All you need to know about IVF

IVF has proved to be a blessing for the modern-day woman. Production of sperm or egg, the fallopian tubes or the uterus, endometriosis, frequent miscarriage, as well as hormonal and auto-immune (antibody) disorders, in both men and women, are the causes of infertility. Women over the age of 30 tend to have a lower chance of pregnancy. Fertility starts declining after the age of 35 for men. The chances of miscarriage, ectopic pregnancy or chromosomal abnormality go up as adults come of age. In such cases, IVF support could be an option.

In the 20th century, the world has witnessed a series of upheavals. The growth of the DINK couples (Double Income No Kids), who choose to be childless during the first few years of marriage, are the ones who commonly resort to IVF support. It is recommended that couples plan for a baby when they are in their 20s as the peak of fertility occurs between 20-30, then starts declining by 20 per cent after 30, 50 per cent after the age of 35 and 95 per cent after 50.

After the age of 45, a woman’s body is not ready to accept the changes that pregnancy brings on. Medical practitioners will insist that after the age of 45, it is risky to conceive and deliver.  

There are several other reasons why a woman may experience fertility problems — premature ovarian failure and uterine factors are some of them. Ovulatory dysfunctions, cervical hostility to sperm ascent and anti-sperm antibodies are also common causes. In India, genital tuberculosis is a very common cause of infertility. The woman’s age, which determines  egg quality, also plays a role in determining infertility. The female reproductive system is a very delicate structure that is easily affected by even the slightest change.

About in vitro fertilisation (IVF) 

In-vitro fertilisation or pre-embryo transfer is a procedure which involves gathering eggs from the woman’s ovaries and mixing with the man’s sperm in a dish in the laboratory. ‘In vitro’ is a Latin term, meaning ‘in glass’. Children born of in-vitro fertilisation are also referred to as “test tube babies”.

IVF involves retrieval of one or more eggs from the ovaries prior to release. Most IVF clinics usually recommend that the woman take drugs, which causes the ovaries to produce several eggs in one cycle. This procedure is called controlled ovarian stimulation.

 It increases the chances of producing several embryos. The eggs are collected or retrieved under anaesthesia using ultrasound. After collection, the eggs are fertilised with the man’s sperm and placed in an incubator to produce one or more embryos. These embryos are then replaced in the woman’s womb. If one or more embryo implants itself, the pregnancy is considered a success. A pregnancy rate of 35- 40 per cent per treatment cycle is expected.
                                                        IVF treatment is conducted using donated sperm if the male partner is infertile or using donated eggs if, for example, the woman has no eggs or responds poorly to ovarian stimulation. Donation might also be used if one of the couple is at risk of passing on a serious inherited disease. 
(The author  is IVF expert and gynecologist at BL Kapur Hospital, New Delhi.)

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