April 7, 2020
Author Name: Dr. Vimmi Kaur Mentor Name: Dr. Nitasha Gupta on April 07, 2020
There are many reasons why people turn to IVF – It can be fertility, a back up plan when you are worried about your life’s progression, the need for genetic testing or because of health issues such as cancer.
No matter the reason, IVF offers hope but it also can be a long, hard, emotional and isolating road.
With more and more couples opting for IVF technique, it is more important than ever to understand how you can make your treatments more successful.
1) Selection of your fertility clinic – The clinic you decide to carry out IVF treatment will significantly affect your IVF success. Therefore we need to well stress on the choice of IVF clinic, their technology, physician as well as laboratory apparatus employed, since every IVF centre does not get the same IVF success rate.
2) Life style modification – Maintaining a healthy weight, reducing stress, eating healthy, quitting smoking , decreasing alcohol intake, regular exercise can help to boost success of IVF.
3) Opting for techniques – Such as Laser Assisted Hatching and Blastocyst Culture enhance IVF success rate.
a) Laser assisted hatching – It is a technique that can make it easier for the embryo to hatch or break through its outer layer or shell (a membrane known as zona pellucida) by creating an opening. This eases implantation.
b) Blastocyst culture – Blastocyst refer to a day 5 embryo , grown in laboratory in cuture media. Embryo transfer at the blastocyst stage have a greater chance of implanting as compared to traditional day 2 or a day 3 embryo transfer.
4) Frozen embryo transfer versus fresh embryo transfer – For patient going through self eggs IVF, frozen embryo transfer can give increase possibilities of IVF success when compared to fresh embryo transfer. Another added advantage of frozen embryo is that the extra embryo might offer the opportunity of attempting once again without needing to have ovarian stimulation all over again. To add on, in frozen embryo transfer ovarian hyper stimulation syndrome(OHSS) which is a rare complication of ovarian stimulation is seldom seen, as compared to fresh embryo transfer, since conception might enhance OHSS risk.
5) Pre implantation genetic testing – It refers to the genetic test done on a day 5 or day 6 embryo to determine whether the embryos are genetically normal or not. Thus it helps us identify chromosomally normal from those abnormals that have no chances of leading to a healthy pregnancy. This is especially beneficial for couples with advanced age and couples with previous IVF failures. The normal “euploid” embryos have definitely higher success rate as compared to abnormal “aneuploid” embryos.
6) Indivisualizing stimulation protocol – After decades of practice using IVF, it is now very clear that “One size fits all” approach no longer exits. Many patient benefit with individualized protocol that considers the patients unique characteristic, needs and treatment history and combines elements from standard protocol to m aximize chances of becoming pregnant. Selection of an effective protocol on an individual basis increases the chances of success and offers several benefits like maximizing oocyte yield, reducing patient discomfort and decreases the risk and drop outs.
7) Improving chances of implantation–
a) Platelet rich plasma (PRP) – Platelet contains a significant amount of growth factor that have positive effects on local tissue repair and endometrial receptivity. Effective embryo implantation requires a receptive and a satisfactory endometrium. So, in patient suffering from weak endometrium, the use of autologous plasma rich protein (PRP) before embryo transfer promotes endometrial growth, improves implantation an therefore pregnancy outcome.
b) Granulocyte colony stimulating factor (GCSF) – It is also a type of growth factor that improves the endometrial vascularity and is thus beneficial if used prior to embryo transfer.
c) Potential role of stem cell – Research has shown that stem cell can treat degenerative diseases, cure malignant cancers and repair damage tissue. However a number of stem cell therapy remain unexplored, thus vast untapped potential still exist with regard to application in treating diseases such as infertility. It may have a potential role to cure infertility and enhance success rates of IVF once the right approach is found.
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