What exactly is IVF? IVF is a frequently used type of assistive reproductive technology. It involves a combination of specifically directed medications and complex medical procedures. First, medications help to boost the development of eggs. The doctor then extracts these developed eggs and they are fertilized with sperms in a laboratory environment. One or more fertilized embryos are then implanted into the uterus. Medications continue and the pregnancy is carefully observed to detect any complications. Many patients require more than one round of IVF for a successful pregnancy.
If a patient wishes to consider IVF as a possible solution for their infertility, or for other personal reasons, it is important to understand that it is a long, step by step procedure which must be followed in order to create the most risk-free environment with highest chances of conception. The tests have undergone after the second step, the first being a detailed consultation with a doctor, who is likely to advise you on what he/she thinks are your best steps forward. This first step is important as once a doctor has knowledge about your medical and genetic history, there may be alternative tests that might be conducted. In vitro fertilization best suits people who have the following issues:
- Women over the age of 40 who have a lesser chance of conception through natural means
2. If fallopian tubes are damaged or blocked and IUI is not an option
3. Reduced function of the ovaries
5. Uterine fibroids
6. Uterine polyps
7. Male infertility, particularly sperm abnormalities
8. Unexplained infertility
9. Women who wish to receive a donor sperm (IVF is a comparatively expensive solution for this when compared to IUI if fertility is not an issue)
In vitro fertilization is a long and complex procedure, the decision to undergo this procedure is dependent on a number of factors. There are a number of tests performed before undergoing IVF, which will determine whether or not a woman is eligible for IVF. These tests ensure that problems such as miscarriage, abnormalities in the embryo or any general infection or disease that could affect the health and chances of successful childbirth are ruled out to the highest extent. These tests can be split into several categories:
- Ovarian reserve testing: This involves a few simple hormone blood tests, which can give a doctor an idea of how many eggs there are in a woman’s body, the ovarian reserve. Three hormones specifically are tested, FSH, AMH, and Estradiol. AMH gives us an idea of the number of eggs remaining, high levels off FSH often means a reducing ovarian reserve, which might affect the effectiveness of IVF.
- Tubal Patency test: HyCoSy, also known as Hysterosalpingo Contrast Sonography, this procedure is unique, normal ultrasound or x-ray do not allow is to properly see and evaluate the condition of the uterus and whether the fallopian tubes are blocked or operational. HyCoSy is a specialized ultrasound examination which gives us a clear view of the fallopian tubes. A contrast agent is inserted into the fallopian tubes which allow the doctor to see. The result of this test is finding out whether or not a woman’s fallopian tubes are operational for an IVF.
- Semen evaluation: In the case where the sperm sample is being provided, a sample is provided and sent to a laboratory for testing. Shape, motility, and concentration of the sperm are some of the things that are tested for. In the case where the male is found to have infertility, ICSI or Intracytoplasmic Sperm Injection, a process where a single sperm is carefully inserted into each egg using micro-manipulation tools, can be done.
- Other options include Digital High magnification, wherein only the healthiest and best sperm are chosen for insertion.
- Prolactin test: Prolactin is a key hormone, vital in the production of breast milk. Too much prolactin in the body can prevent conception. The results of this test can allow a doctor to decide on what drug regiment might be best suited for each woman.
- Screening for infectious diseases: Doctors might screen a patient for HIV, hepatitis B, Chlamydia, Rubella, and varicella. All of these diseases could post a risk to a growing foetus and could cause serious complications.
- An optional test that a doctor might conduct, in order to increase your chances and gain better knowledge about how your body works is known as a mock embryo transfer. A Mock embryo transfer appears as an option in the middle of your IVF cycle. A mock embryo transfer allows the doctor to identify the ideal route to use during the actual procedure. It allows the doctor to understand how the uterus might act during the actual procedure.
Based on the tests conducted, doctors can find information on what the ideal medications and regime the patient should follow, some of these include:
- Hormone-related medications: FSH and LH, or a combination, is sometimes injected to stimulate ovaries. This encourages several eggs to grow at once. HCG is taken after a period of around two weeks in order to help the eggs mature.
- Premature ovulation medications: These will prevent the body from producing the eggs too soon
- Other medications include progesterone, in order to promote the lining of the uterus to develop, to prepare for implantation.
These are some important tests for IVF treatment and will be a part of a process a patient must undergo in order to find out if IVF is the best treatment option for you. It is important to discuss with a doctor what tests need to be done before IVF and share your complete medical history and family medical history, which the doctor will likely inquire about. Based on the findings there may be a number of other tests that may be required. These tests only ensure that you have the best possible chances of having a successful IVF if you decide that this procedure is right for you, it does not guarantee that the IVF procedure will be successful in your case. IVF still carry some risks, regardless of whether the patient has passed all the tests, some of the risks of IVF include:
- Ovarian hyperstimulation syndrome: use of fertility drugs in order to induce ovulation can have negative effects.
- Ectopic pregnancy: Ectopic pregnancy is when the fertilized egg is planted outside of the uterus, there is no way to continue the pregnancy from this stage.
- Age: the older the patient, the lesser chances there are of successful childbirth. Especially women over 45 have a considerably lower chance.
- Stress: The entire process of IVF is a big decision; it can be physically emotionally and financially draining and is very often a trying period for couples.
It is important for any person considering IVF to careful analyses of the process and steps leading up to it and weigh the pros and cons of the procedure. The best consultation is always with a doctor. IVF is generally known as the most effective and successful form of assistive reproductive technology, and once all the required tests have been passed, any person who is ready and willing can undergo the procedure.
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