Understanding IVF Tweetinar on Cloudnine

September 1, 2018

Infertility Treatment

Fertility Technologies

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:

  1. 9-10 days of hormone injections, to stimulate egg development
  2. Egg retrieval under anaesthesia
  3. Fertilisation of the egg and sperm in a carefully controlled environment
  4. Embryo transfer
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

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