IVF: It can be confusing, expensive, and stressful. With numerous blood and hormone tests, ultrasounds, and a large mix of different pharmaceuticals at different times of the month, it is no wonder it may feel like a mountain to climb. This whole process can take a toll on anyone going through it, so I am going to take some of that stress away from you by explaining what IVF is, in a simple and easy to follow way. Hopefully this will clear up any confusion, and empower you to make an educated decision on whether or not it is right for you.
IVF, or In Vitro Fertilization is a complicated medical procedure meant to increase a woman’s chances of having a baby. It increases your odds of getting pregnant by increasing the number of eggs produced, assisting in fertilization (when the sperm meets the egg), and overcoming obstacles such as Fallopian tube issues (tubes that connect our ovaries to our uterus), or sperm problem. IVF is not a cure for infertility, I really cannot stress this enough- IVF is NOT a cure for infertility. Why is this? IVF merely helps the sperm and egg meet, after that, it is all up to the cells to divide in a healthy way. The older women get, the more likely eggs divide abnormally, so although IVF increases the number of chances you get in a cycle to create an embryo, it has absolutely no impact on whether or not that embryo will divide normally.
Basic Steps of IVF:
1. Sperm is collected
2. Eggs are collected from the ovary
3. The egg and the sperm are put together and fertilization occurs (this happen in the lab)
4. The fertilized eggs grow (for 3-5 days) into embryos
5. The embryos are transferred to the uterus
What exactly are your chances of getting pregnant?
Success rates for live births range from clinic to clinic, on average, according to the American Pregnancy Association, percentages include:
· 30-35% for women under 35
· 25-30% for women 35-37
· 15-20% for women ages 38-40
· 5-10% for women over the age of 40
A healthy couple in their prime reproductive years have about a 1 and 5 shot, or 20% chance of getting pregnant during a cycle, so the above numbers are not that bad. It is so important to make sure IVF is done by a board certified reproductive endocrinologist and infertility specialist. I would also suggest looking into top rated clinics with laboratories as well, even if this means traveling to another state. It is worth getting the best, so that you do not have to have multiple cycles.
Here is a brief overview of each step in the IVF cycle:
Day 2 or 3 Tests
On day 2 or 3 of your menstrual cycle (remember day 1 is the first full day of bleeding), you will go have your FSH levels checked, you will probably also have an ultrasound to count and measure your soon-to-be follicles (Follicles are sack like structures that contain eggs). What is the doc looking for? Basically size and the amount of the follicles you are likely to produce. IF everything looks good, you will start injections (self-administered). These Injections are synthetic hormones designed to pump up the amount of eggs you produce, it is going to create more follicles.
Day 5-7
After you are on the medications for a few days, you will go in for another ultrasound to check on the process of the growing follicles. You will most likely get your estrogen level checked as well, as an increase in estrogen means that your follicles are growing. This will continue for about 10 days until your follicles are at the best they can be, and ready to release an egg.
Day 10-12
Trigger shot is administered. This contained HCG, a hormone that will allow ovulation.
36 hours later…
Retrieval of eggs! The follicles are retrieved through a minor surgical procedure. All the developed follicles are removed for fertilization in the lab. The eggs are taken to the lab where the outer membrane is removed, and the ova (egg) is then fertilized with the sperm. Fertilization can happen naturally, where the sperm and the egg are placed together in a petri dish and they come together on their own, or through ICSI, where a single sperm is placed in a pipette, and injected into the ova. This usually happens when the man’s sperm are an issue. The embryos are then left in a dish to divide for 3-5 days.
Day 3 or Day 5 (Embryo transfer)
So depending on the age of the woman, and how well the embryos are growing, transfer will usually occur either on day 3 or day 5 post egg retrieval. Embryo’s that are not chromosomal- normal or compromised will not make it through a very complex cell division. So it is presumed that the 5 day fertilized eggs will survive to a live birth, over the 3 day fertilized eggs because they have gone through the complex cell divisions (some clinics will only transfer 5 day old embryos).
The transfer itself is fairly straight forward. A catheter is inserted into the cervix and threaded about half an inch from the top of the uterus. Then another catheter containing the embryos is inserted, and placed in a nice comfy spot on an ideal implantation area on the uterus. The embryos are then placed in the uterus where they will continue to divide and grow. After that, the mom-to-be is told to rest for about an hour then send home on modified bed rest for a few days.
Two weeks later…
About two weeks later you will take a pregnancy test. You may or may not have had to go in for some testing to see if your progesterone and estrogen were at good levels to maintain a pregnancy. HCG is checked through a blood test, a number about 50 confirms a pregnancy. Once you get a positive pregnancy test, you will receive blood tests every week to make sure HCG is rising and the baby is growing. At 6-7 weeks an ultrasound will be performed to check if there is a heartbeat. After this, women are free to go and plan their births with other providers including midwives.
That is IVF!
In the next blog I will talk about how acupuncture can help during the IVF process, how much acupuncture you should get, and discuss and confront the recent study that came out, stating that acupuncture DID NOT help IVF.
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