Summary

Infertility is a painful predicament for couples to navigate. Assisted reproductive techniques can help infertile couples have biological children. In-vitro Fertilisation (IVF) is the most common and most effective assisted reproduction technique. IVF is a laboratory procedure, where the egg and sperm cells are combined outside the mother’s body, and a fertilised embryo is implanted to create a pregnancy. IVF is recommended to couples above 40, women with fallopian tube blockages or ovulation disorders, men with low sperm motility and couples with unexplained infertility. Women with endometriosis and uterine fibroids may also be recommended IVF. IVF is a rigorous and emotionally intense procedure to go through. While undergoing IVF, if you find yourself struggling with anxiety or depression, seek professional help.

Introduction

Infertility is a difficult challenge for any couple to navigate. The desire to have children is deeply personal and difficulty with conception can be very emotionally painful. Infertility is becoming increasingly common worldwide. Increased stress levels, medical conditions like PCOD or low sperm count, age and a range of other reasons could contribute to a couple’s infertility.

Assisted reproduction can be a great solution for couples who have been actively trying to get pregnant for more than a year with no luck. It empowers couples and offers them hope of becoming biological parents and experiencing the joys of raising a child.

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Also Read: The importance of Annual Gynecological Health Check-up

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What is IVF?

In-vitro Fertilisation (IVF) is a complex series of laboratory procedures to create and implant an embryo to achieve a pregnancy. It is one of the most common and most effective assisted reproduction techniques recommended to infertile couples. “In-vitro” is a latin term that means “in glass”. In this context, it refers to the fact that fertilisation occurs outside the woman’s body, in glass test tubes. Once fertilisation happens in the lab, the embryo thus formed is implanted in the mother’s uterus. Sometimes a surrogate mother may be chosen to carry the baby to term. IVF can also be used to prevent passing on genetic defects to the child from the parents.

How is IVF done?

IVF is a 5 step process:

1. Super ovulation – The mother is given fertility drugs to boost ovum or egg production. These are usually in the form of injectable hormone medications that must be taken at the same time each day, as per your gynecologist’s instructions. Normally a woman produces only one egg per month, but the fertility drugs will result in the production of multiple eggs every cycle. This is called super ovulation. During this stage, the woman usually has trans-vaginal ultrasounds to check the ovaries and blood tests to check for hormone levels.
2. Egg retrieval – Once super ovulation occurs, the mature eggs are removed from the ovaries. This is done through a laparoscopic procedure, guided by ultrasound imaging. The woman is usually given medicines to keep her relaxed during the procedure. A thin needle is inserted through the vagina, into one of the ovaries and connected to a suction device. The eggs and fluid from each mature follicle in the ovary are pulled out. The procedure is then repeated for the other ovary.
3. Insemination and Fertilisation – The best of the eggs retrieved from the uterus are chosen for insemination. During insemination, the eggs are mixed with sperm donated by the male partner. The mixture is stored in a special chamber for fertilisation to happen. During fertilisation, the sperm fuses with the egg to form zygotes. In case the male partner has low sperm motility, the sperm may be directly injected into the egg for fertilisation. This is called intracytoplasmic sperm injection (ICSI).
4. Embryo culture – The fertilised egg (zygote) undergoes cell division and forms an embryo. This process is monitored very carefully in the lab. Once the zygote has reached the embryo stage it is ready for implantation in the uterus. This usually takes 3 to 5 days. Couples who have high chances of passing on a hereditary disorder to their child may choose to undergo pre-implantation genetic diagnosis (PGD). During this test, a single cell is removed from the embryo and screened for the disorder.
5. Embryo Transfer – The embryo is transferred to the uterus for implantation. This is done through a vaginal catheter. At this stage, multiple embryos may be placed in the womb, which can lead to twins, triplets etc. The number of embryos transferred is based on a number of factors, including the mother’s age, and is usually at the discretion of the treating physician. Unused embryos can be frozen for implantation at a later date.

Are you a candidate for IVF?

IVF is recommended to couples over the age of 40. IVF may also be a good option for you if you or your partner has one of the following conditions:

• Fallopian tube damage of blockage – This prevents the mature eggs from descending into the uterus naturally, where they may be fertilised by a sperm cell.
• Ovulation disorder – If the woman doesn’t ovulate regularly, there are lower chances of a mature egg being fertilised to result in a pregnancy.
• Tubal ligation – This is a birth control procedure in which the fallopian tubes are cut or blocked to prevent pregnancy. If the woman has undergone this procedure, but wants to have children at a later date, she may resort to IVF.
• Endometriosis
• Uterine fibroids
• Unexplained infertility

Cancer treatments like chemotherapy or radiation therapy are likely to harm a patient’s fertility. In such cases, the patient may choose to undergo IVF before the cancer treatment to make a biological embryo for future use.

What are the risks associated with IVF?

IVF is a fairly stressful process for the body, mind and soul. While it can give you a beautiful outcome if all goes well, there are certain risks. The woman could suffer complications such as internal bleeding, infections and damage to the bowels or bladder caused during the egg retrieval process. The hormones injected to trigger super ovulation can cause a painful condition called ovarian hyper stimulation syndrome. In such cases, the patient can experience stomach aches, bloating, upset stomach, nausea and diahrrea. Some patients also gain weight rapidly as a result of the excess hormones.

There is also the risk of having an ectopic pregnancy, where the embryo implants outside the uterus, often in the fallopian tube. In such cases, the pregnancy will have to be terminated. There is also the risk of multiple embryos implanting in the uterus at once. Usually mothers who go for IVF are in their 30s and 40s, and carrying multiple babies only makes the pregnancy more risky. There is an increased chance of the mother developing high blood pressure and gestational diabetes.

What to expect while undergoing IVF?

Before starting IVF you and your partner will undergo thorough physical exams and fertility tests. This will include a uterine exam, a pap smear test, a mammogram (for women above 40), a semen analysis and an STI (sexually transmitted infection) panel. The doctor will give you detailed instructions on how to administer your fertility medication. Make sure you follow it to the T, as missing or delaying even one dose can make the whole exercise pointless.

During IVF, you may experience some bloating, cramping, breast tenderness, mood swings, headaches, bruising and light bleeding. This is normal. Some patients also experience mild allergic reactions to the medications. Please bring this to your doctor’s notice immediately.

IVF can also be a difficult path to tread, from an emotional perspective. In Indian society, there is still a slight stigma against assisted reproduction. Surround yourself with support systems in the form of open-minded family members and friends. Check in with your partner regularly, they will be your biggest strength through this process. The excess hormones are known to create more anxiety and feelings of dejection. Remind yourself that its the medication talking, and not you. You can also seek out counsellors and support groups, to share your experiences through this journey.

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Also Read: Egg Freezing – Your Key to Family Planning Freedom

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How much does IVF cost?

IVF is an expensive procedure. The expenses can vary based on the experience and qualifications of the treating physician, hospital reputation and severity of infertility. The base fee typically ranges from Rs.90,000 to 1,50,000 (could be more in major metro cities). The procedures, fertility assessment tests and injectable medication costs are over and above this base fee. Cryopreservation of the embryos, is required, would also be an additional cost. Your reproductive endocrinologist will be able to advise you about the detailed costs for IVF at your first consultation. It is advisable to get an idea of the overall cost of the entire process before deciding to go ahead with IVF so you can be financially prepared.

Choose Kauvery Hospital for Your IVF Journey

Kauvery Hospital, with branches in Chennai, Hosur, Salem, Tirunelveli, and Trichy, offers comprehensive and compassionate care for couples navigating infertility through IVF. Our experienced endocrinologists and fertility specialists are dedicated to providing personalized treatment plans to help you achieve your dream of parenthood. Contact us today to schedule a consultation and learn more about your options.

Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai (Alwarpet & Vadapalani), Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.

Chennai Alwarpet – 044 4000 6000 •  Chennai Vadapalani – 044 4000 6000 • Trichy – Cantonment – 0431 4077777 • Trichy – Heartcity – 0431 4003500 • Trichy – Tennur – 0431 4022555 • Hosur – 04344 272727 • Salem – 0427 2677777 • Tirunelveli – 0462 4006000 • Bengaluru – 080 6801 6801

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