In Vitro Fertilization (IVF) is a medical procedure that helps increase the chances of conceiving for couples with fertility issues. It involves stimulating the woman’s ovaries to produce eggs which are then fertilised with her husband’s sperms to create embryos. In a normal menstrual cycle, a woman’s ovaries produce only one follicle. Using fertility hormone injections, IVF helps increase the number of follicles growing in the ovaries.
Pre-treatment for IVF can begin a month before the start of IVF injections. There are various stimulation regimes in IVF injections. One of the more common regimes is the Antagonist protocol, in which the duration of injections ranges between 9 to 12 days. The injections are self-administered, and daily routines can go on as usual.
Side effects are uncommon but sensitivity at the injection site may occur. If a woman responds well to the medications, she may experience abdominal bloating as the ovaries produce more follicles. She may need several scans to monitor the growth of the follicles before planning the egg retrieval.
The egg retrieval procedure, carried out 11 to 14 days after IVF stimulation, is painless as it is done under light anaesthesia. The harvested egg will be fertilised with the sperm in a laboratory and kept in an incubator. Selected embryos are then transferred back to the uterus after three to five days.
Various forms of hormonal support are given after the transfer, including vaginal pessaries, intramuscular injections and oral medication. A blood test is done about two weeks after the transfer to check if the patient is pregnant.
The success rate in getting pregnant depends on the woman’s age. Women below 35 years old have a 40 to 50 per cent success rate or higher. The rate for women above 35 decreases to 30 to 35 per cent and for those above 40, the rate may only be 5 to 15 per cent.
While success rates are closely related to the age of the woman, practising a healthy lifestyle and treating any pre-existing medical conditions such as thyroid problems and diabetes can help maximise the chances of getting pregnant. The male partner also has a role to play by improving sperm quality. The things that can be done include cessation of smoking, losing weight, and taking supplements, in which results may take up to three months to show any improvement.
Dr. Fabian James Kurian is a Consultant Obstetrician & Gynaecologist and Fertility Specialist at, TMC Fertility and Women’s Specialist Centre Johor Bahru