In Vitro Fertilization (IVF) Health Feed

There are a number of ways in modern day medical science for helping couples conceive, in case they are not able to do so in a natural way. Apart from IUI, IVF and other forms of artificial insemination, one such way is ovulation induction. In this procedure, the ovaries are stimulated to release an egg which can maximize the chances of natural conception, or even through IUI. This is an effective process that works well, provided there are no other infections and diseases at play. It basically works by stoking the relevant hormones with the help of tablets and injections.

Let us find out more about the process.

Varied Tests: Before embarking on the process, the doctor will conduct a number of tests to ensure that you are capable of conceiving by natural means or even with artificial insemination. These tests help in making sure that there are no other ailments in the picture, which may hamper the process of ovulation induction or affect the ovaries in general.

Ovulation Cycle: Thereafter, the doctor will take blood samples in order to study the exact ovulation cycle that the body follows. These blood samples will be studied to measure the level of hormones at different stages so as to find out the most opportune time when the situation may be congenial for the ovulation induction to begin. A transvaginal ultrasound will also be carried out so that the doctor may study the development of follicles within the ovaries. These follicles usually line the ovaries. This ultrasound will also study the thickness and appearance of the womb’s lining.

The Ovulation Induction Cycle: The ovulation induction cycle will begin with tests that will happen starting from day one to day four. Once the tests have ascertained that the body is ready to go through the process with maximum chances of conception, the process will begin on fourth day. On this day, the patient will be given medication like Clomiphene Citrate. This medicine is also usually given to patients who are undergoing IUI or artificial insemination as it is said to increase the likelihood of conception. The Follicle Stimulating Hormone injection will also be given to the patient on the same day.

After the Medication: Once the medication and injections have been administered, the patient will have to go through a test to study the hormone levels in the body. This usually takes place around day 10 or 11. Thereafter, two weeks later, the patient will go through an ultrasound to find out if the ovulation is about to begin.

Time: While this is an effective method, one must remember that the ovulation results may take time for women who do not have normal menstrual cycles.

The concept of egg quality of a woman is derived from the belief that the embryo implantation probability is powerfully related to the age and ovarian reserve of the woman. Thus, it is regarded that the quality of the egg is almost synonymous with the chances of embryo implantation. Its quality cannot be assessed merely by looking at the egg or measuring its ability to receive the fertilization by sperm or simply observing the initial embryo division.

There are a few important factors that contribute to the success or failure of the embryo implantation and some of them are:

1. Diminished ovarian reserve: A woman with an increased FSH level on the third day of the menses is regarded as having diminished reserve of ovary. This implies that her ovary is not competent in sending feedback signals to the pituitary gland and the body responds by producing an increased amount of FSH for stimulating the ovary. For more than 10 years, it has been found that in over thousands of fertility treatment cycles, women with an increased FSH level have a lower egg quality.
2. Advanced age of maternity: Even though the FSH level is normal, the age of the mother who provides the eggs plays an important role to determine the quality of the egg. Quite like women with increased FSH levels, eggs obtained from women aged more than 40 years can have some problems at a later stage of fertilization. Normal FSH levels are not considered a reassuring factor, owing to the lower implantation rate in females aged over 45 years.
3. Diminished quality of egg: With an increase in age, the capacity of the mitochondria in producing energy slowly decreases. The egg is linked to the circulation before ovulation, and it is linked again after the embryo implantation. But during the one week time ranging from ovulation to implantation, the egg and the resulting embryo are contained in the zona pellucida and function on the basis of mitochondrial energy supply. The older age of the woman doesn’t cause any problem at the initial stage of ovulation. Its fertilization and embryonic development are also normal. But soon, it runs out of energy and stops dividing before reaching the stage of implantation.

Therefore, it is important to have the eggs tested to find out any sort of chromosomal abnormality. In case the mother is deficient of producing high quality eggs, the best option is to have donor eggs.
 

If a couple is unable to conceive naturally despite having unprotected sexual intercourse for over a year, they may be diagnosed with infertility. IVF is one of the most common ways of dealing with infertility. This is a process where eggs from the female and sperm cells from the male are harvested and combined in a laboratory to form embryos. The embryos are then reinserted into the woman’s uterus. This is a crucial step of the IVF procedure. In order for the treatment to be successful, at least one embryo must attach itself to the endometrial lining of the uterus. This allows the embryo to receive nutrition from the mother. If the embryo is not attached successfully, it will be expelled from the body. In such cases, the woman is said to have an unreceptive uterus.

One of the ways to check the receptivity of the endometrial tissue is through an Endometrial Receptivity Array (ERA) test. This involves taking a biopsy sample of the endometrial tissue on a particular day of the woman’s menstrual cycle and sequencing the genes of the sample. Collecting the sample takes hardly any time but processing it can take up to 3 weeks. This is akin to a personalized genetic test. The results of the Endometrial Receptivity Array test help to determine the ideal time during the menstrual cycle when the embryos should be implanted.

This test is not always recommended for IVF patients. It is usually advised only if the woman is over the age of 37 years and the couple has had 2 or more failed IVF cycles. It may also be advised if the woman has healthy eggs but is still unable to conceive. This is a fairly simple procedure which may be performed in the doctor’s office. It is not painful and there are no serious risks associated with it.

Though this procedure can make IVF a little more expensive, there are a number of benefits associated with it. For starters, it helps reduce the risk of IVF failure and increases the chances of having a successful pregnancy. This helps save time by increasing the probability of a successful implantation in the first cycle of IVF itself. In the long run, it also helps save money. This is because each IVF cycle has a cost associated with it. Hence, undergoing an ERA once and finding the perfect window for implantation can negate the need for further IVF treatment.

Preimplantation genetic screening is a method used to check the number of chromosomes in an embryo. Up to 50 % of embryos produced may have an incorrect number of chromosomes described as aneuploidy. This is a common cause of miscarriage and implantation failure. Pgs can also be used to test for genetic conditions that are caused by an abnormal number of chromosomes. These include Down's syndrome and Turner syndrome.

Procedure-
The patient undergoes a specialised IVF process using ICSI to create a number of embryos. After three to five days, one or more cells are taken from each embryo. These cells can then be tested to determine the number of chromosomes present. The embryos are frozen to allow time for the genetic testing to take. When the results are confirmed, the embryologist selects one embryo with the correct number of chromosomes to transfer back to the patient.

Who can benefit from preimplantation genetic screening? 
Pgs is offered to women over the age of 37. Using pgs, the chances of pregnancy from embryo transfer in older women are as good as those seen in younger women. However, with advanced maternal age, the chances of making an embryo with the correct number of chromosomes are lower.

Pgs may also be offered if you or your partner have a history of chromosomal abnormality-related conditions in your family. It is important to note that pgs cannot be used to detect the presence of conditions caused by single mutations in genes; for these cases, preimplantation genetic diagnosis (PGD) can be used.

Pgs is one of the investigations recommended if you have had recurrent miscarriage or previously failed IVF.

What are the benefits of PGS?
A significant benefit of PGS is the reduction of miscarriage rates. Aneuploidy is a large contributor to recurrent miscarriage, so by testing embryos before transfer, the rate of miscarriages are reduced and can be of great help to the couples struggling with recurrent miscarriages or IVF failures

IVF is an advanced medical procedure by which couples, who by the natural method cannot conceive, can have a baby. IVF or In Vitro Fertilization is the technique by which the eggs of the female partner and the sperm of the male partner are fertilized in a test tube in the laboratory and after that, they are implanted in the female uterus. There are several reasons why couples fail to conceive naturally, medical reasons being the most common. Lifestyle too plays a very important role in having a blissful, natural pregnancy. Too much stress, anxiety which in turn leads to being overweight, curbs the natural procedure of In-Vitro Fertilization

Can weight really spoil your IVF success?

• For those women, opting for IVF, it can be difficult to go through the procedure and benefit from it in case they are over a certain weight. The process in itself is lengthy including daily tests, medicines and other medical procedures which may be confusing for the patient but weighing more than one should naturally add on to the stress and complications of the process.
• Obesity is one definite factor that reduces the chance of success through IVF. According to doctors, obese patients have problems in producing good quality eggs that can be put to use for the fertilization and often face miscarriages after the implantation. Doctors prefer a BMI or a Body Mass Index of less than 30 but pregnancy rates through IVF have shown to drop if the Body Mass Index is greater than 35 or 40.
• For obese patients, problems arise in administering anesthesia and the retrieval process and also, eclampsia and gestational diabetes, which are more likely in obese patients. So body weight definitely determines the pregnancy rate in a woman and also determines if the mother will go through a complication-free pregnancy or not.
• Women who are considering IVF should put a check on their weight otherwise it might hinder their chances of getting pregnant. But, it is important to note that there is a certain way to get rid of those extra kilos. Crash diets may be the easiest option available for people but it is unhealthy in the long run for a to-be mother.
• Low-calorie diets negatively affect the IVF process. One should remember that everybody is different and everybody has their own needs. It is best left to the doctors to understand the needs of the body.
• Doctors are the best judge regarding how much body weight of an individual may help to conceive through IVF. In case one is overweight, consult the doctor to find the healthiest way to lose it.

A very frequently used treatment both before and during In-Vitro Fertlization is Acupuncture. There is hope among women that it will help increase their chances of conceiving a baby and also provide the necessary support related to reduction of stress during the time of treatment. A range of small clinical trials have been conducted to suggest that acupuncture helps to improve the outcomes of highly stressful and unpredictable treatments of fertility but recent study has found out that this is not what really happens.

The study was undertaken for more than 800 Australian and New Zealand women, who had undergone acupuncture treatment at the time of their IVF cycles but that treatment has not really ensured any significant difference in live birth rates.The finding have been published in the Journal of the American Medical Association, which support recent guidelines set by the American Society for Reproductive Medicine and two very high-quality meta-analysis.

Findings of the Study - the effects of a short course of an IVF cycle administered by acupuncture were examined. They could not come with any concrete conclusion to show that acupuncture leads to increase in live births, clinical pregnancy or result in less number of miscarriages.This study has been undertaken in 16 different IVF centres across Australia and New Zealand, the clinical trial controlled in a random manner, which compares the effects of any experimental treatment on one particular group with those of an alternative treatment for another group, mainly aims to increase the number of live births and pregnancies among 848 women, who are aged in the range of 18 to 42, undergoing an IVF cycle treatment through the use of fresh embryos for a period of four years.The first acupuncture treatment was provided right at the beginning of the In-Vitro Fertilization process, when they are given proper medication to stimulate the ovary for producing follicles.

The successful fertilization was followed by performing acupunture to recognized acupuncture points both before and after the embryo gets transferred to the womb of a woman.The control group used in this study was sham acupuncture. This is a kind of real acupuncture but the difference lies in the fact that it does not involve any needle to be inserted through the skin. For both the groups of women, the needle is being kept in place by a plastic tube but as and when the practitioner gets the needle placed on the skin, for the control group, the needle’s shaft tends to disappear right into the handle, whereas in case of the group receiving treatment, the needle gets through the skin.

The result came up that clinical pregnancy could be possible among 25.7% of women who had received acupuncture and only 21.7% of women in the sham control. Live birth could be achieved only for a mere 18.3% of women who had received acupuncture in comparison to 17.8% receiving the control.There was an increase of only 4%, especially given the low percentage of successful births through IVF. The study does not support that acupuncture can lead to an improve in pregnancy or live births for those undergoing IVF cycle.

One of the major milestones in a woman’s life is the entry into motherhood. For most women, when this does not happen in the natural logical sequence of things, there is anxiety and lot of pressure from family and friends.

However, with advancements now, there are options like intrauterine insemination and in vitro fertilisation (IUI and IVF) available, which can help increase the chances of conception and pregnancy. IVF is where the egg is retrieved from the woman’s womb, fertilised externally and then transplanted back into the uterus where it grows to full term. However, there are always unanswered questions like how long to wait before going for IVF, is it the right procedure for me, etc.

Read on to know to find answers to some of these.

1. Maternal age: As a woman reaches 35 and a man reaches 40, the fertility rates drop significantly. The chances that a woman at 35 will conceive is about 20%, which goes down to 5% if the woman is 40. However, this rate can be significantly increased by using IVF. The quality of the egg would gradually deteriorate, and so if a woman is nearing 40, it is better to consider IVF as the ovarian reserve would be optimal with IVF.
2. Failed intrauterine insemination: In couples who have problems with the sperm reaching the uterus, intrauterine insemination (IUI) is first attempted. However, if 3 or more attempts of fail, it is time to consider IVF.
3. Duration of inability to conceive: While some couples conceive quite promptly in a month or two, most take about 6 to 8 months of unprotected sex to conceive. Therefore, IVF can be an option if you are failing to conceive even after a year. Less than a year, don’t fret. Take it easy and it might just do the trick.
4. Medical health: Both the partner’s medical health should be taken into account. Lifestyle changes like smoking, alcohol abuse, drug abuse should be considered, which can account for poor sexual performance and therefore lead to an inability to conceive. Health conditions like diabetes and heart disease can also lead to infertility. Hypothyroidism in women is another thing that must be ruled out, as it often leads to an inability to conceive.
5. Sexual problems with the partner: One of the first things to do before going for IVF is to check that the male does not have any issues. Be it erection issues or ejaculation issues or sperm issues, they need to be ruled out. Sperm quality, quantity, and motility have to be analysed, and if they are optimal, IVF can be considered.

In vitro fertilization (IVF) is continually helping many infertile couples achieve their goal of conception. It has the highest success rate of Assisted Reproductive Technologies (ARTs). Along with helping the parents overcome diseases in their bodies, they help prevent predicted diseases in the offspring by offering the option to pick and choose healthy and improved embryos. Needless to say, it is both a biological and social breakthrough.

There are several diseases in the parent body that IVF can help successfully bypass. They are:

• Low Sperm Count
This condition occurs when the man produces healthy, normal sperm but produces it in very low quantities. As a result, fertilization cannot properly occur. IVF can help in this regard. The healthy sperm is obtained, and procedures are carried out in the laboratory to make it suitable for fertilization.

• Fallopian Tube Damage
This occurs due to permanent and irreversible scarring of the Fallopian tubes in the female partner. Sometimes, the tubes are so damaged that surgery fails to bring it back to normal, or surgery is not feasible without harming the woman’s health farther. In such cases, IVF is very helpful as it discards the use of the Fallopian tubes in reproduction by bypassing them.

• Ovulation Issues
IVF can help a couple conceive in spite of ovulatory difficulties the woman might have. Ovulatory difficulties involve infrequent ovulation of the female More Than One Cause of Infertilityor irregular ovulation. Both these cases make it very difficult, if not impossible, for the couple to conceive.

• Inexplicable Infertility
IVF aids a lot in these cases too. In some cases, causes of infertility cannot be pinpointed after several diagnostic tests. The processes are both money and time to consuming and leaves the patients frustrated if the process fails. IVF can come to the rescue then. It has a proven track record of success aiding couples with undiagnosable infertility issues.

• More Than One Cause of Infertility
When there are several causes of infertility in both the male and female bodies, or if there are several problems with the body of an individual partner. IVF can aid successful conception.

IVF is a breakthrough biological and scientific procedure that is helping people conceive in spite of several fertility issues in their bodies. There are various debilitating reproductive disorders that IVF has helped overcome in recent years. The most major ones are listed above, and you can also benefit from IVF if you have those!