In vitro fertilization (IVF) , also known as test tube baby is a medical procedure used to help individuals or couples with fertility problems to get pregnant. It involves the fertilization of an egg outside the body, in a laboratory setting. Millions of babies have been born through IVF and it is a safe ,minimally invasive procedure with good success rates. The IVF process involves:

1. Ovarian Stimulation: The woman undergoes hormone therapy to stimulate the ovaries to produce multiple eggs (rather than the single egg that typically matures each month). This is usually done using hormones like FSH (follicle-stimulating hormone) and LH (luteinizing hormone) or a combination of both.
2. Egg Retrieval: Once the eggs are ready, they are retrieved through a minor surgical procedure. A needle is used to collect the eggs from the ovaries, usually done under sedation. There are no cuts in the body and the woman can go home within couple of hours. In women with less number of eggs (poor ovarian reserve ), multiple cycles of egg pick up may be needed to get adequate eggs.
3. Fertilization: In the lab, sperm from the male partner is used to fertilize the eggs. Nowadays, a technique called intracytoplasmic sperm injection (ICSI) is commonly being used, where a single sperm is directly injected into an egg.
4. Embryo Culture: The fertilized eggs (embryos) are then monitored as they develop in the lab for 3 ( day 3 embryos) to 5 days( blastocyst). The embryologist will observe the embryos’ growth and quality.
5. Embryo Transfer: One or more healthy embryos are selected and transferred into the woman’s uterus, where implantation and pregnancy may occur. This step is typically done without anesthesia. Embryo transfer may be done in the same cycle as egg pickup (fresh embryo transfer) or in a later cycle after preparing the lining of the uterus ( endometrium) which is called as frozen embryo transfer. Both yield equal success rates . The success rate after 1 embryo transfer is approximately 50 % , after 2 embryo transfers around 75 % and upto 87.5% after 3 embryo transfers. Surplus embryos can be safely kept frozen and used for next pregnancy.
6. Pregnancy Test: About 10–14 days after the embryo transfer, a blood test ( B Hcg)  is done to determine if implantation occurred and the woman is pregnant.

IVF can be used to treat a variety of fertility issues, including blocked fallopian tubes, male infertility, ovulation disorders, and unexplained infertility. It can also be an option for those who are using donor eggs or sperm or who are considering surrogacy. IVF is a safe and promising procedure for infertile couples and is performed by a fertility specialist in liason with an embryologist.

MYTHS AND FACTS ABOUT IVF

There are many myths and misconceptions surrounding in vitro fertilization (IVF). Here are some common myths and the facts that clarify them:

1. Myth: IVF always results in pregnancy.

Fact: IVF does not guarantee pregnancy. Success rates vary depending on various factors like the woman’s age, the cause of infertility, the quality of eggs and sperm, and the clinic’s expertise. While IVF can significantly improve chances of pregnancy, it is not always successful in the first attempt.

2. Myth: IVF is only for women who are infertile.

Fact: IVF is commonly used for infertility treatment, but it can also help individuals or couples who are facing other reproductive challenges, such as male infertility, blocked fallopian tubes, or genetic disorders. IVF can also be an option for same-sex couples or single people who want to have a child with donor sperm or eggs.

3. Myth: IVF leads to multiple pregnancies (twins or triplets).

Fact: IVF can increase the likelihood of multiple pregnancies, especially when more than one embryo is transferred to the uterus. However, advances in IVF technology and selective embryo transfer have made it possible to reduce the risk of multiple pregnancies. Many doctors now recommend transferring one embryo at a time to reduce the risk of complications.

4. Myth: IVF is painful.

Fact: While IVF involves some procedures that may sound intimidating (such as egg retrieval and embryo transfer), they are typically done under sedation or anesthesia, so pain is minimal. The hormone injections required for ovarian stimulation can cause mild discomfort , they are usually injected just below the skin with a very thin needle and are not painful.

5. Myth: IVF can cause birth defects.

Fact: IVF itself does not increase the risk of birth defects. However, some studies suggest a slightly higher risk of certain birth defects, but the overall risk remains low. It’s important to note that factors like maternal age and underlying health conditions also play a role in the risk of birth defects.

6. Myth: IVF is only for older women.

Fact: IVF can be used by women of various ages, but success rates tend to decrease with age, especially after the age of 35. IVF is a viable option for women in their late 30s and early 40s, but egg quality and quantity decline with age, which may affect success rates. Many women opt to freeze their eggs at a younger age for future IVF use.

7. Myth: IVF is very expensive, and it’s only for the wealthy.

Fact: IVF can be expensive, but costs vary widely depending on the clinic, location, and individual circumstances. Some health insurance plans may cover part of the cost, and there are also financing options available. It’s a financial investment, but it’s accessible to many people, and there are also programs or assistance for those who need financial help. For example, couples with ESI (Employees State Insurance scheme) are currently availing three free IVF cycles . Many medical colleges are also establishing IVF units where low cost IVF is being done.

8. Myth: IVF doesn’t work for same-sex couples.

Fact: IVF can be used by same-sex couples, whether they are female couples using donor sperm or male couples using a surrogate and either donor eggs or eggs from a partner. IVF offers options for building a family for individuals and couples, regardless of their sexual orientation.

9. Myth: IVF can cause emotional and psychological problems.

Fact: While IVF can be emotionally and physically challenging due to the stress, hormones, and uncertainty of the process, many couples find it a worthwhile option to pursue their dream of having a child. Support from fertility counselors, support groups, or even partners and family can help manage these emotional ups and downs.

MEET A FERTILITY SPECIALIST AT THE EARLIEST AND EXPLORE THE OPTION OF IVF BEFORE ITS TOO LATE !!!

Dr.Chaitra Sathyanarayan