InVitro Fertilisation (IVF) is popular due to its high success rates compared to other fertility treatments and has the potential to treat a wide range of male and female infertility issues.
Think "infertility", and the first word that is likely to pop into your mind is IVF. That is because medical advancements and technological improvements have made IVF more accessible and successful, leading to a growing number of success stories.
IVF (In Vitro Fertilisation) has become a well-known option for individuals and couples facing infertility issues related to ovulation, endometriosis, unexplained infertility, or problems with the quality or count of sperm. It's especially beneficial for those who have blocked or damaged fallopian tubes or for males with reduced fertility. Though underscored by medical and scientific processes, IVF is deeply intertwined with emotional experiences.
The first step to achieving a healthy pregnancy is understanding the IVF process and the rollercoaster of feelings that come with it. This article breaks down IVF's complexities into manageable bits and simplifies the medical terms. Knowledge and understanding are your allies in making informed decisions to help achieve a healthy pregnancy.
Achieving a Healthy Pregnancy with IVF: The 6 Stages of IVF
Stage 1: Ovarian Stimulation
The first step in IVF is ovarian stimulation. This involves taking medications to stimulate the ovaries to produce multiple follicles that contain mature eggs. The medications used are called gonadotropins, hormones that stimulate follicle development in the ovaries. Throughout this stage, the growth and maturation of the follicles are monitored by ultrasound and blood tests. Depending on how your body responds, the medication and dosage may need to be adjusted to encourage your ovaries to produce multiple follicles.
Step 2: Egg Retrieval
Once the follicles have matured sufficiently, you will be given a final maturation or 'trigger' injection - about 36 hours before the scheduled procedure. This allows enough time for the eggs to mature fully. The trigger injection usually contains a hormone called human chorionic gonadotropin (hCG), which mimics the natural hormone surge that triggers ovulation.
The process of egg retrieval involves a minor surgical procedure called transvaginal ultrasound-guided follicle aspiration. This is comfortably done under sedation. A thin needle is inserted through the vaginal wall to reach the ovaries and collect the mature eggs from the follicles. The number of eggs retrieved can vary, but it is usually between 8 and 15. Your male partner is asked to provide a sperm sample on the same day. As this is an outpatient procedure, you get to go home after.
The eggs are then examined under a microscope in the laboratory to assess their quality and maturity. Any eggs that are deemed immature or of poor quality may be discarded. The remaining eggs are then prepared for the IVF process.
Stage 3: Sperm Preparation
Before the sperm can be used, it must be washed in the laboratory. Washing involves mixing the sperm with a solution and then spinning it at a high speed (centrifugation), which causes the sperm to separate. Healthy sperm, which are denser, will settle at the bottom, while the other substances will remain on top. The healthy sperm are washed with a sterile solution to remove any remaining debris or impurities and ensure that only the healthiest sperm are used for fertilisation.
Stage 4: Fertilisation (In Vitro)
Once the ova (or eggs) and sperm have been collected and prepared, the stage is set for fertilisation. This stage is where IVF gets its name, as fertilisation happens in vitro or "in glass".
The eggs and sperm are incubated in a culture dish in the laboratory. The dish is placed in an incubator that mimics the conditions of the woman's reproductive system. During incubation, the sperm cells swim towards the eggs and fertilise them. In some cases where sperm count or motility is a concern, a technique known as Intracytoplasmic Sperm Injection (ICSI) is used. This technique involves injecting a single sperm directly into an egg. Once the sperm fertilises an egg, it is called an embryo.
The embryos are carefully observed and nurtured in the lab for 3 to 5 days. During this time, you will receive regular updates from the clinic about the progress of your embryos.
Stage 5: Embryo Transfer
By day 5, the embryologist can assess which embryos have the most significant chances of implantation and successful pregnancy. At this stage, the embryos consist of about 100 - 150 cells and have differentiated into two distinct cell types: the inner cell mass, which will develop into the fetus, and the trophectoderm, which will form the placenta.
The transfer procedure involves placing one or two embryos into a catheter and then transferring them into the womb of the woman. The procedure is usually performed at a fertility clinic or doctor's office. Any unused embryos can be frozen for future use using a frozen embryo transfer process.
Stage 6: The Two-Week Wait
After treatment, you will need to wait two weeks before performing a pregnancy test. The two-week wait allows the embryo to implant into the uterus and pregnancy hormones to build up in the body.
It can be an emotionally taxing time as there is uncertainty and anticipation. It is essential to take care of your emotional well-being during this period and seek support from a counsellor if needed.
If the pregnancy test is positive, the fertility specialist will oversee the rest of the pregnancy. If it is negative, the fertility specialist will use the information gained through the IVF cycle to refine the fertility treatment plan and explore other options.
Coping with the emotions of IVF
During IVF, taking care of your mental and emotional well-being is crucial. Engage in activities that help you relax and reduce stress, such as mindfulness, meditation, or yoga. Prioritise self-care by engaging in hobbies, spending time in nature, or pampering yourself with a massage or a warm bath. Remember to listen to your body and permit yourself to rest when needed.
Communicating openly with your doctor about your emotional state is also important. They can provide guidance and resources and even recommend counselling or therapy services to help you navigate the emotional challenges of IVF. Seeking professional support can offer a safe space to process your feelings and develop coping strategies specific to your situation.
Empowered with Knowledge and Hope
IVF success rates depend on several factors, including age, the cause of infertility, and the quality of the embryos transferred. While the average success rate per cycle is approximately 30%, it's important to remember that everyone's experience is different. A medical consultation can provide more personalised information based on your situation.
Lastly, be patient and kind to yourself throughout the IVF journey. Understand that it is normal to have ups and downs and that it may take a few attempts to achieve a successful pregnancy. Celebrate small victories along the way and acknowledge your strength and resilience. You are not alone; rely on family, friends, and professional counselling to support you in coping with the emotions of IVF.
Choosing to do IVF is a major decision, but with the right support and medical care, it can also be an empowering one. Our specialist fertility gynaecologists at Crestcare Nelspruit are ready and looking forward to providing the comprehensive care and support you need.