In vitro fertilization (IVF) is a medical procedure that helps couples struggling with infertility to conceive a child. The journey toward IVF can be overwhelming, but with proper preparation, you can optimise your chances of a successful outcome.
What Is In Vitro Fertilisation?
The term “in vitro” means outside of a living organism, such as in a test tube or a culture dish.
The procedure for in vitro fertilisation involves gathering reproductive cells from the parents and fertilising the egg cell with the sperm cell in a laboratory environment. After the embryo has developed under controlled conditions for a few days, it is transferred into the mother’s uterus, where, if all goes well, it will implant and develop into a healthy pregnancy.
In vitro fertilisation is a process - it takes patience and a commitment of time, finances and health to be successful, but the outcome can bring prospective patience a lot of joy.
When To Seek Professional Guidance
If you have been trying to get pregnant for a year or more, with no luck, it might be a good idea to get in touch with a fertility specialist or reproductive endocrinologist.
Fertility specialists can provide more value than a normal doctor because they can conduct a series of tests to assess your fertility potential and identify any underlying issues you might have. They consider your unique situation and provide you with personalised advice for your reproductive journey - which may or may not include IVF.
A big advantage of working with a specialist is that they can tell you all the options available to you. If IVF is the option that will work best for you, they already have a relationship with you and can guide you through the process.
What Happens During The IVF Process?
The good news is, if you are reading this, you are already searching for information about the IVF process. Educating yourself about IVF will help you to prepare mentally and emotionally.
Each of the different stages involved in the IVF process brings with it its own challenges. Learning about ovarian stimulation, egg retrieval, fertilisation, embryo development, and embryo transfer can help you prepare for each stage.
If you are planning to embark on an IVF journey, familiarising yourself with the medications, procedures, and potential side effects associated with each stage will help you navigate the process with confidence.
The first phase of the IVF cycle involves stimulating the release of multiple mature egg cells from your ovaries. These egg cells will later be harvested for fertilisation.
The ovarian stimulation phase takes between 10 to 14 days, during which time you will self-administer 1-2 hormone injections per day to manage ovulation. Different hormones are used in combination and in dosages specific to your unique needs, to guide the ovulation cycle and ensure the release of one or more egg cells.
Your doctor will show you how the injections should be done and make sure you understand how to self-administer them. They are all subcutaneous (underneath the skin) injections, which you will usually give in your stomach and thigh.
The needles used for these injections are relatively small - 25 to 30 gauge - also known as insulin needles or short needles. The injections themselves might be uncomfortable, but they aren’t very painful (depending on your pain tolerance, of course).
To make the injections more comfortable, it is a good idea to choose a site with a thick layer of subcutaneous fat, to rotate injection sites, to use a quick, sure motion and to ice the area for a few minutes before the injection.
In addition to the discomfort of the injections, you might experience some side effects as a result of the hormone treatment. You might recognise some of the side effects as normal ovulation symptoms: fatigue, mood swings and breast tenderness. But you might also experience headaches, fatigue and nausea.
Ovarian hyperstimulation syndrome (OHSS) can also occur - which is when your ovaries become enlarged and filled with fluid as a result of the medication. Mild OHSS can cause bloating, nausea and discomfort, but severe cases will need medical intervention.
Don’t worry though, your doctor will monitor your progress through blood tests and ultrasound examinations throughout the ovarian stimulation phase, to track the development of the ovarian follicles.
Once the ovarian follicles grow large enough, a hormone shot (known as a trigger shot) is given to induce the final maturation of the eggs and prepare them for retrieval. The trigger shot is timed precisely to schedule the egg retrieval procedure.
Egg retrieval is usually performed 34-36 hours after the trigger shot.
The procedure is typically done on an outpatient basis. You may be given a mild sedative or anaesthesia to keep you comfortable during the process. Egg retrieval takes about 20-30 minutes and the procedure generally includes the following:
- An ultrasound-guided needle is inserted into the vagina and through the vaginal wall, as a shortcut to access to ovaries. This is called transvaginal ultrasound aspiration.
- When the needle reaches the ovaries, mature ovarian follicles are identified and the needle is used to draw out the fluid (which contains the egg cells) from the follicles, using gentle suction.
- The egg cells are isolated from the follicular fluid and collected in a test tube or Petri dish by the embryologist.
After the procedure, you will usually be observed for a short period in the clinic to monitor your recovery from the sedation or anaesthesia. Most people can go home on the same day, but it's essential to have someone accompany you as you may feel drowsy.
On the day of egg retrieval, the male partner or a sperm donor provides a semen sample. In some cases, sperm may be obtained through other methods like testicular aspiration (where sperm is extracted from the testicles using a needle) or epididymal aspiration (collecting sperm from the connection point between the testicles and the vas deferens).
Fertilisation And Embryo Culture
After reproductive cells have been sourced from the parents, the work of fertilisation is handed over to the laboratory.
The eggs and sperm are combined in a laboratory dish to facilitate fertilisation. In some cases, intracytoplasmic sperm injection (ICSI) may be used, where a single sperm is injected directly into an egg.
After fertilisation, the embryos are cultured in a laboratory incubator for a few days to allow for development.
One or more of the resulting embryos are selected and transferred into the uterus using a thin catheter. This is a relatively simple and painless procedure, similar to a Pap smear.
About 10-14 days after the embryo transfer, a blood test is done to determine if the procedure was successful and you are pregnant.
On average, a complete IVF cycle, from the start of ovarian stimulation to the pregnancy test, can take approximately 4 to 6 weeks.
What Can I Do To Help IVF Succeed?
The success rates for IVF vary from clinic to clinic and they are influenced by your age and reasons for infertility. In general, success rates for the first round of IVF range from 25% - 55%. On average, couples undergo three rounds of IVF before falling pregnant.
Do not be discouraged. There are things that you can do to optimise your chances of implantation and pregnancy.
Focus On Your Physical Health
Being physically healthy can significantly improve the chances of IVF success.
You can start preparing for IVF by exercising and eating a balanced diet, which helps to ensure that your body gains is strong and well-nourished enough to grow a baby. Exercise and a healthy diet can also help you maintain a healthy body weight, to avoid the dangers of being overweight while pregnant.
Maintaining a balanced diet means incorporating nutrient-rich foods like fruits, vegetables, whole grains, lean proteins, and healthy fats into your meals.
Another way to prepare, physically, is to avoid unhealthy habits like smoking, excessive caffeine and alcohol intake, and the use of illicit drugs as they can adversely affect fertility.
Going through IVF can be emotionally challenging, so it is important to prioritise your mental well-being from the start. Consider seeking counselling or joining a support group for individuals or couples going through fertility treatments. It is important to have a strong support network - lean into your partner, friends, or family members for emotional support.
Engaging in relaxation techniques such as going for regular walks, meditating, doing yoga, or doing mindfulness exercises can also help reduce stress and clear your mind.
We all know that having a baby will change your life, but in the case of undergoing fertility treatment such as IVF, the path to getting pregnant might also be life-changing.
Preparing for these life changes by making mindful lifestyle adjustments can positively impact IVF outcomes.
Managing stress is one of the most important lifestyle adjustments you can make because constant stress has a very bit impact on your fertility. Getting enough sleep, engaging in regular exercise and in activities that bring you joy can help you maintain a positive mindset throughout the process.
You can also manage your environment by avoiding exposure to environmental toxins and harmful chemicals.
Medication And Supplement Review
During IVF, you may be prescribed medications and supplements to support the process. Review your current medications with your doctor to ensure there are no potential conflicts.
You can also discuss with your healthcare provider which supplements, such as folic acid or prenatal vitamins, may be beneficial for you to take during the IVF preparation phase.
Plan For Time Off
IVF treatment often requires multiple appointments and procedures. Plan ahead and discuss the required time off work with your employer. Be prepared for the possibility of needing time off for rest and recovery following procedures, as well as for emotional support during the process.
IVF can be expensive, and it is crucial to plan your finances accordingly. Research your insurance coverage, explore available financial assistance programs, and budget for potential additional costs like medications, laboratory work, and genetic testing. Consider discussing your options with a financial advisor to ensure you are financially prepared for the IVF process.
Stay Positive And Take Care Of Yourself
Preparing for IVF is a multifaceted process that involves physical, emotional, and logistical considerations. By following these steps and working closely with your healthcare team, you can enhance your chances of a successful IVF journey. Remember to take care of yourself and seek support when needed. Stay positive and trust in the expertise of your medical professionals as you embark on this transformative path to parenthood.