If you have been trying to conceive a baby for a while without success, you may be thinking about in vitro fertilization, or IVF.
This is one of several fertility treatment options, all of which you should understand carefully before deciding to try. Get started by learning the answers to some of the most common IVF questions.
What is IVF?
IVF is considered by most doctors and specialists to be the most effective treatment for couples that are having trouble conceiving. There are many different fertility problems that can be solved with IVF treatment, including Fallopian tube blockage or damage, low sperm count, or general infertility whose cause has not been found.
The basic idea behind the treatment is to take eggs directly from the ovary, so that there is no need for them to pass through the Fallopian tube to the uterus. Then the eggs are mixed with sperm in a laboratory, making their job much easier as well! Finally, the fertilised egg is put into place in the uterus.
How does IVF work?
The cool thing about IVF is that it allows the egg and the sperm to do their jobs on their own—they just do it in an environment that’s easier to work in! But there are usually a few extra steps involved in the IVF process. If you have IVF treatment, your doctor will determine if there are any steps in the series that you may skip and will help you through the process. But the typical steps in the IVF process include:
- Taking fertility drugs: sometimes this is all a woman needs and she becomes pregnant naturally. Essentially, these rev up your ovaries to produce as many mature eggs as possible. In most cases, the medicine is called gonadotrophin-releasing hormone (GnRH), which is taken for a couple of weeks, either in injection form or in tablet form.
- Having hormone injections: after the fertility drugs, you’ll need some extra hormones too, in order to keep helping your ovaries produce more mature eggs. A doctor or nurse usually administers these for 10 to 14 days. The medical team will also keep track of your hormone levels and check up on your eggs during this time.
- Getting your eggs removed: the doctor will keep a close eye on your eggs via ultrasound so that he or she will know when they’re ready to be fertilised. The tool they use for extraction is a hollow needle in the end of an ultrasound probe. They use the probe to find the eggs, and then the needle to take them out. The procedure can be uncomfortable with mild to moderate pain afterward.
- Collecting your partner’s sperm: don’t forget the other half! Around the same time that you’re having your eggs removed, your partner will need to provide a sperm sample. Or, if you are using donated sperm, the sample will be prepared. The medical team will then analyse the sperm and decide which ones are most likely to successfully fertilise an egg.
- Fertilisation: the eggs and sperm are mixed together in a culture dish and monitored. Within 24 hours, the medical team will be able to tell if any eggs have been successfully fertilised. If yes, they will be monitored for the next two to five days.
- Embryo transfer: once the eggs have been successfully fertilised, they can be inserted. Depending on your personal fertility situation, the doctors may go ahead and implant them as early as two days after. Or, they can wait until 5 days, when they have grown into a clump of cells, officially known as a blastocyst. Sometimes more than one embryo has been successful and multiple embryos can be implanted. However, no more than three will ever be inserted during a round of IVF.
- More hormones: continuing to take progesterone will help your uterine lining grow thick enough to support the embedding and growth of an embryo.
- Storing what’s left: If there are any leftover fertilised eggs that were not implanted, the medical team may store them just in case they need to be used for a future round of treatment.
After following these steps, the doctor will keep a close eye on your progress. If (at least) one of the embryos continues to grow, congratulations, you’re pregnant! If the first round of IVF treatment doesn’t work, however, the doctor may use any leftover fertilised eggs for another round of treatment, or you may start from the beginning of the process again.
Who can have IVF treatment?
As with all medical procedures, IVF is not for everyone. There are a number of factors that can influence your eligibility, especially whether or not the procedure would be covered by the NHS. Here are some of the recommendations, according to the National Institute of Clinical Excellence (NICE):
- For women between the ages of 23 and 39, as many as three rounds of IVF treatment should be covered by the NHS.
- For women between the ages of 40 and 42, only one round of IVF treatment should be covered, and only provided that they have a sufficient amount of viable eggs and have never had the treatment before
- Women who already have children are most likely ineligible
- Women who have already had IVF treatments, whether paid for privately or by the NHS, are most likely ineligible
- Be prepared to spend some time on a waiting list, as there is more demand than capacity for IVF treatment
- Priority will be given to those couples who have a demonstrated infertility problem
What is the difference between IVF and artificial insemination?
IVF and artificial insemination are not the same thing. There are key differences to the procedures, which means that each is optimal for a different type of client, and also that each will have different rates of success. Here are some of the major differences between the two:
- Whereas IVF involves removing the eggs and fertilising them in a lab, artificial insemination implies choosing healthy semen and inserting it directly into the uterus.
- Both procedures stimulate the ovaries to produce more eggs, but this stimulation is minimal with artificial insemination.
- Artificial insemination is not a viable option for women who have Fallopian tube blockage or for men who have very weak sperm.
- Artificial insemination is not a viable option for couples who have been trying for more than 3 years or for women with endometriosis.
- There is no way to check on fertilisation status with artificial insemination, something that is indeed possible with IVF.
- The chances of conceiving are much lower with artificial insemination than with IVF.
What are the success rates of IVF?
IVF is such a desirable option for many couples precisely because the success rates are so high. Of course, the specific chances of getting pregnant will depend on many factors, especially age. These are the age-specific likelihoods of success, according to statistics from 2010:
- Under 35 years: 32%
- 35 to 37 years: 28%
- 38 to 39 years: 21%
- 40 to 42 years: 14%
- 43 to 44 years: 5%
- Over 45 years: 2%
Additionally, having been pregnant or giving birth previously increases your chances. It is also helpful to maintain a healthy body weight, avoid excessive alcohol and caffeine consumption and refrain from smoking.
Finally, the more rounds of IVF treatment you have to try, the less likely it is to work for you. However, IVF isn’t the end of the road in terms of having a child and there are still other options for you to explore.
What are the advantages and disadvantages of IVF treatment?
There are many advantages of using IVF to work around fertility problems. Primarily, the chances of success are much higher than other options. For many women, especially those with Fallopian tube problems, it is the only viable choice. And although some have suggested that there is a connection between IVF and birth defects, there is no evidence to back up this claim.
However, there are some risks that could make you think twice about IVF. Specifically, there is a slightly increased possibility of having an ectopic pregnancy. You are also much more likely to have twins or even triplets than you would be with a natural pregnancy, since more than one embryo is implanted in every treatment. This can be a dream come true, or it could be a nightmare if having multiples results in pregnancy complications. Finally, there can be some unpleasant symptoms related to the fertility drugs, like nausea and headache. Or you could suffer from ovarian hyperstimulation syndrome (OHSS), where the ovaries become painfully swollen and treatment needs to be cancelled.
How much does IVF cost?
As mentioned previously, some people are eligible for IVF treatments through the NHS, and others are not. If you are considered eligible, your treatment will be free. However, there are private clinics that can provide you with the service, but for a hefty cost. You can expect prices of up to £5,000 per round of treatment, and you will have to pay this amount again if you need any additional rounds.