On 16th August 2018, Cloudnine conducted a live Tweetinar on Understanding IVF on its Twitter handle @CloudnineCare. It was helmed by Dr. Radhika Sheth, Fertility Specialist at Cloudnine Hospital, Malad, Mumbai. The Tweetinar drew spirited participation from Twitter users and swept across a gamut of in vitro fertilisation-related topics.
Specialist Details: Dr. Radhika Sheth
Specialty: Reproductive Endocrinology
Clinical Focus and Expertise: Infertility evaluation, infertility treatment, reproductive medicine, intracytoplasmic sperm injection (ICSI), in vitro fertilisation (IVF), intrauterine insemination (IUI), polycystic ovarian syndrome (PCOS) management
Tweetinar Questions & Answers
|1||What is the success rate for IVF?||IVF success hinges on multiple factors, age being the foremost. The average IVF success rate is about 40-45% per cycle.|
|2||Is age an important determinant of IVF success?||Yes, age plays a vital role in determining IVF success.|
|3||What are the factors that influence IVF success?||The quality of the sperm and egg, the receptivity of the uterus, and the ages of the partners are some important factors.|
|4||I lost my right fallopian tube last year due to an ectopic pregnancy, and recently discovered that my left tube is also blocked. What are my options for conception?||IVF is a suitable option for tubal blockages and losses, and may be your next best option.|
|5||I have an extremely low AMH of 0.38. Am I still a viable candidate for IVF?||The chances of IVF success decline as AMH lowers. However, IVF can still be attempted with an AMH of 0.38.|
|6||I have been trying to conceive for over a year but have so far been unsuccessful. What should I do?||Consult a fertility specialist for further evaluation and seek appropriate treatment, if necessary.|
|7||Are birth defects more likely to occur in IVF, than in natural conception?||This is a misperception. Most couples that seek IVF have an advanced maternal age or low sperm count. As a result, they have a higher propensity to produce embryos with defects. The chances of defects for such couples are just the same as they would be, if they were to conceive naturally.|
|8||Despite having had my fibroids removed, I am finding it difficult to conceive. Should I consider IVF?||In your case, there may be factors other than fibroids that are posing as hurdles to conception. Consult a fertility specialist to have your fertility profile assessed.|
|9||Does IVF work on women with PCOS?||Women with PCOS generally respond well to IVF programmes.|
|10||What is the right age for IVF?||There is no ‘right’ age for IVF. The lower the age, the better the success rate.|
|11||What are the risks of IVF?||IVF poses a slight risk of ovarian hyperstimulation syndrome, which causes the formation of multiple eggs. This, in turn, can lead to a multiple pregnancy. However, on Cloudnine, we minimise this risk by tailoring conservative, custom-made protocols.|
|12||When is IVF needed?||Common scenarios include extremely low sperm count, low egg reserves, bilateral tubal blockage, premature ovarian failure, multiple failed IUI cycles, severe endometriosis and third-party donor programmes (egg or sperm).|
|13||Can one follow a daily exercise routine during IVF treatment?||Yes, as long as it includes only light exercises that don’t put pressure on the abdomen.|
|14||Are there any risks to having a baby via IVF?||The odds of a multiple pregnancy are higher with IVF. Higher order pregnancies can present complications like prematurity and low birth weight.|
|15||Is there an age limit for IVF?||There is no age limit, although outcomes are usually inversely proportional to age.|
|16||Any popular IVF myths you can bust?||Here are some.
Myth: IVF is usually advised only when the female partner has problems.
Fact: IVF is equally suited for problems with the male or female partner.
Myth: IVF has a 100% success rate.
Fact: IVF success rates vary between 40-45%. The lower the age, the higher the success rate.
Myth: IVF requires hospitalisation.
Fact: IVF requires only a few hours at the hospital each time for egg collection and embryo transfer.
Myth: IVF is painful.
Fact: Contemporary IVF routines are less painful than earlier, thanks to minimal-pain injections.
Myth: IVF requires complete bed rest.
Fact: IVF does not require a change in your daily routine.
|17||Is a baby conceived through IVF more likely to have mental or physical problems?||No, IVF does not increase the risk of health problems in the fetus.|
|18||Can a couple have twins via IVF?||IVF does increase the chances of twins. However, this risk can be minimised through a single embryo transfer protocol.|
|19||Is it possible for a couple to conceive naturally the second time around after having had a child via IVF?||It is possible depending on why IVF was needed the first time around.|
|20||Is IVF expensive?||It is a relatively expensive procedure due to the technology involved. There is no standard pricing for IVF. The price of a cycle pivots on the exact protocols employed.|
|21||Can tubal blockages be opened via IVF?||Tubal blockages can be opened via laparoscopy.|
|22||Is IVF painful?||IVF is not painful. The egg retrieval procedure is done under anaesthesia, and is therefore, painless.|
|23||Do fertility hormones pose long-term health risks?||No, they don’t.|
|24||How long does it take to complete an IVF cycle?||An IVF cycle takes between 18-20 days from initiation to completion.|
|25||How long after an IVF cycle does one know its outcome?||An IVF outcome is known about 12-14 days after embryo transfer.|
|26||Is it worth trying another IVF cycle after a failed one? Does the probability of success fall with each successive attempt?||It is definitely worth attempting a new cycle after a previously failed one. The cumulative success rate of 3 IVF cycles stands at roughly 50-55%.|
|27||Does IVF increase the odds of twins or triplets?||Yes it does, although this risk can be minimised.|
|28||Does IVF require frequent visits to the hospital?||In total, about 4-5 visits are needed for an IVF cycle.|
|29||After how long of trying for a baby naturally, do you recommend that a couple consider IVF?||A couple should try for 12 months on their own before seeking help. A fertility specialist can then gauge which fertility treatment they are best suited for after performing diagnostic tests.|
|30||Are all infertile couples within the permissible age band, suited for IVF?||IVF suitability is case-dependent. A fertility specialist can recommend the most viable treatment based on careful evaluation.|
|31||How can a woman prepare her body for an IVF cycle?||A good diet and optimal hydration are necessary precursors to IVF. Also, it is important to have your thyroid and haemoglobin levels checked before embarking on a cycle. In some cases, a hysteroscopy may be advised before IVF for correction of certain uterine problems.|
|32||What are the medical prerequisites for IVF?||To go ahead with a cycle, blood pressure and blood sugar must be in the normal range.|
|33||Can polyps interfere with implantation?||Yes. This is why polyps must be removed prior to embryo transfer.|
|34||With both endometriosis and fibroids, is it still worth pursuing IVF?||A fertility specialist will be able to give you answers only after gauging your suitability based on a diagnostic routine.|
|35||How long does one need to stay at the hospital for an IVF cycle?||While a few visits to the hospital may be required, none require more than a few hours each. The egg retrieval routine may require admission of a few hours; nothing more.|
|36||How is IVF fit determined?||Pre-IVF tests can shine a light on whether a woman is suited for IVF. Apart from this, overall health should be optimal in order to qualify for IVF.|
|37||How safe is IVF?||IVF is considered a relatively safe treatment procedure. Contemporary treatment protocols have brought the risk associated with IVF down to a negligible level.|
|38||Can obesity impact IVF outcomes?||Yes, obesity can have an adverse effect on IVF outcomes.|
|39||Does endometriosis affect implantation?||Yes, it can hinder implantation.|
|40||Is IVF governed by legal guidelines?||IVF in India is currently governed by IPMR guidelines.|
|41||Is 3 cycles the maximum advisable cap for IVF?||Every case is different, and you may be advised a fourth cycle by your fertility specialist after a careful review.|
|42||How much does IVF cost?||There is no standard pricing for IVF. The price of a cycle pivots on the medical conditions involved and the exact protocols employed.|
|43||How long does one need to take fertility hormone injections as part of an IVF cycle?||In an IVF cycle, 9-10 days of injections are generally needed for egg development.|
|44||Today is my eighth day after embryo transfer and I still don’t have any pregnancy symptoms. Should I be worried?||Not everybody has symptoms in the early days. Only a beta HCG test on the prescribed date can confirm whether you are pregnant or not.|
|45||What are the steps of IVF?||IVF entails the following steps:
|46||What is the likelihood of IVF success for a woman with low AMH?||Depending on AMH reserves, the likelihood is about 15-25%. However, age also plays a critical role in IVF success.|
|47||I do not have a uterus, but I do have ovaries. Can I still grow my family?||You can! You can have your embryo transferred to a gestational surrogate via IVF. Consult a fertility specialist to discuss this in detail.|
|48||I got pregnant on my fourth IUI attempt, only to have it end in miscarriage at ten weeks. Should I opt for IUI or IVF as a next step?||Your fertility treatment plan will depend on factors like age, duration of infertility and sperm count. Speak to your fertility specialist to know more.|
|49||What is the best treatment for blocked fallopian tubes?||A laparoscopy can shed light on whether a particular blockage can be removed. Alternatively, IVF is a preferred choice for conception among women with tubal blockages.|
|50||Does severe coughing or vomiting affect IVF success?||Any illness can adversely impact IVF success.|
|51||Is IUI recommended for low sperm count?||IUI is not a suitable treatment for low sperm count. Your fertility specialist may perform a detailed fertility assessment before suggesting a further course of action.|
|52||Does IVF increase the chances of preterm labour?||IVF presents a slightly increased risk of preterm birth compared to natural conception.|
|53||Can endometriosis be treated without surgery?||This depends on the severity of endometriosis.|
|54||Can a woman with one fallopian tube get pregnant naturally?||Yes!|
|55||Despite all our reports being normal, we are not able to conceive. What should we do?||Unexplained infertility is a distressing thing. IUI is generally recommended in such cases.|
Authored By: Dr. Radhika Sheth Fertility Specialist, Cloudnine Hospital