IVF: Symptoms, Causes, Treatment and Cost

In vitro fertilization (IVF) refers to a procedure widely famous for being used to assist fertility, and prevent further problems in pregnancy. It comprises certain steps such as the collection of mature eggs from the ovaries of the patient, and fertilization in the laboratory by sperm. The embryos are then transferred into the uterus of the patient. The full IVF process often takes close to three weeks to finish.

IVF is quite popular among couples who face certain problems with reproduction. IVF injections are given to the mother to obtain a healthy IVF baby. IVF's success rate is pretty much high.

Summary- Globally, IVF is utilized for resolving reproduction-related issues. Eggs and sperm can be donated by parents or sometimes by other healthy donors.

IVF involves five major steps for its completion and success. These can be stretched over a period of time, or simply three weeks, as recommended by your doctor. One cycle might work for some, and others might need more than one cycle too. The five most important stages of an IVF procedure include:

1. Ovulation Induction or its stimulation- The beginning of the IVF surgery starts by intaking synthetic hormones leading to the production of several eggs per month, rather than only a single egg that is naturally produced. Multiple eggs are essential in the process because a single egg reduces the chances of guaranteed fertilization. Methods of intaking the synthetic hormones are

   • Use of medication to stimulate the ovaries- The stimulation of the ovaries can be done by taking injections of a follicle-stimulating hormone (FSH), or a luteinizing hormone (LH), sometimes both are also combined. These hormones further help in the development of more than one egg.

   • Use of medication for the maturation of oocytes- After 8 to 14 days after the follicles are ready for the retrieval of eggs, you will be asked to intake Human chorionic gonadotropin (HCG), and other such medications for egg maturation.

   • Use of medication to avoid premature development of ovaries- Premature ovulation can lead to releasing these developed eggs too soon, rendering the process unsuccessful.

   • Use of medication for preparation to line the uterus- Your doctor is most likely going to advise you to take progesterone supplements for making the lining of your uterus receptive to implantation and during the transfer of the embryo.

   After two weeks of ovarian stimulation, doctors will further use methods such as vaginal ultrasound (monitoring process to check the development of the follicles through imaging exams), and blood tests (which measure the ovarian response to estrogen, and other hormones).

   This stage is extremely crucial because the whole of IVF depends on its success. Sometimes, complications such as inadequate development of follicles, premature ovulation, excess development of follicles, and other medical issues may cause the IVF procedure hindrance, and your doctor may prescribe a change in medication or choose the option of an egg donor.

2. Retrieval of the egg- The retrieval process usually takes place after 34-36 hours, after your last injection, and before the onset of ovulation. You will be sedated and provided medication for pain. The method normally used for retrieval of the eggs is known as Transvaginal ultrasound aspiration where a probe counting an ultrasound is inserted in your vagina to identify the follicles. A thin needle is then used, with the assistance of the ultrasound guide to retrieve eggs from these follicles. These eggs are incubated, with the help of sperm but not all eggs develop into embryos, only the healthy ones do.

   Sometimes, ovaries cannot be accessed through a transvaginal ultrasound, then an abdominal ultrasound is used instead as a guide. A suction is connected to the needle, which can remove the eggs effectively in about 20 minutes. The only side-effect one usually experiences after egg retrieval is cramps and pressure. These eggs are then placed in a cultured medium or nutritive liquid. They are incubated, with the help of sperm. Not all eggs develop into embryos, only the healthy ones do.

3. Retrieval of the sperm- If one is using their partner’s sperm, the semen sample needs to be provided at the clinic on the morning of the egg retrieval. The sperm is then separated from the semen fluid in the lab. Masturbation or testicular aspiration (a surgical procedure using a needle to extract sperm from the testicles.) can be used. If the partner cannot provide the semen, an anonymous sperm donor can also be chosen.

4. Fertilization of the egg- Two common methods used for fertilization in the IVF process include:

   • Conventional insemination- The most used method is the incubation of the egg and sperm overnight when mixed.

   • Intracytoplasmic sperm injection (ICSI)- is commonly used when previous IVF cycles have failed, and the only resort is injecting the healthy sperm into the mature egg.

5. Transferring the embryo- After the egg retrieval, embryo transfer is done after 2-5 days. A mild sedative is utilized to complete the IVF procedure painlessly, but cramping may be experienced. A catheter or a long and flexible tube is inserted into your vagina with a little amount of fluid attached to the end of the catheter, and a syringe containing one or more embryos is placed directly in the uterus of the patient.

   Summary- IVF procedure is divided into five stages to carry out distinct specified steps. Each step is executed carefully for a successful pregnancy.

Generally, people tend to confuse an IVF and a test tube baby being different procedures. However, IVF is the process, of fertilization of an egg and a sperm in a laboratory leading to the growth of a test tube baby. IVF is the treatment process, and the test tube baby is the result.

While undergoing an IVF procedure, one must keep in mind some dos.

• Do prioritize your health for at least three months even before conception. It is incredibly important to be healthy yourself, to carry a healthy child.

• Do attempt to manage your stress, using various methods such as painting, hiking, cooking, or other relaxing hobbies.

• Eat in moderation, and plan a balanced diet including carbohydrates, proteins, vitamins, and minerals.

• Do establish a night routine, and sleep at the same time every day.

• Do use vitamin supplements.

• Do take plenty of rest and indulge in creative activities.

Certain restrictions must be followed for an overall successful IVF.

• Do not drink alcohol. It is harmful during pregnancy.

• Do not get addicted to caffeine, or lower your caffeine intake.

• Do not use diets, or aim for weight loss. It is difficult to carry a child with less weight.

• Do not overwork, or stress yourself.

Summary- Test tube baby is the final outcome of IVF procedures. The entire procedure is carried out for obtaining a test tube baby.

Some complications may arise when getting an IVF treatment. One must be aware of them and proceed accordingly.

• Several births- The transfer of more than one embryo, even accidentally can lead to multiple births which may not always be ideal. A pregnancy containing several fetuses has a high risk of early labor and an underweight pregnancy period.

• An IVF procedure can sometimes lead to premature birth and low birth weight of the infant.

• The risk of miscarriage- Statistics prove that women who conceive through IVF are at a higher risk, almost 25% higher of miscarriage than those who conceive naturally.

• Ovarian hyperstimulation syndrome– The use of hormone-inducing drugs like HCG can lead to complications such as swollen or painful ovaries. These cause bloating, diarrhea, cramps, shortness of breath, weight gain, and abdominal pain that can last up to weeks if you are pregnant.

• Complications during the egg-retrieval procedure- The use of needles to retrieve eggs from the follicles may lead to infection, bleeding, bowel damage, and risk to the bladder.

• Possibility of birth defects- It is yet to be completely proven, but there have been noticed trends where the age of the mother can lead to complications during birth, especially during IVF treatments.

• Stress- Stress is a given side-effect of an IVF procedure. It can be mentally, emotionally, and physically draining on the patient. Do seek counseling and support from your loved ones.

Summary- There are several adverse consequences that are found to be linked with IVF procedures. Mental stress and miscarriages are some of the common complications.

Eating according to your body’s requirements to fulfill its end goal, is entirely necessary, especially during the IVF procedure. Here are some guidelines on what to eat during IVF:

• Avoid making big lifestyle changes, like reducing gluten or doing a keto diet while undergoing the IVF process.

• A healthy, fulfilling, and balanced diet is most advantageous. Preferably, a plant-based and nutritious one. The partner donating the sperm is also recommended to follow a healthy diet with you.

• Use fresh fruits, and salads made of fresh vegetables as snacks.

• Fish and poultry are excellent sources of lean protein.

• Fill up on whole grain foods, like quinoa.

• Use low-fat dairy instead.

• It is in your best interest to avoid consuming processed foods, red meat, and excessively fatty and gastric-inducing foods.

• Do not intake too much salt, switch to herbs and other spices.

• Hydrate yourself well.

• Lean towards foods containing magnesium, calcium, folic acid, iron, and zinc.

Summary- For a successful IVF procedure, it is very important to plan a customized diet. Fruits, vegetables, dairy products, fish, etc. must be incorporated into the diet.

While it is essential to stock up on the foods you must eat during an IVF, it is helpful to know the kind of food you must avoid.

• Alcohol should be avoided at all costs.

• Processed foods, especially processed meats are a health hazard to someone undergoing an IVF.

• Raw fish or meat can also be dangerous.

• Say no to carbonated drinks, cigarettes, and junk food.

• Cheese, soy, and full-fat milk must also not be eaten during an IVF procedure.

Summary- During the entire IVF one needs to be very careful about everyday meals. One must exclude alcohol, junk foods, cigarettes, processed foods, etc. from her diet.

The IVF treatment is a five-stage process. It includes the preparation period. The preparation period has several methods involved, ovarian reserve testing, semen analysis, infectious disease screening, uterine exam, and mock embryo transfer. Based on these results, your doctor further recommends the course of the IVF treatment procedure.

Next, the five stages are- ovulation induction, egg retrieval, sperm retrieval, fertilization, and embryo transfer. The IVF treatment for pregnancy can be tedious and can stretch over 2-3 weeks, sometimes, even more. However, with expert assistance at Pristyn care, you are guaranteed a good IVF treatment process, with only the best doctors and facilities.

Summary- IVF treatment comprises of specified five-staged process. Ovulation induction, embryo transfer, fertilization, etc. are some of the crucial steps.

What are the best medicines for IVF?

Several medications are provided during IVF treatment. Some are taken orally, some have to be injected, and these are guided by your doctor. The dosages and the timings for intake of these medicines will be told to you by the doctor himself, depending upon your individual IVF treatment procedure. However, the best medicines for IVF include:

• Follicle-stimulating hormone (FSH)- Approximately given for 14 days, these help induce the ovaries to produce eggs. They can be provided in a combination or a singular form.

• Human chorionic gonadotropin (HCG)- A single shot is required to stimulate the eggs for maturation and proceeding to the ovulation period.

• Leuprolide acetate- Given as a trigger shot, via an injection that aids in controlling the stimulation process.

• Certain birth control pills or supplements may also be provided by your doctor to better your chances for the IVF treatment process. Especially, estrogen and progesterone supplements.

Summary- Medicines are often prescribed by doctors after a detailed examination. Medicines containing FSH and HCG often support this process.

The average IVF treatment cost in India ranges from Rs.1,00,000 lakh to Rs.3,50,000 lakh, for one cycle. These are excluding the additional requirements of testing and medications. The IVF treatment cost is much cheaper in India than in other countries like the USA or Europe.

Summary- The cost of an IVF process is usually high-priced. Despite of high benefits, everyone cannot afford it.

Usually, women who suffer or undergo complications such as Endometriosis, Ovulation problems, egg quality, blocked fallopian tubes, Antibody issues (affecting the eggs and sperms), sperm count issues, or infertility, go through with the IVF procedure.

Those eligible for an IVF are:

• A woman is physically healthy to carry a baby and donate eggs.

• Those women undergoing complications like PCOS, and who cannot naturally get pregnant.

• Single women who wish to have a baby.

• Those who have no history of substance abuse.

• Those who are mentally and emotionally stable.

• Women who are 40-45 or even lesser years of age, not beyond.

Summary- Women who do not suffer from any disorders and are completely healthy can go for an IVF procedure. They must fall under the age group of fewer than 45 years.

There are certain eligibility criteria one must fulfill to undergo an IVF. If not fulfilled, they are not allowed to access the IVF treatment procedure.

• The age criteria- Women up to a maximum of 45 years of age can opt for an IVF treatment. Donor eggs, anonymous or not, are accepted up to the age of 50. It is thoroughly recommended to go through with the IVF treatment process earlier rather than later, due to complications relating to age.

• Drug abuse criteria- The partners undergoing the IVF must not use or abuse any kind of substance. Smokers are recommended to quit before undergoing an IVF treatment.

• Physical Health criteria- Those who are underweight or overweight must reform themselves into their best physical health to gain the maximum IVF success symptoms. Obesity or malnutrition can harm the carrier or even the baby in the future, or may also lead to constant IVF failure symptoms.

• Mental health criteria- Those who are suffering from any type of mental disorder or emotional abuse/trauma are not given access to an IVF treatment. They are required to attend therapy first.

Summary- There are certain parameters that must be fulfilled before IVF such as women must be healthy physically and mentally and there should not be more than 45 years of age.

After the IVF procedure, usually after 2 weeks, your doctor is going to test whether you are pregnant or not.

If the IVF is successful, you will be referred to pregnancy specialists or an obstetrician. You must now hold responsibility for your pregnancy and enjoy this period. Treat your body well, as it now is growing your baby. Avoid strenuous exercise and an unhealthy lifestyle. Do go in for daily checkups with your doctor. Mentally, prepare yourself and your partner to become parents. Seek therapy or counseling if required. Follow all guidelines required to follow in a pregnancy.

If the IVF is not successful, you will not be termed pregnant and will get your period within a week or two. If you wish to opt for another cycle of IVF treatment your doctor will recommend ways to improve your condition and health for the next time. If there is any unusual amount of bleeding or extreme side effects contact your doctor immediately.

Summary- After the IVF procedure, doctors leave you with certain post-treatment guidelines. It must be followed very carefully as it helps doctors to monitor your health status accurately.

After you are done with the last phase of the IVF surgery, that is the embryo transfer your ovaries are likely to still be enlarged. You can resume your daily activities, but strenuous activities can cause discomfort. You may also face other side effects after the IVF including:

• Bloating

• Cramping

• The swabbing of the cervix area after the embryo transfer may result in the passage of some clear fluid shortly after.

• Constipation

• Slight pain may also be felt, but contact your doctor immediately if it increases, in case of an infection, or the twisting of an ovary (ovarian torsion)

Summary- IVF procedure also leads to some adverse effects. Miscarriage, ectopic pregnancies, and premature births are some of the common aftereffects.

IVF is a boon to infertile couples but along with benefits, it also results in certain side effects, such as-

• Premature births
• Egg-retrieval process complications
• Low birth weights
• Miscarriage
• Ovarian hyperstimulation syndrome
• Multiple births
• Cancer
• Birth defects, etc.

Summary- For a successful IVF procedure, we must consult a specialist in this field. They can be highly qualified and trained reproductive endocrinologists and gynaecologists

An IVF has helped thousands of people across the world overcome infertility and the bane of not carrying a child. It has created families and provided happiness to the lives of parents. It is a relatively safe procedure, with maximum chances of success. With Pristyn Care, and its excellent resources you are guaranteed a good experience with specialists and surgeons trained to suit your IVF needs and guide you in this journey.

Summary- IVF is one most widely used methods to counteract infertility. It involves a higher success rate with fewer side effects.