Author Name: Dr. Ganesh Mhaske Mentor Name: Dr. Sutapan Samanta on April 08, 2020

IVF has made unbelievable strides in field of infertility in recent years. The whole world got startled with the first IVF baby, Louis brown in 1978 by untiring efforts of P. Steptoe and RG Edwards from London. In India “Harsha” is the first fully documented IVF baby born on 6th Aug 1986 in Mumbai.

15 % of all couples who intend to become parents are unable to do so by natural means. The ultimate advantage of IVF for those not so fortunate couples is achieving a successful pregnancy and a healthy baby. Since its inception IVF has provided the opportunity for pregnancies to more than 8 million of couples worldwide that would probably have never occurred.

In following situations where IVF offers big advantages:

1) Tubal factor Infertility
Sexually Transmitted Infections like Chlamydia and gonorrhea , abdominal or genital tuberculosis particularly in developing countries like India , and diseases such as endometriosis can cause Tubal scarring or blockage.
Two main treatment options available for tubal factor infertility are surgical and nonsurgical procedures. Patients opting for tubal surgery for blocked tubes should know that these procedures increase the risk of scar tissue and adhesions which leads to increased risk of ectopic pregnancy, a life threatening condition.

For women with blocked, functionally damaged fallopian tubes or previous tubal sterilization, IVF is the non-surgical option which provides the best opportunity of having a child with good outcome.

2) Male infertility Male infertility following low sperm production, abnormal sperm function or male partner having even nil sperm count (Azoospermia ) can get a baby following advanced IVF techniques . Following development of ICSI, only one normal sperm and ovum required to achieve pregnancy. ICSI is a boon and revolutionized the treatment of male factor infertility.

3) Premature ovarian failure
In young female with premature ovarian failure or peri-menopausal women with low ovarian reserve , IVF provides them a ray of hope that they can conceive or achieve a successful pregnancy and a healthy baby by using donor oocyte.

4) Pre-implantation genetic screening (PGS)
By advanced diagnostic technique like PGD ( Pre-implantation Genetic Diagnosis ) or CGH ( Comparative Genomic Hybridization ) Couple having family history of genetic disorder like mentally retarded baby (Down syndrome ) , cystic fibrosis, thalassemia or when one of the partner is carrier for these conditions in that case PGD provide assured way to improve pregnancy outcome.

5) In conditions like PCOD where women ovulates infrequently , unexplained infertility where basic fertility investigations for both partners remain normal , Endometriosis IVF always has upper hand in achieving successful pregnancy.
6) IVF has given hopes to single mother.

7) It provides freedom to couple to freeze their excess embryo which can be used for future frozen embryo transfer (FET) later on.

As someone says “EVERY COIN HAS TWO SIDES”, similarly IVF has certain disadvantages.

1. Multiple pregnancy and its associated risk to mother and baby Multiple pregnancies are the greatest avoidable risk of IVF. The health and financial burdens it places on mother and also risk of miscarriage, preterm birth, which is a leading cause of infant mortality. However it can be overcome by adopting SET (Single Embryo Transfer) cycle.

2. IVF cycle is costly and success of IVF is not guaranteed. In fact, less than 50 to 60 percent of all couples starting an IVF cycle will achieve a pregnancy and not all of the pregnancies will result in a baby. Hence proper selection of an IVF Centre is extremely necessary in terms of success rate and ethical practice.

3. Although rare IVF has certain risks, including ovarian hyper stimulation syndrome, infections and ovarian torsion. OHSS is potentially life threatening, however it can now be effectively prevented or managed in good set up and by experienced fertility specialist.

4. Ethical concerns about the treatment of leftover embryos after successful IVF pregnancy is also a concern in unregulated fertility clinics.

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