IVF ExplainedKatlyn Joy |20, July 2013
Over 35 years ago the first in-vitro fertilization was done. Now over 5 million babies have been born worldwide from this most common assisted reproductive technology. IVF is when eggs are removed from a woman's ovaries and placed in a petri dish and then sperm are introduced so fertilization can occur.
Who Chooses IVF?
IVF is an option for couples who cannot otherwise conceive. Typically before trying IVF couples will have tried fertility drugs, lifestyle measures to eradicate low sperm count, and surgery to the woman's reproductive organs if indicated. Usually the last method tried before IVF is artificial insemination where the man's sperm will be placed directly into the uterus.
What Happens Before the Procedure?
Before eggs can be retrieved from the uterus, the ovaries must be stimulated by hormone therapy. This involves injecting hormones yourself, often into the abdomen or the buttocks. The drugs are taken for a week or two for the purpose of forcing the ovary to produce several eggs instead the typical one per cycle. IVF needs several eggs for the procedure because not all the eggs will successfully become fertilized. Doctors will check to see when the eggs are ready by doing ultrasounds or blood tests.
Retrieval of Eggs
For this procedure, a woman will be lightly sedated and a thin needle will be inserted into the abdomen to retrieve eggs from the follicle. If the eggs are not easily located, then the procedure will be done as a laparoscopic surgery guided by a tiny fiber-optic lens. Should surgery be required more anesthesia will be needed.
Before putting the key elements: sperm and eggs together, the doctors will identify the best specimens among the samples. Those chosen will be placed together in an incubator. Within hours fertilization will occur. An embryo will observed two days following fertilization, and five days after it will be a blastocyst. This is when a fluid cavity is formed which is where the fetus and placenta will form.
While the fertilized eggs may be placed as soon as a day after the procedure, most are observed for a couple days before being placed in the uterus to make certain they are developing normally.
The Big Day: The embryo transfer
A long flexible tube with a syringe on one end is used to place the embryos into the uterus. The embryos are placed in fluid for the transfer via a catheter which is guided through the vagina, the cervix and into the uterus. The woman should lie still for a couple hours to give the most chance for the embryos to take hold in their new environment.
Risks of IVF
Some of the risks of IVF include problems with injecting the fertility drugs, like tenderness at the site, bruising, swelling, hematoma, or allergic reactions.
Ovarian Hyperstimulation Syndrome is another risk and can result in fluid accumulating in the chest or abdomen, or blood clots which can rarely lead to stroke, or enlarged ovaries which can be twisted and require surgery. Some women become nauseated, gain weight or experience shortness of breath.
Whenever anesthesia is used there are inherent risks such as an allergic reaction. During egg retrieval, there is a small risk of bleeding or infection and rarely damage to organs.
With IVF there is always an increased risk of multiple pregnancies due to the implantation of several embryos. Risks are always higher with multiples such as preterm labor.
Another risk is a tubal pregnancy, as ectopic pregnancies occur in about five percent of pregnancies through IVF.
If not all embryos are implanted, the remaining ones can be frozen for future attempts.
While an emotional cost of IVF can be the stress involved, the monetary cost can leave some couples out of the picture. IVF can cost upwards of several thousand for just one attempt. It may take three or more tries for many couples.
The Centers for Disease Control and Prevention states that the most recent numbers, from 2009, indicate that IVF procedures result in pregnancy in between 29 and 30 percent of procedures and live births result in 22.4 percent of attempts. However, different factors affect outcomes such as health and age of the parents, and the quality of the eggs, the sperm and the embryos themselves.
However, it is hardly looked at as an experimental procedure anymore and many advances have been made in the field. Those who long to have a biological child can find IVF a gift worth the risks.
Sources: WebMD, University of Rochester Medical Center, CNNKatlyn Joy is a mother to 7 children, and a freelance writer. She earned her Master of Arts in Creative Writing and Poetry, and a Bachelor of Arts in English and was previously an adviser to new mothers on breastfeeding through a maternity home program. She currently resides in Colorado with her family.
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