Infertility is more common than you think it is. 1 in 6 couples will face infertility issues while trying to conceive. Infertility isn't limited to just women, as men are just as likely to experience it. Again, infertility is common and isn’t gender-specific.
Roughly 5% of couples experiencing infertility will turn to IVF (In-vitro fertilization) for help. There are many reasons a couple may turn to IVF in addition to infertility issues such as same-sex couples or even carrying a genetic disease. With all that in mind, 1 in 50 babies is born using IVF in the United States.
Now that you know how common it is, let's look into things you should consider before doing IVF.
What is IVF (In vitro fertilization)?
IVF is a series of procedures that help with fertility and the conception of a child. For IVF, your mature eggs will be collected (retrieved) from your ovaries and fertilized by sperm in a lab. It's not romantic, but it's effective. The fertilized egg (embryo) or multiple eggs (embryos) will be transferred to your uterus.
Everyone's body is different. For a complete cycle of IVF, you can expect it to last three weeks. Sometimes, it can take longer, depending on whether any steps are split up or delayed.
Read More: When to See a Fertility Specialist
Why is IVF done?
IVF, at times, might be the primary treatment offered to women with infertility – especially women over 40. Before IVF, your doctor may recommend trying less-invasive treatment options such as fertility drugs. Certain fertility drugs can help increase the production of eggs or intrauterine insemination.
Certain health conditions may make IVF the best option for your fertility journey. Some of those are:
Endometriosis: Endometriosis happens when tissue similar to your uterus lining implants and grows outside of your uterus. Endometriosis can affect the functions of your ovaries, uterus, and fallopian tubes.
Ovulation disorders: If you experience irregular or even absent ovulation – you'll have fewer eggs available to be fertilized.
Fallopian damage or blockage: Any damage (or blockage) to your fallopian tube will make it difficult for an egg to be fertilized or even an embryo to travel to your uterus.
Uterine fibroids: Common in women in their 30s and 40s, fibroids are benign tumors in your uterus. Fibroids can interfere with the implantation of the fertilized egg.
Sperm production or function issues: If your partner is suffering from below-average sperm concentration, poor mobility, or even abnormalities – it can make it difficult for the sperm to fertilize your eggs.
In cases where you don't have a functional uterus or if pregnancy as a whole would pose health risks – you may have another person do IVF and carry the pregnancy. A gestational carrier is a woman who agrees to have another couple's fertilized egg implanted in her uterus. Since the carrier does not provide the egg – they are not biologically related to the child.
Is IVF usually successful?
IVF is the most effective form of assisted reproductive technology. If you and your partner are considering IVF, it's good to know that your eggs and sperm may be used. In cases where this isn't possible, anonymous donors may be involved to supplement eggs, sperm, or embryos.
Between 12 days to two weeks after the egg retrieval – your doctor will do a blood test to detect if you're pregnant.
Depending on many factors, such as your age and the cause of infertility – success rates may vary greatly. Your OB-GYN can offer more specific potential risks to you and determine if IVF is the right treatment for your fertility journey.
Some things that may affect your success rate:
Your age: You're more likely to get pregnant with IVF if you're younger. For women over 41 – you may be counseled into considering donor eggs to increase your chances of success.
Cause of your infertility: If you have a normal supply of eggs, your chances of getting pregnant from IVF go up significantly. If you have severe endometriosis, you're less likely to be able to get pregnant from IVF.
Read More: What Women Should Know About Their Ovaries
Reproductive history: If you've successfully given birth to children in the past – you're more likely to be able to get pregnant from IVF. Success rates are lower for women who've used IVF in the past but didn't get pregnant.
Embryo status: Having more developed embryos in the transfer process is directly related to higher pregnancy rates than less-developed embryos. Not all embryos will survive the development process.
Your lifestyle: Smokers tend to have fewer eggs to retrieve during IVF, which may lead to more miscarriages. As a whole, smoking will decrease your IVF success by 50%. Obesity can also lead to a decrease in the chances of getting pregnant.
Your OB-GYN can talk directly about any additional factors that could lead to inefficient results with IVF.
What happens during an IVF procedure?
There are several steps to the IVF cycle. Beginning with ovarian stimulation to egg retrieval, sperm retrieval, fertilization, and embryo transfer. The entire procedure could last between two to three weeks. In some cases, more than one cycle may be needed.
Ovulation induction: The start of your IVF cycle begins with using synthetic hormones to stimulate your ovaries to produce multiple eggs. In a normal cycle, you'd develop a single egg. Multiple eggs are needed since some of your eggs won't fertilize or develop normally after fertilization.
Your doctor will talk to you about what medications to use and when to use them during this time. With two to three weeks of ovarian stimulation, your eggs should be ready for retrieval. Your doctor will then decide if the eggs are ready through either a vaginal ultrasound or blood tests. A vaginal ultrasound is an imaging exam of your ovaries that shows the development of follicles.
Your IVF cycle may be canceled during this time for these reasons:
- Premature ovulation
- Inadequate number of follicle development
- Too many follicles develop, which can cause ovarian hyperstimulation syndrome. Ovarian hyperstimulation syndrome is an exaggerated response to excess hormones. It can cause your ovaries to swell and become painful.
Egg retrieval: Egg retrieval will happen In your doctor's office, about 34 to 36 hours after your final injection and before ovulation. This process includes:
- Being sedated and given pain medication.
- Having a transvaginal ultrasound aspiration done. A transvaginal ultrasound is used to examine your reproductive organs. An ultrasound probe will be inserted into your vagina to look at follicles. A thin needle is inserted into the guide, which will go through your vagina, into the follicles, and retrieve the eggs.
- The eggs will then be removed from the follicles, typically within 20 minutes.
- After the procedure, you may experience some cramping or a feeling of fullness.
- The mature eggs are then placed in a nutritive liquid and incubated. If the eggs appear healthy and mature – they will be mixed with sperm to (try) create embryos. Not all eggs will be successfully fertilized.
Sperm retrieval: A semen sample will need to be provided by your partner. This is typically done through masturbation. The sperm are then separated from the semen fluid in a lab.
Fertilization: Two types of fertilization can be attempted. Conventional insemination is when the healthy sperm and mature eggs are mixed and incubated. Intracytoplasmic sperm injection is when the healthy sperm is injected directly into each mature egg.
Embryo transfer: Done at your doctor's office (or clinic) will take place two to five days after egg retrieval.
Your experience will include:
- You'll be given a mild sedative. The procedure is usually painless.
- A catheter will be inserted into your vagina through your cervix and into your uterus.
- A syringe containing embryos will be attached to the end of the catheter and will implant the embryos in your uterus.
If the procedure was successful, you could expect an embryo to implant into the lining of your uterus six to 10 days after egg retrieval.
After you've received the embryo transfer – you can get back to your normal routine. Your ovaries will be enlarged during this time, so consider cutting back on too rigorous of activities as they may bring you discomfort.
Some other side effects may include:
- Breast tenderness
- Passing clear or bloody fluid
IVF is an invasive and expensive procedure to have. An average IVF cycle could cost anywhere from $12,000 to $17,000 (not including medications). Determining if the procedure is right for you starts with the right conversations with your doctor and your partner.