What is IVF? - All about IVF
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Couples thinking about IVF as a treatment option, couples getting
ready for IVF or couples undergoing IVF treatment need to understand what is IVF. This article gives detailed
answers to questions below (please click for answers):
What is IVF?
IVF is the acronym of In Vitro Fertilization which is one of the most
effective assisted reproductive technologies (ART). In IVF, fertilization of multiple eggs by sperm take place in a
laboratory setting, and one or more embryos formed are then transplanted into mother's uterus.
When is IVF used?
IVF can be used to treat infertility in a couple caused by male
factors, female factors or both male and female factors. Women suffering
from damaged or blocked fallopian tubes,
cervical mucus defect, endometriosis, ovulatory disorders or sperm allergy and men suffering from sperm disorders, blocks in vas deferens or ejaculatory duct, retrograde ejaculation, premature ejaculation or erectile dysfunction can be treated with IVF. IVF is also used to treat
What is IVF procedure?
In IVF, fertility drugs are used to stimulate production of multiple
ovaries (eggs) in women. Once these eggs mature, the fertility specialist retrieves them from ovary through a minor
surgical procedure. In a laboratory setting, each egg is then mixed with sperm collected from normal ejaculate of
male partner or sperm retrieved from the reproductive tract of male partner. This would result in fertilization of
multiple eggs and formation of multiple embryos. One or more healthy embryos are then transplanted into woman's
womb (uterus). A successful pregnancy is achieved when one or more of these transferred embryos gets implanted to
the uterus lining and starts growing there. There is a possibility of having a multiple pregnancy (pregnancy with
two or more foetuses); if more than one embryo is transferred to a woman's womb by IVF. This has a few risks
associated with it. It is advisable to discuss with the fertility specialist about
it. Embryos that are left over from an IVF cycle can be freezed for
future use, donated to other infertile couples or destroyed.
IVF can also be performed using donated eggs and/or donated
The video below shows a 3D animation of IVF
How long does IVF treatment take?
One IVF cycle, that starts with use of fertility drugs to stimulate production of multiple
ovaries and ends with transfer of embryos to mother's uterus can take approximately four to six weeks.
Pregnancy tests can be performed in between day 9 and day 14 after embryo transfer. IVF treatment does not usually
require the individual under treatment to get admitted to the clinic or hospital (all procedures are performed on
outpatient basis). However, regular visits to the clinic would be necessary till embryo transfer.
What is the success rate of an IVF cycle and what factors
influence success rate?
Success rates of IVF can be defined either in terms
of pregnancy rates (achieving a successful pregnancy that may or may not result in a live
birth) or in terms of live birth rates. The success rate depends on a number of factors such as age
of woman under treatment, underlying causes of infertility (could be male factors, female factors or both male and
female factors), expertise of treatment facility and whether donor eggs or mother's own eggs are used for
Success rates are usually higher for women below 35 years of age and
lower for women above 42 years of age. However, if donor eggs (that can be retrieved from a younger woman) are
used for IVF, success rates do not depend as much on age. On an average, success rate of a single IVF cycle in
terms of achieving a successful pregnancy is 29.4% and success rate of a single IVF cycle in terms of live
birth is 22.4%.
Failure of an IVF cycle can be challenging to go through. Be aware
that repeated IVF cycles or another treatment method prescribed by the fertility
specialist might help in achieving a successful pregnancy and giving birth to a healthy
Please click IVF success rates of clinics in the United States for more information.
How much does IVF cost? How to finance IVF costs?
Cost of IVF can vary with
location of clinic, success rates of clinic, expertise of treatment facility etc. In US, one IVF cycle costs
between 10,000 to 15,000 dollars. An IVF cycle can have additional costs, if donor eggs (can be very expensive) or
donor sperm are needed or procedures such as intracytoplasmic sperm injection (ICSI), assisted hatching or blastocyst transfer are performed in conjunction with IVF. Discuss in advance with the
fertility clinic about total costs involved for an IVF cycle and budget for hidden costs such as taking
time off work and travel expenses.
Insurance plans may either partially cover IVF or may not
cover IVF at all. It is advisable to read the insurance plan carefully and get the help of an independent
insurance advisor to find out whether the insurance plan covers the treatment. Click infertility insurance laws for more information on 15 states in the United States that require
insurance coverage for infertility treatments.
Some other options for financing IVF are:
Some fertility clinics offer financing options in partnership with local
If there is a flexible spending account offered by the employer, use
Take out money from retirement fund
Take out a loan
Shared risk or refund IVF programs: Couple pays up front for multiple IVF
cycles. If the treatment does not succeed within the number of cycles for which the payment is made up
front, the clinic or program refunds all or part of the money. Please pay attention to the terms and
conditions which define "success" of the treatment. Some clinics define success of treatment as
achieving a successful pregnancy, while others define it as live birth, that is, having a take-home
What are the risks of IVF?
Major risks of IVF are: ovarian hyper stimulation syndrome or over
stimulation of ovaries (by fertility drugs), multiple pregnancy (pregnancy with two or more foetuses) that
can cause high blood pressure and diabetes in mother, premature labor and babies having low birth weight, ectopic
pregnancy(a condition in which a fertilized egg gets implanted to fallopian tube instead of uterus and
starts growing there), infections or damage to reproductive tract,
birth defects in babies (chances are very low) and allergic reactions to drugs.
What are the things to take care of after IVF?
Once embryos are transferred to mother's uterus, the couple has
to wait for two weeks to see symptoms of pregnancy (in case of a successful IVF). Pregnancy tests can be performed
between days 9 and 14 after embryo transfer.
It is important to stay relaxed. Following activities are usually
forbidden after embryo transfer:
Couple are advised not to indulge in sexual intercourse and orgasms
either till a foetal heartbeat is detected or till a negative pregnancy test.
In some cases, spotting and abdominal cramps result from IVF
procedures or implantation of embryo to uterus lining. Though this is not some thing to worry about, in case of
doubt, consult the fertility specialist as a precautionary measure.
The fertility specialist may give additional instructions depending
on an individual's medical and treatment history. Usually, there are no issues with going to work, travelling and engaging in light activities during the
two week wait period after IVF.
What is blastocyst transfer in IVF?
A blastocyst is an embryo that has developed in the laboratory for at
least five days after fertilization. A healthy blastocyst hatches from its shell (zona pellucida) six days or
earlier after fertilization. It is then ready to get implanted to the uterus lining.
In a normal IVF procedure, embryos are transferred to mother's uterus
usually on the third day after fertilization. But in blastocyst transfer, embryos are transferred after they
have developed to blastocyst stage on day 5 or day 6 after fertilization.
Blastocyst transfer has following advantages:
However, IVF procedure involving blastocyst transfer requires more
complex laboratory settings that have additional costs associated and approximately 50 % of embryos which
could have been freezed for future use or donated to other infertile couples are lost during the process. In addition, blastocyst transfer has an increased risk of identical
What is assisted hatching in IVF?
An outer layer called zona pellucida protects an embryo till it
reaches the blastocyst stage of development (on day 5 or day 6 after fertilization). Then the embryo has
to hatch out of this outer layer, so that it can implant to the uterus lining of mother. In some cases, the
outer protective layer of embryos might be thicker than usual. This makes it difficult for the embryo to hatch out
and get implanted to the uterus. Assisted hatching uses micro manipulation techniques to weaken the outer layer of
an embryo by making a small opening. This process helps embryos to hatch out and successfully implant to uterus
lining. Assisted hatching is performed while the embryo is in laboratory, usually on the third day after
Assisted hatching is recommended for couples who had two or
more failed IVF cycles, women over 38 years of age, women with high levels of follicle stimulating hormone (FSH) on
day 3 of menstrual cycle, and for couples whose embryos have thick zona pellucida.
are very low, assisted hatching can cause damage to embryo and can increase risk of monozygotic
What is intracytoplasmic sperm injection (ICSI) in IVF?
Intracytoplasmic sperm injection (ICSI) can be performed in conjunction with in
vitro fertilization (IVF). ICSI may be recommended for men who suffer from sperm disorders such as low sperm count,
complete absence of sperm cells in semen, poor sperm motility or abnormal sperm morphology. These disorders prevent
sperm from successfully penetrating and fertilizing an egg. ICSI can also be used to treat infertility in men
caused by premature ejaculation, erectile dysfunction or if previous attempts of IVF failed to achieve a successful
Treatment starts with collection of sperm either from normal
ejaculate of male partner or from the reproductive tract of male partner and retrieval of ovaries (eggs) from
female partner. Donated sperm and/or ovaries can also be used for ICSI. In a laboratory setting, a selected single
sperm is then injected into the cytoplasm of an egg. This makes it easier for the sperm to penetrate the egg and
fertilize it. Then another single sperm and egg are picked from the sample and same process is repeated (it is
repeated a few times to increase chances of formation of multiple embryos). One or more healthy embryos are then
transplanted into woman's womb (uterus).
Please visit the page:
What is IUI? for information on IUI.
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