April 8, 2020
Author Name: Dr. Divya Mentor Name: Dr. Amol Wankhede on April 08, 2020
Incidence of infertility in India is 10 to 15%, in other words 27.5 million couples are living with a long cherished dream of becoming parent. If we broaden our vision then 48.5 million couples in world, which is 1 out of 4 are struggling with the same issue. All women who are facing similar situation in their life, you all need to know and understand that you are not alone in the tough journey towards motherhood. So relax,keep calm and take a deep breath first.
IVF has already turned dream of 8 million people till now into reality. So keep your fingers crossed, you are just one step away for enjoying motherhood. In vitro fertilization (IVF) also known as ‘test tube baby’ is a process involving mixing of man sperm with female egg outside the body in laboratory to form embryos. Those embryos (one or more) are then transferred into woman’s womb. But should every woman go for IVF? No, certainly not, most important part is identifying problems at earliest, so that every woman can live their dream into reality at perfect time. Listed below are few circumstances under which one should go for IVF without a glitch.
1. Bilateral fallopian tube blockage or damage: Blockage of both tubes leaves us with no other option as we all know natural pregnancy begins in tube. Damage to tubes can be due to chronic pelvic infection, tuberculosis, collection of dirty water or pus (hydrosalpinx / pyosalpinx) and with history of previous abortions.
2. Severe male factor infertility: In cases of azoospermia (no sperm in semen sample) and severe oligospermia (very few sperms in semen sample), natural pregnancy is not possible as there are no sperm or they get destroyed before reaching to fallopian tubes. In these cases, IVF utilises micro surgical techniques like TESA/TESE/PESA/MICROTESA which enables extraction of sperms from man’s testis. So in many cases IVF enables men to become biological father.
3. Menopausal state / Premature ovarian failure (POF): when a woman stops having her periods for a year, she attains menopause. POF is also known as premature menopause, which is cessation of periods in young women. In both situations a woman become devoid of eggs in the ovary and no more has potential to bear a child. IVF works magical for these people by bringing their periods back and getting them pregnant with the eggs of other younger women (Donor oocyte).
4. Endometriosis: Endometrioma or Chocolate cyst is a condition in which blood like material gets collected inside the ovary. It releases toxins, which damages the eggs, affects egg forming capacity of ovary. It distorts tubal anatomy thus blocking the chance of normal pregnancy. Endometriosis affects uterine walls which is called as Adenomyosis, which also decreases chances of embryos to get implanted in uterus.
5. Cases which need Preimplantation Genetic Screening (PGS): In PGS, few cells are taken out from an embryo by an expert embryologist and are sent to genetic laboratory for chromosomal or genetic study. With the help of IVF we can screen the embryos first, so that only healthy embryos would be transferred resulting in a healthy baby. Hence IVF is a gift for those couples who have any hereditary disease which can be genetically transmitted to their future baby or who has history of previously affected child.
6. Advance maternal age: Late marriage and delayed childbearing has become very common these days. Studies have revealed, that age is one of the single most important factor impacting pregnancy -as egg forming capacity and quality of egg starts declining rapidly after 35 years of age. Also chances of genetic abnormalities increases with increasing age. In these patients IVF helps them to conceive and also enables them to screen embryos for any genetic abnormality.
7. Couple who want to postpone pregnancy: In this era of corporate world and competition, every couple want to gain financial and career stability before they plan their pregnancy. For these females it becomes difficult to become pregnant at appropriate age and they have to delay their pregnancy. But as age advances there egg forming capacity decreases and so as chances of conceiving naturally. These women can undergo IVF stimulation, can get there eggs or embryos freeze for future use. So that they can plan their pregnancy whenever they are prepared for it. Hence IVF relieve their stress by bridging the gap which was essential for them to build up their career by making their wish come true at their ease.
8. Unexplained infertility: Among the couple who are seeking treatment for infertility, about 5% of couples are these couple whose reports remains normal but still they are unable to conceive. In this scenario simpler treatment like IUI can be offered but many times waiting for too long to try their luck is not a good choice. IVF is a direct key to their luck.
Besides above mentioned conditions Anovulation which is not responding to simple treatment, previous 2 or 3 IUI failure patients and few other circumstances in which other sort of treatment has failed for them, woman should go for IVF treatment.
IVF technique has other benefits to like anyone can go for it, you can use donated egg or a sperm if you are deprived of your own. You can take help of any close relative or family member to give you a baby by acting as surrogate. New genetic screening methods (PGS) have decreased the incidence of abortions, increased the chances of successful pregnancy and having a healthy baby.
There are some disadvantages or side effects associated with this treatment. It is a costly approach for most of the people in developing country like India. But many IVF centers are providing this treatment at affordable cost. Also many centers are providing packages for 2 or 3 cycles of IVF which is making easy for couple who have faced failed IVF treatment previously.
There are other minor side effects such as giddiness, headache, heaviness in abdomen, bloating sensations, which many times does not require any specific treatment. OHSS i.e. Collection of fluid inside abdomen is worrisome complication. Predicting patient with possible chances of OHSS, using appropriate protocol for stimulation and trigger, certain medicines, proper monitoring helps us to lower the incidence of OHSS or to manage it at earliest stage.
Undoubtedly, IVF is very effective way to combat infertility and become pregnant. But while deciding for the treatment, second most important aspect is going for a center which has significantly high success rate. It is of great significance because going for IVF is a big step, as it involves your money, emotions relationships and your precious time. Couple facing infertility are already under lot of stress, anxiety and tremendous social pressure due to attached stigma. So a quick move towards most fruitful route( IVF)and towards a center with good success rates can help you bring your baby at home in least possible time.
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