Things You Should Know About Giving Birth Through In Vitro Fertilization

Infertility is a common phenomenon affecting around 1 in 6 couples all over the world. It may be solely due to either of the partners or a result of a combination of both. Some couple who are unable to conceive go for the in vitro fertilization process or IVF to birth a child. IVF may be considered as an option even by same-sex couples, single women or those having a genetic disorder. In vitro fertilization is a procedure for the treatment of infertility that assists in the conception of a child. It is one of the Most Effective Assisted Reproductive Technologies (ART) available, however, the chances of conception depend on other factors too. This may include factors like age, the reason behind partner's infertility, quality of egg and so on.

Things to Know Before the Procedure

Before opting for the procedure, there is a lot of mental and physical preparation that goes in to ensure a higher success rate. Some of the things to keep in mind before the procedure include the following.

1. Let the body take its time- IVF is a huge step, which is why it must be given its due time. 3-6 months is an ideal time to prepare for IVF; it is mandatory to consult a professional regarding the same. Consult a gynaecologist specializing in fertility.
2. Quit smoking and drinking- Smoking and drinking during IVF can considerably reduce the chances of conception. Nicotine makes the ovaries resistant to fertilization. Alcohol consumption during an IVF cycle reduces success rate by 50%, rendering the treatment mostly unsuccessful.
3. Consume fertility enhancing foods- Foods that enhance fertility must form a major part of the diet for IVF. Foods like eggs, fish roe, seeds, nuts, caviar etc. nourish the offspring. Moreover, other fertility enhancing foods like algae, bone marrow, seaweed, raw milk, oats, sprouts, etc are also good options. Remember the golden rule- When in doubt, go for fresh seasonal, organic whole foods cooked at home.
4. Improve sleep patterns- The quality and quantity of sleep influences the sex hormones, sperm production and ovulation. Therefore, it is crucial to ensure that both partners are getting quality sleep. Most importantly, 1-2 weeks before the procedure.
5. Reduce stress- Stress is not only bad for the mother-to-be, but it also affects egg health. Moreover, having a relaxed state of mind boosts the process of contraception. Stress isn't great anyway!
6. Perform breathing exercise- Breathing into the belly eliminates stress hormones from the body. It is good to be done during any of the stages and anywhere. It helps by flipping the switch from the sympathetic nervous system to the parasympathetic nervous system.

Things to Know About the Procedure

Before finally deciding to go for the in the vitro fertilization process, it is good to know how it works and how the process goes about.

Phases of the In Vitro Fertilization Process

The process of receiving IVF can be split into three phases-

Phase 1 - Stimulating the Ovaries

The first phase involves receiving fertility shots to increase the production of the follicle and stop ovulation. This would involve a number of visits to the doctor for blood tests and ultrasounds.

Phase 2 - Egg Retrieval or Egg Collection

When a woman undergoes IVF, the doctor prescribes a hormone therapy that triggers the maturation and production of multiple oocytes. For the eggs to fertilize in the laboratory, the collection must be done before the eggs are released. This requires carrying out follicle puncture before natural ovulation. This phase involves minor surgery to retrieve the mature eggs. Even though it is a minor surgery, sedation is required to prevent any form of pain. The main step here is getting into the follicles and aspirating the follicular fluid to collect oocytes. The doctor would then prepare the eggs and place them in a petri dish where the sperm is introduced. This involves injecting a single sperm into each egg.

Phase 3 -  Fertilization

Once the fertilization of the eggs takes place, the cells continue to divide till Day 3 or 5. This is the day when the embryos are transferred. After this, they may be screened for any disabilities like downs syndrome, muscular dystrophy, cystic fibrosis, etc. After this, it is for the parents to decide the number of embryos they want to transfer to the uterus.

Starting the IVF Procedure

Before the IVF treatment, the doctor would perform a number of tests on both the partners to confirm the levels of fertility. Some of the requirements include-

• Ovarian Reserve Test- The doctor would do an ovarian reserve test to determine the quantity and quality of the eggs. This involves a blood test during the first few days of the menstrual cycle. The doctor would determine the response of fertility medication on the basis of the test result and an ultrasound of the ovaries.
• Uterine Cavity Exam- The doctor may ask for a uterine cavity exam using a sonohysterography. Here the doctor injects a fluid through the cervix into the uterus after which ultrasound is done to create images of the uterine cavity. The doctor may perform a hysteroscopy where he inserts a flexible telescope into the uterus through the vagina to determine the state of the cavity.
• HSG- It is a common procedure where the doctor injects a dye through the cervix and takes x-rays to look at the cavity confirming if the fallopian tubes are open.

The Risks and Costs of the Procedure

The in vitro fertilization process is costly and may take a lot of time. Moreover, it is not a sure shot procedure and one may have to go through 2 or 3 rounds before finally conceiving. Besides, the procedure can be mentally draining, especially if they have been waiting for long to conceive. Some of the risks associated with the procedure are-

• multiple births- In vitro fertilization increases the risk of multiple births if one chooses to implant more than one embryo. Being pregnant with multiple babies also means a higher risk of early labour.
• premature delivery and low birth weight.
• ovarian hyperstimulation syndrome- The ovarian hyperstimulation syndrome may occur as a result of injectable fertility drugs when the ovaries become swollen or painful. Some common symptoms are bloating, nausea, vomiting, diarrhoea and abdominal pain.
• miscarriage- The rate of miscarriage is similar for women who conceive using IVF and those who conceive naturally. This rate may, however, increase as the age of the mother increases. Moreover, using frozen embryos also increases the risk of miscarriage.
• egg-retrieval procedure complications- The doctor uses an aspirating needle during egg collection which could cause infection, bleeding or damage to the bladder, blood vessels, or bowels.
• birth defects- There may be chances of birth defects in IVF pregnancies.
• ectopic pregnancy- An ectopic pregnancy happens when the fertilized egg is outside the uterus, mostly in the fallopian tube.

Besides, the procedure is expensive and does not guarantee pregnancy in all cases. The price for fertility medications, ultrasounds, blood tests, etc. can be tough on the pocket. Moreover, most insurance companies cover diagnostic procedures but not IVF treatment.

Things to Know After the Embryo Transfer Procedure

After the IVF embryo transfer, the success rate depends only on the implantation and embryos potential. In such a scenario, the patients may ask a number of questions including what to avoid, how much rest is necessary, and so on. Once the patient has left the hospital, life comes back to normal as the embryo has been transferred and it is just a countdown to pregnancy test day. The best thing to do after the procedure is to continue leading the normal lifestyle. Try not to worry much about the pregnancy and the results. More useful tips and precautionary measures after the procedure are mentioned below.

Rest Duration

It is good to rest after the procedure, however, a 30 minute rest period in the clinic is more than sufficient, unless suggested otherwise. Once out of the clinic, there is no reason behind the extension of this time period. At home, one can get back to all the normal activities apart from heavy weight-lifting, using a trampoline, and be performing strenuous exercises. One can perform daily chores where no physical exertion is needed.

Drink Plenty of Water

Drinking water is highly recommended (given urination is normal) as it not only clears the body of harmful toxins but helps the body in many ways. Also, limit salt intake.

Sexual Intercourse

Before taking the pregnancy test, the doctor recommends a period of pelvic rest. During this period, the couple must abstain from having sexual intercourse.

Avoid Water Immersion Baths

It is best to avoid hot baths in the bathtub or entering the swimming pool or going to the beach as it may open the mother to germs causing infection. This might hinder the IVF treatment.

Medication

Any sort of medication must be taken after the doctor's approval. Moreover, if the doctor suggests any sort of medication, its consumption must be timely.

Optimism

One must stay optimistic and positive about the treatment. A positive state of mind affects the body considerably, making it a stress-free period.

Testing for Pregnancy

During normal pregnancy, the embryo attaches to the uterine lining after about 6 to 8 days of entering the uterus. Basically, the entire implantation process can take up to one complete week before completion. Considering the IVF cycle, day 3 embryos must remain in the uterus for a minimum of 3 more days before implantation. However, if it is a day-5 embryo, it must be able to attach to the uterus immediately. Now, the only thing that remains is the pregnancy test. There are two types of pregnancy tests i.e., urine test/ blood test. Usually, one must take the pregnancy test 10-15 days after performing follicle puncture (egg collection). In case of a frozen embryo transfer, this can be done within 10 days, starting from the stage of embryo development. An early pregnancy test will only give a false negative result as the pregnancy hormone increases progressively. An early test would not be able to detect the HCG levels as they may not be detectable. More info on hCG levels. Whatever the outcome is, it is best to inform the doctor at the soonest as they would be able to take it further from there. If the result indicates pregnancy, a visit to the gynaecologist would mean an ultrasound and other physical examination to ensure proper health. If the result is negative and vaginal bleeding is there, one can wait for a few days to do another test.