproductive Medicine the average cost for one in vitro fertilization (IVF) cycle is more than $12,000. Basic IVF can be as much as $15,000 or maybe as low as $10,000. It’s rarely lower than that. These numbers do not include the cost of medications, which average around for a single cycle.
Additional costs for IVF
While basic IVF costs around $12,000, if you need additional assisted reproductive technologies, the cost will be higher. For example, ICSI treatment (where a single sperm is injected directly into an egg) may be an additional $1,000 to $2,500. Genetic testing of embryos, or PGT, maybe around $3,000 or more. It may go as low as $1,800 or as high as $7,500. (1)
Embryo freezing, including the initial freezing and storage, may cost an additional few to several hundred dollars. Yearly storage fees range anywhere from $200 to $800 per year.
If one has frozen embryos from a previous cycle and wants to use them, doing so is significantly cheaper than doing a complete IVF cycle with fresh embryos. The average cost for a frozen embryo transfer (FET) is about $3,000– $5,000.
If one plans on using an egg donor, the overall cost will be significantly higher—from $25,000 to $30,000 for one cycle. Using a sperm donor is less expensive, costing anywhere from $200 to $3,000 extra, or between $13,000 and $17,000 per IVF cycle.
Using a gestational carrier is the most expensive of all IVF options. If you include all the legal fees, agency fees, IVF costs, and payment to the gestational carrier, the cost can range anywhere between $50,000 to $100,000.
Embryo donation is the least expensive of the donor options. It’s often cheaper than a regular IVF cycle. An embryo donor cycle costs anywhere between $5,000 and $7,000. This is assuming the embryo has already been created.
Due to date calculator
IVF is the only process through which one can find the exact date when a baby is conceived. Due dates can be calculated through different formulas depending upon the type of IVF. If IVF and embryo transfer have been successful there are three ways of estimating the date.
- Day of egg collection
- Day of transfer i.e. day 3
- Day of transfer i.e. day 5
IVF vs IUI
Intrauterine insemination (IUI), additionally referred to as synthetic insemination, is a way in which the uterine hollow space gets sperm immediately from a catheter. This approach reduces the time and distance required for the sperm to tour to the egg and fertilize it. This system is not like IVF, in which the eggs and sperm are positioned collectively outdoor of the frame in a managed environment. IUI is usually used to deal with moderate male component infertility and couples with unexplained infertility. A character present process IUI can also acquire medicinal drugs to stimulate ovulation. A physician will inject the sperm into the uterus at some stage in the ovulation period. IUI is an easy technique that usually takes 5–10 mins as compared to IVF. IUI is likewise less expensive than IVF. IUI, on average, expenses among $300–1,000 without insurance. However, IUI is likewise much less successful than IVF. Once the sperm is injected via way of means of docs into the uterine, the frame’s herbal approaches will take over. In IVF, docs can screen whether or not an egg has been fertilized and choose the nice embryo(s).
Success costs for IUI are typically round a 3rd of that for IVF. Additionally, IUI won’t be an appropriate fertility remedy withinside the following situations in which a character: has blocked fallopian tubes has intense endometriosis is in their overdue 30s or over 40 has low-first-class eggs has a low wide variety of eggs This remedy is likewise now no longer appropriate if the cause for infertility remedy is intense male component infertility.
Insemination vs ICSI
It is a way that injects a single sperm into an egg for fertilization.
ICSI is a not unusual place remedy for couples experiencing male aspect infertility. It may additionally enhance the threat of fertilization in humans with a formerly unsuccessful IVF cycle. It is likewise for cycles that plan to apply preimplantation genetic testing.
The American College of Obstetricians and Gynaecologists accomplice ICSI with a barely better hazard of delivery defects, including:
- Angelman’s syndrome
- Beckwith-Wiedemann syndrome
- Autism spectrum disorder
- Intellectual disability
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