Somehow, IVF - or in vitro fertilisation - has always been used interchangeably with fertility treatment in urban, everyday parlance. The terms have managed to remain tantamount to each other. And yet, the truth is, IVF is just one fertility treatment - among dozens of others - that forms a part of the fertility solutions umbrella. As one of the most effective treatments available, it's no surprise that it's better known than its counterparts.
If you've been recommended IVF and are considering your next steps, this article should help shine the way.
IVF, unlike natural or artificial insemination, is an advanced fertility treatment that involves uniting eggs and sperm in a petri dish, in a carefully controlled environment. The most resilient resultant embryo (or embryos) is then matured up to 5 days, to the blastocyst stage, and placed inside the uterus for implantation. IVF is on the more expensive end of the fertility treatment spectrum and is usually recommended to couples after other viable options have been exhausted, or in the absence of another first-line treatment.
Not all couples with infertility may need to opt for IVF; other treatments like intrauterine insemination (IUI) and ovulatory stimulation may suffice for many. Typical profiles for IVF are outlined below.
Studies have proven that less than 9 million sperm per millilitre of semen can dramatically bring down the chances of a healthy pregnancy - naturally. However, a man with a low sperm count can still be a suitable candidate for IVF, and even more so for ICSI. ICSI is a powerful sperm selection method that injects a healthy sperm directly into an egg to boost the chances of fertilisation. It is preferred in cases of sperm deficiency.
Women who do not respond to ovulation induction may be required to consider IVF as their only route to conception. For example, extreme cases of polycystic ovarian syndrome can lead to severely compromised ovulation, with IVF proving to be the only hope.
Scarred, blocked or structurally problematic fallopian tubes may hinder the flow of the egg from the ovaries to the uterus and pose obstructions to sperm. Tubal blockages may make it impossible for a couple to conceive on their own.
A vasectomy or tubectomy, or both, can render you and your partner incapable of conceiving naturally. In such a case, IVF may be your only shot at conception.
In endometriosis, uterine tissue begins to grow outside the walls of the uterus, causing pelvic adhesions, inflammation of the fallopian tubes and decreased reproductive function. A laparoscopy can be useful in inspecting the reproductive landscape, paving the way for a carefully tailored IVF treatment.
A couple, where the husband or wife harbours a known genetic disorder, may choose to perform preimplantation genetic testing on their embryos prior to implantation. Preimplantation genetic testing can help in creating a genetic profile of each embryo and rule out those with genetic predispositions.
While some couples may be advised IVF after they have attempted simpler routines like IUI, surgery and follicular stimulation, for others, an advanced fertility treatment may be the only option. Couples who opt for donor sperm or eggs or carry serious genetic diseases may choose IVF. Also, cancer patients about to embark on chemotherapy or radiotherapy may prefer to freeze healthy eggs or sperm to safeguard their fertility (these can be thawed and used in IVF later).
Your IVF outcome hinges on how experienced and well-equipped your fertility doctor is. Embryo transfer is an intricate procedure that leaves zero margin for error. It involves the scrupulous arrangement of a host of elements - from catheter positioning and progesterone injections to ultrasound imaging and final embryo placement; every step is as important, if not more, than the last. If you have faced recurrent failures with IVF, your fate may be more a result of your doctor than your disease. If you're already on your fourth cycle and still haven't seen any luck, it's time you considered a change of fertility specialist. Ask among friends and relatives, scour online reviews, evaluate fertility outcomes and visit various IVF centres to gauge your level of comfort. When it comes to making the final decision, choose a seasoned fertility doctor with a proven track record. It only takes one successful cycle to make a miracle. Let your next one give you yours.