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Overview

In Vitro Fertilization: Cost, Procedure, Recovery, Risk & Complication

What is IVF?

In-Vitro Fertilization (IVF) consists of a series of procedures that are used for the treatment of genetic or fertility problems, while assisting the conception of a child. One of the most effective forms of assisted reproductive technology, IVF procedures can be conducted using a woman’s own eggs and her partner’s sperm. It can also be done by taking the eggs, sperm or embryos from a known or unknown donor. There are some cases where a gestational carrier (a woman with an embryo implanted in the uterus) can be used.

During IVF, mature eggs are retrieved from a woman’s ovaries and fertilized with the sperms in the lab. Once it has been fertilised, the egg or eggs are implanted back in the uterus. A cycle of IVF can take about 2 weeks.

Indication

One may have to undergo an IVF treatment in the following conditions:

  • If a woman’s fallopian tubes are blocked or damaged
  • If ovulation is infrequent/absent, or there are few eggs available for fertilization
  • Loss of normal functions of the ovary before reaching the age of 40
  • A previous treatment of tubal ligation, where the fallopian pipes have been cut/blocked permanently. In this case, one can opt for IVF instead of tubal ligation reversal.
  • Poor mobility, abnormality in sperm size/shape, or below average concentration of sperm of the male partner
  • If you have the conditions of endometriosis (uterine tissue will implant and grow outside the uterus) or uterine fibroids
  • Unexplained fertility or a genetic disorder

What Procedure is followed :

Pre Procedure

Before beginning the process of IVF, both the partners may have to go through certain pre-procedure screenings such as:

  • Ovarian reserve testing, for determining the quality and the quantity of the eggs. The concentration of estrogen, follicle stimulating hormone as well as the antimullerian hormone in your blood is checked by your doctor in the initial days of the menstrual cycle. These test results may help in predicting the response of your ovaries to fertility medications.
  • Analysis of the semen of the male partner
  • Screening for any infectious disease like HIV
  • A mock transfer of the embryo for determining the depth of the uterine cavity and the technique that may work best for you
  • An examination of the uterine cavity that may involve sonohysterography (fluid is injected in the uterus through the cervix and an ultrasound creates images of the uterine cavity) or hysteroscopy
  • Some serious question like the numbers of embryos that will be transferred, what needs to be done with the extra embryos, how to handle a multiple pregnancy, and the complications that may occur with donor eggs and sperms or a gestational carrier have to be discussed.

During Procedure

IVF treatment involves the following steps:

  • Ovulation induction, where synthetic hormones stimulate the ovaries for producing multiple eggs. You have to be under several medications for a week or two before the eggs are ready for retrieval. Vaginal ultrasound or blood tests are examined by the doctor to determine it.
  • Egg retrieval, through a transvaginal ultrasound. In this process, an ultrasound probe is inserted in the vagina for the identification of follicles. A thin needle is guided through the ultrasound guide to reach the vagina for collecting the eggs. The laparoscopy method can also be used for the same.
  • Sperm retrieval through masturbation or testicular aspiration in case the partner’s sperm is being used
  • The next step is fertilization either by insemination (sperm and eggs are incubated overnight) or Intracytoplasmic sperm injection (ICSI), where a single sperm is injected directly in a mature egg.
  • Embryo transfer is next step performed at the doctor’s clinic. It takes place two to six days after the retrieval of the eggs.

Post Procedure

Once the embryo has been transferred, you can go back to your regular schedule. However, your ovaries may be enlarged for a few days, so it is advisable to avoid any vigorous activity that may cause discomfort.

The side effects of post treatment may involve:

  • Passing of a small amount of clear/bloody fluid after the procedure, which is caused because the cervix is swabbed before the transfer of the embryo
  • Mild bloating and cramping
  • Constipation
  • Breast tenderness because of the high levels of estrogen

In case you have a moderate or severe pain after the transferring of the embryo, consult your doctor who will evaluate your condition. Any indication of a complication like an infection pr ovarian torsion can be examined and treated.

Risk & Complication

An IVF procedure may bring along with it certain risks and complications like:

  • Multiple births if more than one embryo has been implanted in the uterus. Multiple foetuses can often lead to premature delivery or a low birth weight of the newborn.
  • The frequent injection of fertility drugs to induce ovulation may lead to ovarian hyperstimulation syndrome, a condition where the ovaries become painful and swollen.
  • Using an aspirating needle for collecting eggs may lead to bleeding, damage or infection in the bowel, bladder or a blood vessel.
  • In some cases, there may be chances of an ectopic pregnancy. This is a condition where the fertilised egg will implant outside your uterus, generally in the fallopian tube. The egg would not be able to survive outside the uterus and the pregnancy will not be possible to be continued.
  • Miscarriage or birth defects
  • There may be a possible connection between some medications used in IVF and a specific type of ovarian tumor, though there have not been enough cases to support it.
  • The procedure of IVF can be physically, emotionally as well as financially draining, leading to stress.

More Info

Make sure that you continue having the medications after the embryo transfer has been successfully completed. It is better to avoid travelling during this period. It is generally after 2 weeks after the embryo transfer that you have to go for a pregnancy test. It is important not to be stressed during this phase, but be optimistic and occupied. Also, the pregnancy test must be conducted by a doctor at the clinic and not by yourself at home.

The cost of an IVF treatment may vary from Rs. 10,000 – Rs. 70,000, depending on your condition.

Popular Health Tips

IVF Myths Debunked - Know The Facts!

MBBS Bachelor of Medicine and Bachelor of Surgery
IVF Specialist, Delhi
IVF Myths Debunked - Know The Facts!

In vitro fertilization or IVF is deemed as one of the wonder treatments for couples who are facing infertility issues. Whether it is due to poor sperm quality of blocked fallopian tubes, IVF has proven to be a safe and effective solution. However, like with all new techniques, IVF also has some myths which need to be understood before signing up for the procedure. With so much at stake in terms of finances and time, understanding the process will help set realistic expectations and improve the success rate of IVF.

Myth 1: High success rate. While IVF has very high success rates, some women just fail to get pregnant. This could be about 5% of the women and may not be attributable to any particular cause. Each woman responds differently, and failure to conceive through IVF could be due to no explainable cause. What is interesting is that though the first attempt failed, subsequent attempts may be successful. Failing the first cycle does not mean failure in subsequent cycles. Also, success rate differs from clinic to clinic, and so choose one which has a proven track record and good success rates. It should not just have good doctors but also the essential technology and infrastructure to support the IVF technique.

Myth #2: IVF leads to multiple births. While achieving multiple births is easier through IVF, it always does not lead to multiple births. Multiple embryos are implanted, only to improve the chances of success. It does not necessarily translate into multiple births. In women over 38 years of age, it is mandatory to only transfer a single embryo as multiple births are very likely to be complicated.

Myth #3: Rest and time off work. It is believed that IVF has a higher success rate with proper rest and time off work. Rest is definitely required the first few days after embryo transplant but it definitely later assumes a normal course of things. It is not that too much time off work is required, just because you had an IVF. Your body might be different and require more rest, but that could have been the case even with a normal pregnancy.

Myth #4: The medications with IVF are going to have lots of side effects. While the hormones given to promote egg release do have their side effects of making you feel moody and emotional, it is only transient. Once the egg release happens, fertilization is done, and embryo transplant is done, then things should settle down. The effects should wear down once the embryo is implanted and then things should settle down. Of course, pregnancy brings its own hormonal changes, which will run their course through pregnancy.

In case you have a concern or query you can always consult an expert & get answers to your questions!

3986 people found this helpful

IVF Treatment: 5 Important Factors For Success

IVF Specialist, Mumbai
IVF Treatment: 5 Important Factors For Success

In vitro fertilization (IVF) is a medical procedure that side-steps the sexual act of conceiving and helps infertile couples, conceive a biological child. It involves the manual process of fertilization by combining an egg and sperm in the laboratory and then implanting the embryo into the female to impregnate her.

A number of factors play an important role in the success of the procedure and some of them are:

  • Lifestyle habits - Certain lifestyle factors can significantly affect your prospects of getting pregnant through this route. Smoking can reduce your prospect of success using this procedure by about 50%. It can cause you to have lesser number of eggs retrieved during the procedure while increasing instances of miscarriages. Likewise, obesity, alcohol use, consumption of excessive caffeine and drugs can adversely affect your chances of getting pregnant using IVF.
  • Embryo status - Embryos that are better developed with good grade stand a higher chance of experiencing success than less developed embryos. More importantly, not every embryo is able to survive the development process.
  • The age at which you get pregnant - A factor that plays a role in influencing your chances of experiencing success in your IVF procedure is the age at which you opt for this procedure. The lower your age, the chances that you may get pregnant and deliver a healthy child using your own eggs witness an increase. On the other hand, if you're aged 41 and above, or your egg reserve is very low donor eggs are the most preferred option as they help to increase your prospects of meeting a success.
  • Cause of Infertility - If your supply of eggs is normal, success rate using IVF is high. Women who suffer from the problem of endometriosis experience lesser chances of getting pregnant than women who have unexplained fertility.
  • Reproductive history - IVF success rate chances are higher if you've delivered a baby previously using IVF.

In case you have a concern or query you can always consult an expert & get answers to your questions!

 

1 person found this helpful

How to Improve Egg Quality for Pregnancy or IVF?

MBBS Bachelor of Medicine and Bachelor of Surgery
IVF Specialist, Delhi
How to Improve Egg Quality for Pregnancy or IVF?

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.
 

3 people found this helpful

IVF or IUI - Which Is Right for You?

MBBS Bachelor of Medicine and Bachelor of Surgery
IVF Specialist, Delhi
IVF or IUI - Which Is Right for You?

Intrauterine insemination (IUI) and in vitro fertilization (IVF) are two commonly used methods of fertility treatment, which increase a couple’s chance of becoming pregnant.

The Procedure

IUI- IUI is a procedure during which processed and concentrated motile sperm are inserted directly into a woman’s uterus. This procedure is timed according to a woman’s ovulation, and may be performed one to two times in the days immediately following the detection of ovulation. After ovulation a woman’s egg is picked up by the fallopian tube and waits there for the sperm. Since the IUI procedure deposits higher concentrations of good quality sperm close to where the egg is waiting, the chances that the egg and sperm will find one another are increased.

IVF- IVF is the most successful method of fertility treatment utilized today to help couples to conceive. The basic components of the IVF process include stimulation of the ovaries to produce multiple eggs at a time, removal of the eggs from the ovary (egg retrieval), fertilization of the eggs in the laboratory, and subsequent placement of the resulting embryos into the uterus (embryo transfer). The chance of pregnancy from IVF depends primarily on the age of the woman, the cause of infertility, and factors related to the quality of the IVF laboratory.

Success Rates

IUI Treatment: There is a marked difference between IVF and IUI pregnancy rates. IUI has a success rate between 5% and 20%, but it can even be as low as 1-2 %, depending on the woman’s age and fertility levels. The chances of conceiving through IUI is higher if fertility drugs are administered along with the treatment.

IVF Treatment: IVF has a high success rate – between 20% and 35% and it can even go as high as 40%. This may not seem like a lot, but it is very high, considering that an average young and fertile couple has only a 15-20% chance to conceive in a month. It is important to understand what IVF and IUI success rates mean and the factors that affect it before deciding on a fertility treatment. You can also use any reliable online IUI vs IVF comparison tool to determine your approximate success rates with each of these treatments, depending on your age, lifestyle, and medical history.

You should use online sources of information to understand more about fertility problems, how age affects fertility levels, and whether freezing your eggs is a good option for you. However, discuss all these issues with your doctor to ensure that you have the right information and that you have understood it correctly. Fertility specialists provide you with personalized fertility plans based on your health which is why you should always talk to them before you make any decision.

In case you have a concern or query you can always consult an expert & get answers to your questions!

3285 people found this helpful

Womb Scratching & IVF Success: Does It Help You Get Pregnant?

MBBS Bachelor of Medicine and Bachelor of Surgery, Dgo, Fellowship In Reproductive Medicine
IVF Specialist, Hyderabad
Womb Scratching & IVF Success: Does It Help You Get Pregnant?

In vitro fertilisation (IVF) is a medical procedure followed for those women or couples suffering from infertility or for certain specific genetic problem. In the normal course, women or couples experience positive results within a few IVF cycles. However, in spite of reasonable pregnancy rates, some women may require few more cycles to achieve pregnancy. In such cases, in order to ensure a healthy pregnancy, the gynecologist may suggest the women undergo Endometrial Scratching before IVF. 

Endometrium explained in brief: 

The uterus is located in the pelvic region and it is in the size and shape of a pear. The inner cavity of the womb or uterus is protected by the tissue lining called endometrium, also called endometrial. The endometrium plays a significant role in supporting the pregnancy. 

The enhanced success of achieving pregnancy: 

The endometrial scratching procedure is a very simple one, which is resorted, so as to improve the results of IVF procedure. In this procedure, the gynecologist uses a very fine catheter and makes a small scratch on the endometrial lining. In fact, the scratch causes a kind of inflammatory reaction in the uterus. This inflammatory reaction induces the endometrium to be highly receptive to embryos during the successive menstrual cycle. This added receptivity enhances the success of pregnancy during the next menstrual cycle. 

Considering the higher level of success in achieving pregnancy, the endometrial scratching procedure has gained popularity in the IVF procedure. However, some of the other issues related to endometrial scratching may be as follows: 

  1. Endometrial scratching optimises the uterine lining and thereby, makes it easier to continue the embryo implanting procedure. Normally, before the endometrial scratching procedure, the gynecologist may suggest endometrial biopsy. 
  2. The endometrial procedure is usually suggested for those women who had two or more unsuccessful IVF procedures, despite having good quality embryos. However, in some cases, depending on the health of the patient and various other factors, the gynecologist may suggest this endometrial scratching at the very first IVF procedure. This procedure can be availed either for fresh embryos of the couple or frozen embryos or for the donor egg. 
  3. Although this is a part of a surgical procedure; endometrial scratching is very simple and painless and it is done without administering anesthesia. The procedure does not require any hospitalisation. In fact, the patient can go home soon after the procedure. Except for a few pain killers, this procedure does not require any extensive medication. 

This is a safe and easy procedure. Neither does it lead to any side effects, nor is the procedure burdensome for your wallet. Many couples have been benefited by this endometrial scratching procedure.

In case you have a concern or query you can always consult an expert & get answers to your questions!

1777 people found this helpful

Popular Questions & Answers

Myself 33 years old. Married since 8 years. Passed through three unsuccessful ivf cycle. Both fallopian tube damaged. Having only one ovary .kindly guide. What to do.

MS- Gynaecology, MBBS
Gynaecologist, Delhi
May be your endometrium is not good. Ask your Dr. what is the cause. You may need surrogacy if uterus has problem.

What is the success rate for first ivf cycle? And say if once cycle fails, would there be a waiting period in between before going for another cycle?

MS - Gynaecology, MBBS Bachelor of Medicine and Bachelor of Surgery
Gynaecologist, Varanasi
Hardly 25% after first ivf cycle. 40% after 2-3 cycles there is no waiting period in between until n unless you develop some big cysts in ovaries.
1 person found this helpful

Hi, If I go for ivf for my first baby can I still try for natural conception for the second one? Also, what are the chances of having twins through ivf if my amh is 8.22, lh 8.8, fsh 6.07, prl 24.32?

MD - Obstetrtics & Gynaecology, DNB - Obs & Gynae, MBBS Bachelor of Medicine and Bachelor of Surgery, Fellowship In Bask & Advanced Reproductive Techniques
IVF Specialist, Mumbai
If your tubes are healthy and husband's sperms good, you can still conceive naturally even after IVF. The chances of twins with IVF depends not on your reports but on the number of embryos transferred. We recommend transferring no more than 2 embryos in each attempt. With 1-2 embryos being transferred, approx 75% of pregnancies turn out to be singleton and approx 25% twins.
2 people found this helpful

I am doing follicular study for 1st baby my age is 34 can my follicle get ruptured without hcg injection and should I have sex today is 12th day and size is 23x20 bt not ruptured please suggest me fast what to do.

MD - Obstetrtics & Gynaecology, FCPS, DGO, Diploma of the Faculty of Family Planning (DFFP)
Gynaecologist, Mumbai
No problem in having sex. May or may not rupture without HCG. Any couple desirous of pregnancy and not getting same naturally must meet Gynecologist or infertility specialist accepting facts that it needs many reports and different trials of treatment. Means couple must have patience and go to one in whom they have trust to stick for long time.

Recommend me a medicine for postponing my june periods since am going on vacation in the. Month.of May. Also is it safe to take this medication since planning to go for ivf in june. My lmp was on 31st March.

MD - Obstetrtics & Gynaecology, FCPS, DGO, Diploma of the Faculty of Family Planning (DFFP)
Gynaecologist, Mumbai
There are hormonal drugs for same but any drug can be prescribed by only doctor who has examined you or can examine you so go to such medical practitioner. - Gynecologist

Table of Content

What is IVF?

Indication

What Procedure is followed :

Risk & Complication

More Info