In Vitro Fertilization: Step-by-Step

In Vitro Fertilization(IVF): Preparation, Procedure, and Risks

In vitro fertilization, commonly known as IVF, is a widely used assisted reproductive technology (ART)that helps individuals or couples struggling with infertility to conceive a child. It involves retrieving eggs from a woman’s ovaries and fertilizing them with sperm. This fertilized egg is known as an embryo. The embryo can then be frozen for storage or transferred to a woman’s uterus, but it is important to understand the preparation, procedure, and risks associated with In Vitro Fertilization (IVF) before deciding to undergo treatment.

Depending on your situation, IVF can be used:

  • your eggs and your partner’s sperm
  • your eggs and donor sperm
  • donor eggs and your partner’s sperm
  • donor eggs and donor sperm
  • donated embryos

Your doctor can also implant embryos in a surrogate, or gestational carrier. This is a woman who carries your baby for you.

However, IVF may be an option for the following reasons:

  • a person is unable to get pregnant naturally
  • a person or couple is diagnosed with unexplained infertility
  • male factor infertility or abnormal sperm parameters, such as low sperm count, or abnormalities in sperm shape
  • a person’s fallopian tubes are blocked

Parents may also choose IVF if they run the risk of passing a genetic disorder on to their offspring. A medical lab can test the embryos for genetic abnormalities. Then, a doctor only implants embryos without genetic defects.

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Step-by-step In Vitro Fertilization

Before beginning IVF, women will first undergo ovarian reserve testing. This involves taking a blood sample and testing it for the level of follicle stimulating hormone (FSH). The results of this test will give your doctor information about the size and quality of your eggs.

Your doctor will also examine your uterus. This may involve doing an ultrasoundwhich uses high-frequency sound waves to create an image of your uterus. Your doctor may also insert a scope through your vagina and into your uterus. These tests can reveal the health of your uterus and help the doctor determine the best way to implant the embryos.

Men will need to have sperm testing. This involves giving a semen sample, which a lab will analyze for the number, size, and shape of the sperm. If the sperm are weak or damaged, a procedure called intracytoplasmic sperm injection (ICSI) may be necessary. During ICSI, a technician injects sperm directly into the egg. ICSI can be part of the IVF process.

Choosing to have IVF is a very personal decision. There are a number of factors to consider.

  • What will you do with any unused embryos?
  • How many embryos do you wish to transfer? The more embryos transferred, the higher the risk of a multiple pregnancy. Most doctors won’t transfer more than two embryos.
  • How do you feel about the possibility of having twins, triplets, or a higher order multiple pregnancy?
  • What about the legal and emotional issues associated with using donated eggs, sperm, and embryos or a surrogate?
  • What are the financial, physical, and emotional stresses associated with IVF?
  1. stimulation
  2. egg retrieval
  3. insemination
  4. embryo culture
  5. transfer

A woman normally produces one egg during each menstrual cycle. However, IVF requires multiple eggs. Using multiple eggs increases the chances of developing a viable embryo. You’ll receive fertility drugs to increase the number of eggs your body produces. During this time, your doctor will perform regular blood tests and ultrasounds to monitor the production of eggs and to let your doctor know when to retrieve them.

Egg retrieval is known as follicular aspiration. It’s a surgical procedure performed with anesthesia. Your doctor will use an ultrasound wand to guide a needle through your vagina, into your ovary, and into an egg-containing follicle. The needle will suction eggs and fluid out of each follicle.

The male partner will now need to give a semen sample. A technician will mix the sperm with the eggs in a petri dish. If that doesn’t produce embryos, your doctor may decide to use ICSI.

Your doctor will monitor the fertilized eggs to ensure that they’re dividing and developing. The embryos may undergo testing for genetic conditions at this time.

When the embryos are big enough, they can be implanted. This normally occurs three to five days after fertilization. Implantation involves inserting a thin tube called a catheter inserted into your vagina, past your cervix, and into your uterus. Your doctor then releases the embryo into your uterus.

Pregnancy occurs when the embryo implants itself in the uterine wall. This can take 6 to 10 days. A blood test will determine if you’re pregnant.

IVF success rates

For 2019, the CDC estimated that the percentage of intended egg retrievals that resulted in live birth deliveries was:

  • 52.7% among people aged under 35 years
  • 38% among people aged between 35–37 years
  • 24.4% among people aged between 38–40 years
  • 7.9% among people over the age of 40

These statistics vary depending on where the procedure takes place.

Age is the most important risk factor that affects the success rate with IVF.

However, the likelihood of success can depend on other factors, including:

  • the cause of infertility
  • ovarian reserve test results
  • whether or not pregnancy or a live birth has occurred before
  • the strategy that will be used

IVF costs

The average cost of one IVF cycle in the U.S. varies between $10,000–15,000. However, some insurance providers cover infertility treatments such as IVF. Therefore, a person with health insurance may obtain IVF treatment at a lower cost.

Coverage will be dependent on the health insurance provider and the state that the person lives. Currently, 17 states in the U.S. require insurance providers to either cover or offer coverage for infertility treatment by law.

Screenings

Screening and testing are available to determine the sex of the embryo and to identify if there any genetic abnormalities.

Primarily, preimplantation genetic testing (PGT) was a procedure used by doctors to detect genetic disorders in the embryo’s DNA. These could result in a birth abnormality or developmental issue.

In addition, doctors now also conduct this method to identify the sex of the embryo before implantation during IVF. Doctors can analyze which chromosomal make up the embryo processes to determine if the embryo will be male or female.

A 2018 study notes that over 72%Trusted Source of contacted ART clinics offer preimplantation testing.

Risks associated with In IVF

As with any medical procedure, there are risks associated with IVF. Risks, or better say complications include:

1.bleeding, infection, or damage to the bowels or bladder (rare)

2.multiple pregnancies, which increases the risk of low birth weight and premature birth

3.miscarriage (pregnancy loss)

4.ectopic pregnancy (when the eggs implant outside the uterus)

5.ovarian hyperstimulation syndrome (OHSS), a rare condition involving an excess of fluid in the abdomen and chest

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